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Gao F, Lu Y, Cheng Q, Ai Q, Jiang B, Luo ZJ, Yang GR, Lv KK, Yuan Q, Li HZ. Blood cadmium levels and overactive bladder in middle-aged and older adults in the United States: Insights from NHANES 2007-2020 data. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 363:125148. [PMID: 39461613 DOI: 10.1016/j.envpol.2024.125148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 10/08/2024] [Accepted: 10/17/2024] [Indexed: 10/29/2024]
Abstract
Cadmium is a common environmental pollutant associated with various health risks. Its neurotoxic, muscle-damaging, and pro-inflammatory properties may be related to overactive bladder (OAB), though few studies have assessed its impact on urinary function. This study aimed to examine the potential link between cadmium exposure and OAB. Using data from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), we analyzed adults aged 40 and older (n = 15,467) in a cross-sectional design. OAB was defined by the refined Overactive Bladder Symptom Score (OABSS). Weighted multivariate logistic regression examined the associations between blood cadmium levels and OAB and its components. Age and gender stratifications were performed, and restricted cubic splines (RCS) were used to explore non-linear associations between blood cadmium and OAB. Sensitivity analyses and co-exposure analyses with other pollutants were conducted to assess OAB definition stability, subgroup differences, and exposure collinearity. The prevalence of OAB was 26.2%. While blood cadmium showed a small, non-significant positive association with overall OAB, it was inversely associated with nocturia severity (OR = 0.85, 95% CI 0.74-0.98, p < 0.05). Blood cadmium was also linked to more severe urinary incontinence in the 50-59 age group and among non-Hispanic Black adults. A non-linear association between blood cadmium and OAB was observed (p for nonlinearity = 0.016, p < 0.05). In co-exposure analyses, cadmium remained a dominant and independent factor. These findings suggest that cadmium exposure may have a complex association with OAB and may relate differently to its various components. Further research is needed to explore these relationships.
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Affiliation(s)
- Fan Gao
- School of Medicine, Nankai University, Tianjin, 300071, PR China; Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China
| | - Yin Lu
- School of Medicine, Nankai University, Tianjin, 300071, PR China; Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China
| | - Qiang Cheng
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China
| | - Qing Ai
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China
| | - Bin Jiang
- School of Medicine, Nankai University, Tianjin, 300071, PR China; Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China
| | - Zhen-Jun Luo
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China; School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, 261000, PR China
| | - Guo-Rong Yang
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China; People's Liberation Army Medical College, Beijing, 100853, PR China
| | - Kai-Kai Lv
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China; People's Liberation Army Medical College, Beijing, 100853, PR China
| | - Qing Yuan
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China.
| | - Hong-Zhao Li
- Senior Department of Urology, The Third Medical Center of Chinese People's Liberation Army General Hospital, Beijing, 100039, PR China.
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Abushamma F, Abu Alwafa R, Shbaita S, Aghbar A, Zyoud SH, Hashim H. The correlation between academic stress, overactive bladder syndrome (OAB) and quality of life among healthy university students: A cross-sectional study. Urologia 2024; 91:426-434. [PMID: 38247131 DOI: 10.1177/03915603231225632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
INTRODUCTION This study aims to assess the presence of overactive bladder syndrome (OAB), academic stress, and their impact on quality of life (QoL) of healthy university students. METHODS A cross-sectional study recruited university students from different academic streams, between January 2021 to December 2021. Demographics, overactive bladder-validated 8 questionnaire (OAB-V8), International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB) questionnaire, and Perception of Academic Stress (PAS) scale were collected. The correlation between the variables was assessed using the Social Sciences Statistical Package (SPSS) version 21. RESULTS Three hundred and 89 people met the inclusion criteria. There were 241 (62%) females, and 248 (63.8%) of the students were under the age of 22. Four academic streams were included: Engineering 96 (24.7%), Humanities 121 (31.1%), Medicine 85 (21.8%) and Nursing 87 (22.4%). OAB was found among 103 (26%) students. The mean OAB-V8 score was 5.8 ± 6.6. The mean PAS scale was 53.9 ± 9.4. The mean ICIQ-OAB score was 1.5 (0-9). Male gender 62 (60%), smoking 42 (40.8%), academic stream (Humanity 40 (38.8%)) and year (third and fourth-year students 34 (33%) and 33 (32%), respectively) have a statistically significant positive correlation with OAB (p < 0.001). Humanity stream (mean rank 169.2) and junior students (first and second years with mean rank of 174 and 177), respectively, had high level of academic stress and low PAS scale. There is a weak but statistically significant inverse correlation between OAB and the PAS scale (r = -0.211) (p < 0.001). CONCLUSION OAB is prevalent among healthy university students and is directly related to academic stress. Both OAB and academic stress have impact on quality of life. We hope this study will help to raise awareness of OAB among university students to early identify and treat such a condition, avoiding unnecessary bother among healthy university students.
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Affiliation(s)
- Faris Abushamma
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Department of Urology, An-Najah National University Hospital, Nablus, Palestine
| | - Rola Abu Alwafa
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sara Shbaita
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Amir Aghbar
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Department of Urology, An-Najah National University Hospital, Nablus, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
- Clinical Research Center, An-Najah National University Hospital, Nablus, Palestine
| | - Hashim Hashim
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
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Park J, Lee H, Kim Y, Norton C, Woodward S, Lee S. Effectiveness of Fluid and Caffeine Modifications on Symptoms in Adults With Overactive Bladder: A Systematic Review. Int Neurourol J 2023; 27:23-35. [PMID: 37015722 PMCID: PMC10073005 DOI: 10.5213/inj.2346014.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/03/2023] Open
Abstract
Overactive bladder (OAB) is prevalent in men and women and negatively impacts physical and psychological health. Fluid and caffeine intake modifications, which are lifestyle modification interventions, are simple methods to manage OAB. However, studies that synthesized both interventions and found scientific evidence are scarce. This review aimed to synthesize scientific evidence on whether fluid and caffeine intake modifications are effective for OAB symptoms. PubMed, CINAHL (Cumulative Index for Nursing and Allied Health Literature), Embase, Scopus, the Cochrane Library, KoreaMed, and RISS (Research Information Sharing Service) were used to search for studies and 8 studies were included. The Cochrane risk of bias tool (RoB 2.0) and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) were used to assess the quality of selected studies. Due to the heterogeneous outcome variables, a meta-analysis was not conducted. Among the 8 included, 7 studies were randomized controlled trials and one was a quasi-experimental study. Four studies assessed urgency. Caffeine reduction was statistically effective for urgency symptoms, but increasing fluid intake was not. Frequency was assessed in 5 studies, which showed decreasing caffeine and fluid intake was effective in treating the symptoms. Urinary incontinence episodes were assessed in 6 studies, and nocturia in 2. Restricting caffeine intake was effective in treating these 2 symptoms, but restricting both caffeine and fluid intake was not. Quality of life (QoL) was examined in 5 studies, and modifying fluid and caffeine intake significantly improved QoL in 2. Although there were limited studies, our review provides scientific evidence that fluid and caffeine intake modification effectively manages OAB symptoms. Further research should examine acceptability and sustainability of interventions in the long-term and enable meta-analysis.
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