Presentation Authors: Tomohiro Matsuo*, Yasuyoshi Miyata, Tsutomu Yuno, Kyohei Araki, Yuichiro Nakamura, Yuji Sagara, Kojiro Ohba, Hideki Sakai, Nagasaki, Japan
Introduction: Metabolic syndrome due to visceral fat accumulation is important in the development of lower urinary tract symptoms (LUTS) such as overactive bladder (OAB). The relationship between these factors and frailty symptoms, mainly reduced psoas major muscle mass and LUTS, have recently gained attention. However, to date, few reports have clarified the relationship between visceral fat mass and muscle mass and LUTS and its severity. This study aimed to clarify the relationship between them.
Methods: This study included patients who underwent abdominal computed tomography as a screening examination within the preceding 3 months and who were not diagnosed with or received treatment for LUTS. Patients with neurogenic bladder and/or malignant tumors and male patients were excluded considering the effects of benign prostatic hyperplasia. Subjective symptoms were assessed based on Core Urinary Tract Symptom Score (CLSS) and OAB Symptom Score (OABSS), and objective findings were assessed by uroflowmetry. OAB was defined as a score â‰¥2 on OABSS item Q3 (urgency) and a total score â‰¥3. The umbilical visceral fat area (VFA) and the psoas major muscle area (PMA) at the L3 vertebral level were calculated using the image analysis system, and the relationship with each parameter related to subjective symptoms and objective findings was assessed.
Results: In total, 182 patients were included. In terms of storage symptoms, 71 subjects (39.0%) met the diagnostic criteria for OAB. The VFA was significantly greater (94.7Â±5.8 vs. 69.4Â±94.7 cm2, P < 0.001) and the PMA was smaller (12.7Â±0.6 vs. 14.1Â±0.4 cm2, P=0.030) in the OAB group than in the non-OAB group. The VFA was positively correlated with the severity of urgency (OABSS-Q3: r=0.219, P=0.003; CLSS-Q3: r=0.259, P < 0.001). The PMA negatively correlated with the severity of urgency (OABSS-Q3: r=-0.249, P=0.002; CLSS-Q3: r=-0.266, P < 0.001). The PMA was weakly correlated with severity of stress urinary incontinence (CLSS-Q5: r=-0.148, P=0.046). Regarding voiding symptoms, the VFA was positively correlated with severity of slow urinary stream (CLSS-Q6: r=0.157, P=0.035). There was no correlation between the PMA and voiding symptoms. The PMA was positively correlated with voided volume (VV) and maximum flow rate (Qmax) (VV; r=0.254 P < 0.001: Qmax; r=0.236, P < 0.001). However, the VFA was negative correlated with both these indices (VV; r=0.300 P < 0.001: Qmax; r=-0.248, P < 0.001).
Conclusions: Although this was a cross-sectional study, VFA and decrease in PMA correlated with the presence or absence of LUTS, such as OAB and its severity.