【摘要】 目的:关于尿失禁与糖尿病人群全因死亡率和心血管死亡率之间关系的研究有限，需要进一步的研究来调查这种关系。方法:数据收集自2001—2018年美国国家健康与营养调查数据库，建立纳入和排除标准，共纳入4 819人的队列。采用多因素加权Cox回归分析，全面探讨糖尿病人群尿失禁与全因及心血管疾病死亡率的关系。采用亚组分析探讨异质性。结果:在急迫性尿失禁对全因死亡率影响的研究中，在调整所有协变量后，糖尿病患者急迫性尿失禁的全因死亡率高于无急迫性尿失禁的患者(HR=1.33,95%CI:1.15～1.54)。在糖尿病患者急迫性尿失禁与心血管死亡的研究中，与没有急迫性尿失禁的受试者比较，糖尿病患者急迫性尿失禁发生心血管死亡风险增加(HR=1.32,95%CI:1.02～1.72)。亚组分析显示存在2个交互协变量，剔除变量后关系仍然显著。全因死亡和心血管疾病死亡的多因素Cox回归分析结果显示：急迫性尿失禁会增加糖尿病患者死亡风险(HR=1.36,95%CI:1.17～1.58;HR=1.35,95%CI:1.02～1.78)。压力性尿失禁和混合性尿失禁之间没有明显的联系。结论:本研究结果表明急迫性尿失禁会增加糖尿病患者的全因死亡率和心血管死亡率。需要进一步的研究来阐明糖尿病患者急迫性尿失禁与全因死亡率和心血管疾病死亡率之间的因果关系。更多还原

【Abstract】 Objective: Studies on the association between urinary incontinence and all-cause and cardiovascular mortality in diabetic populations are limited, so further studies are needed to investigate this association. Methods: Data were collected from the National Health and Nutrition Examination Survey database(2001-2018). Inclusion and exclusion criteria were established. A cohort of 4 819 individuals was included. Multivariate weighted Cox regression analysis was performed to comprehensively explore the relationship between urinary incontinence and all-cause and cardiovascular disease mortality in the diabetic population. Subgroup analysis was performed to explore heterogeneity. Results: In the study on the effect of urge incontinence on all-cause mortality, after adjusting all covariates, more all-cause mortalities occurred in diabetic subjects with urge incontinence compared with subjects without urge incontinence(HR=1.33, 95%CI: 1.15-1.54). Also in the study of urge incontinence versus cardiovascular death in diabetic patients, risks of cardiovascular death increased in diabetic patients with urge incontinence compared with subjects without urge incontinence(HR=1.32, 95%CI: 1.02-1.72). Subgroup analysis showed that there were two interacting covariates, and the relationship was still significant after removing variables. The results of multivariate Cox regression for all-cause death and cardiovascular disease death showed urge incontinence increased the risks of death in diabetic patients(HR=1.36, 95%CI: 1.17-1.58; HR=1.35, 95%CI: 1.02-1.78). No significant association was found between stress incontinence and mixed incontinence. Conclusion: Our results suggest a positive impact of urge incontinence on all-cause and cardiovascular mortality in diabetic patients. Further studies are needed to elucidate the causal relationship between urge incontinence and all-cause and cardiovascular mortality in diabetic patients.更多还原