尿失禁与抑郁症和焦虑症发病风险的前瞻性关联研究

A Prospective Study of Urinary Incontinence with Depression and Anxiety Disorder

目的分析尿失禁与抑郁症和焦虑症的发病风险之间的关联。方法本研究基于英国大型队列研究(UK Biobank),排除了基线患有及随访1年以内确诊抑郁症或焦虑症的样本,最终495398人被纳入分析。采用Cox比例风险回归模型估计基线是否患有尿失禁与抑郁症和焦虑症的风险比(hazard ratio,HR)及其95%置信区间(confidence interval,CI)。结果在中位随访时间11.55年间,共记录了新发抑郁症患者22569例(发病率39.5例/万人年),新发焦虑症患者18949例(发病率33.2例/万人年)。调整基线混杂因素后,与未患尿失禁的人相比,患尿失禁的人群发生抑郁症和焦虑症的风险分别提高了92%和55%(抑郁症:HR=1.92,95%CI=1.77~2.08,P=4.72×10^(-55);焦虑症:HR=1.55,95%CI=1.40~1.70,P=1.80×10^(-18))。在年龄<50岁的人群中,与未患尿失禁的人相比,尿失禁患者发生抑郁症或焦虑症的风险增加了134%和90%(抑郁症:HR=2.34,95%CI=1.98~2.76,P=2.2×10^(-23);焦虑症:HR=1.90,95%CI=1.53~2.36,P=5.4×10^(-9))。结论尿失禁会增加抑郁症和焦虑症的发病风险。年轻群体相比老年群体抑郁症和焦虑症的发病风险更高。

Objective To evaluate the associations of urinary incontinence with the risk of depression and anxiety disorder.Methods This study using the UK Biobank,excluded the samples with depression or anxiety disorder at baseline and the samples diagnosed with depression or anxiety disorder within 1 year of follow-up,494397 individuals were finally included in the analysis.Cox proportional hazards regression models were used to estimate the hazard ratios(HRs)and 95%confidence intervals(CIs)for relative risks of the association between urinary incontinence and depression and anxiety disorder.Results In the median follow-up period of 11.55 years,22569 individuals with depression(incidence rate=39.5/10000 person-years)and 18949 individuals with anxiety disorder(incidence rate=33.2/10000 person-years)were recorded.After adjusting for baseline confounders,the risk of depression and anxiety disorder were increased by 92%and 55%respectively in people with urinary incontinence(depression:HR=1.92,95%CI=1.77-2.08,P=4.72×10^(-55);anxiety disorder:HR=1.55,95%CI=1.40-1.70,P=1.80×10^(-18)).Among individuals younger than 50,the risk of depression and anxiety disorder were increased by 134%and 90%respectively in people with urinary incontinence(depression:HR=2.34,95%CI=1.98-2.76,P=2.2×10^(-23);anxiety disorder:HR=1.90,95%CI=1.53-2.36,P=5.4×10^(-9)).Conclusion Urinary incontinence may increase the risk of depression and anxiety disorder,and these risks were stronger in younger individuals.