Presentation Authors: Masaya Ito*, Yasukazu Nakanishi, Madoka Kataoka, Kazumasa Sakamoto, Kosuke Takemura, Hiroaki Suzuki, Noriyuki Iida, Kenichi Tobisu, Fumitaka Koga, Tokyo, Japan
Introduction: While the relationship between nocturia and metabolic syndrome has been reported, that between nocturia and malnutrition has yet not been fully examined although both nocturia and malnutrition are reportedly associated with overall survival. The controlling nutritional status (CONUT) score, as calculated from serum albumin, total cholesterol concentration, and total lymphocyte count, is a practical tool for nutritional assessment. In this study, we investigated the effect of malnutrition as evaluated by the CONUT score on nocturia in males.
Methods: This retrospective study included 340 men whose CONUT scores and other variables were recorded at the initial visit for voiding-related symptoms between 2015 and 2018 in our hospital. We assessed frequency of nocturnal voiding according to International Prostate Symptom Score. Severe nocturia was defined as voiding at night â‰¥ 3 times. Malnutrition was defined as CONUT score â‰¥ 4. Associations of severe nocturia with malnutrition and other clinical variables were examined using univariate and multivariate logistic regression analyses. The other variables collected were age, prostate-specific antigen, prostate volume, body mass index (BMI), hypertension, diabetes, insomnia, sleep apnea syndrome (SAS), cardiovascular disease, use of any medications for voiding symptoms, serum sodium concentration, C-reactive protein (CRP), and estimated glomerular filtration rate (eGFR).
Results: Median age and CONUT score were 72 years and 1, respectively. Numbers of times voiding at night were 0-1/2/3/4+ in 86/75/84/95 men, respectively. The rates of malnutrition (CONUT score â‰¥ 4) in men with voiding at night 0-1/2/3/4- were 2%/5%/17%/20% ( < 0.01), respectively. Univariate analysis demonstrated that age, BMI, hypertension, SAS, sodium concentration, CRP, eGFR and malnutrition were associated with severe nocturia. In multivariate analysis, malnutrition (odds ratio [OR] 4.0, P < 0.01) was an independent risk factor of severe nocturia in males, as were higher age (OR 2.3, P < 0.01), lower BMI (OR 1.9, P = 0.01), the presence of SAS (OR 8.0, P < 0.01), higher CRP (OR 2.1, P < 0.01), and lower eGFR (OR 4.9, P < 0.01).
Conclusions: To our knowledge, this is the first study to demonstrate that malnutrition as evaluated by the CONUT score is associated with severe nocturia in males.