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ASSOCIATION BETWEEN NOCTURIA AND FRACTURES IN A COMMUNITY-DWELLING ELDERLY POPULATION AGED 70 YEARS AND OVER: RESULTS OF A 3-YEAR PROSPECTIVE COHORT STUDY IN JAPAN
Vol. 179, No. 4, Supplement, Sunday, May 18, 2008
THE JOURNAL OF UROLOGY®
incidence of diabetes, coronary disease, myocardial infarctation and sudden death. These alterations have been denominated as metabolic syndrome (MS).Our aim was to determine the prevalence of MS in patients under HT for metastatic PC METHODS: Between June and July 2007, 54 patients under HT for metastatic or locally advanced PC were evaluated for the presence of MS. Adult Treatment Panel III was applied. The data was DQDO\]HG LQ GLIIHUHQW JURXSV DFFRUGLQJ WR WKH WLPH RI +7 *URXS Androgen blockade for more than 3 months (long-term group - LTG) and Group 2: Androgen blockade for less than 3 months (short-term group - STG) RESULTS: The population average age was 72 years old (47-82), and 22 of all patients presented MS, of which 5 were in the STG and 17 in the LTG. Average time of blockade in the LTG was 13 PRQWKV )RUW\ ¿YH SDWLHQWV SUHVHQWHG K\SHUWHQVLRQ or developed this condition during the study period, 24 patients (44%) had fasting glucose higher than 110 mg/dl, 12 patients (22%) presented triglycerides higher than 150 mg/dl or HDL lower than 40 mg/dl and 24 patients (44%) had abdominal circumference larger than 102cm. The most used HT was goserelin acetate 3.6 mg every 28 days (41 patients or RQO\SDWLHQWV KDYHKDGVXUJLFDORUFKLHFWRP\'HPRJUD¿F data are presented on table 1. The prevalence of MS in the STG was DQGLQWKH/7* ¿JXUH CONCLUSIONS: MS may has a high prevalence on patients under HT for prostate cancer, causing important adverse effects. Urologists have to attend to these new insights on the treatment of prostate cancer.
143
METHODS: We conducted a Comprehensive Geriatric $VVHVVPHQWRIDOOUHVLGHQWVZKRZHUH\HDUVRIDJHLQDWDQ urban district in the northern part of Japan. The population-based crosssectional survey was conducted using an extensive health interview for each participant. We investigated the incidence of fractures for three years using data from the national health insurance system. The relevant cases were abstracted from medical records of hospitals regarding the cause and the position of the fractures. We compared the risk of fall-related fractures with or without nocturia (2 or more episodes per QLJKW XVLQJDWLPHYDU\LQJPXOWLYDULDWH&R[SURSRUWLRQDOKD]DUGPRGHO adjusted for age, sex, body mass index and physical activity. RESULTS: Of the 788 Japanese people (28.9% participation rate) included, 429 were female and 359 were male. The mean age was 74.9 ± 4.77 years (range 70 to 97). Fractures were observed in 28 cases and fall-related fractures were observed in 23 cases. Arm fractures, lower limb fractures and lumber spine and pelvic fractures comprised 30%, 40% and 20% of the cases, respectively. The odds-ratios and FRQ¿GHQFHLQWHUYDOVRIWKHULVNRIIUDFWXUHVDPRQJWKRVHHOGHUO\ with or without nocturia are presented in Table 1. The multivariate oddsUDWLRV FRQ¿GHQFH LQWHUYDOV UHJDUGLQJ WKH SUHVHQFH RI QRFWXULD among fractures and fall-related fractures were 2.45(1.08-5.54) and 2.63(1.05-6.57), respectively. &21&/86,216 :H FRQFOXGH WKDW WKHUH LV D VLJQL¿FDQW increase in the risk of fractures associated with the presence of two or more episodes of nocturia. +D]DUGUDWLRVRIIDOOIUDFWXUHDFFRUGLQJWRQRFWXULD nocturia Fall-related fractures Person-years of follow up No. of cases Crude model Multivariate adjusted HRs*
<2 (N=426) 1641 8 1.00 1.00
(N=362) 1357 15 2.28(0.97-5.38) 2.63(1.05-6.57)
All fractures Person-years of follow up No. of cases Crude model Multivariate adjusted HRs*
(N=426) 1641 10 1.00 1.00
(N=362) 1357 18 2.19(1.01-4.75) 2.45(1.08-5.54)
*Adjusted for age, sex, body mass index, physical activity
Source of Funding: Grant for Research Conducted by the Japanese Society for Promotion of Science from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
403 Table 1. Patients data and results
Glucose Age (average ABP> > 130-85mmHg 110 mg/ years) (n - %) dl (n - %)
Short-Term 74 Blockage Short-Term 71 Blockage Total 71,8
HDL < 40 mg/dl and/or Abdominal Triglycerides > 200 Circunference mg/dl > 102cm (n- %) (n - %)
16(35,5)
7(29,1)
3(25)
10(41,6)
29(64,5)
17(70,9) 9(75)
14(58,4)
45(83,3)
24(44,4) 12(22,2)
24(44,4)
Source of Funding: None
402 ASSOCIATION BETWEEN NOCTURIA AND FRACTURES IN A COMMUNITY-DWELLING ELDERLY POPULATION AGED 70 YEARS AND OVER: RESULTS OF A 3-YEAR PROSPECTIVE COHORT STUDY IN JAPAN Haruo Nakagawa*, Yoshihiro Ikeda, Yasuhiro Kaiho, Naoki Nakaya, Kaori Omori, Kaijun Niu, Shinichi Kuriyama, Ryoichi Nagatomi, Ichiro Tsuji, Yoichi Arai. Sendai, Japan. INTRODUCTION AND OBJECTIVE: The incidence of fallrelated fractures is associated with high rates of mortality and morbidity in the elderly, and can increase with age. On the other hand nocturia also increases with age. The objective of the present study was to evaluate the association between nocturia and fall-related fractures in a community-based elderly population aged 70 years and over.
SIGNIFICANT DIFFERENCES EXIST IN REPORTING FOR ABLATION OF RENAL MASSES: A COMPARISON OF STUDIES PUBLISHED IN UROLOGY AND RADIOLOGY LITERATURE David A Kunkle*, Robert G Uzzo. Philadelphia, PA. INTRODUCTION AND OBJECTIVE: Ablation of renal masses may be performed under open, laparoscopic or percutaneous guidance. Technical results for ablation have increasingly been reported in the radiology literature. The purpose of this study is to identify differences in outcomes and endpoints between ablation series published in the urologic and radiologic literature. METHODS: A search was performed reviewing the English language literature for renal masses treated by ablation. Series reporting technical aspects of ablation or animal models were excluded as were studies published in journals outside the urology or radiology literature. Median series data were collated and statistically compared using Fisher’s exact and Mann-Whitney tests. RESULTS: In urologic journals, 67% of published ablation studies examine cryoablation while 88% of radiologic reports examine RFA (Table). Nearly 40% of urologic series involved a percutaneous approach. Differences exist in the median follow-up in urologic vs radiologic journals (15.1 vs 11.2 months, p=0.06). Pre-treatment biopsy was performed with a 95% median incidence among urologic reports versus only 71% in radiology literature. No post-ablation biopsies were performed in radiology series, but were routine (12.1%) or for radiographic enhancement (21.2%) in urology journals (p=0.009). Reablation for initial treatment failure was performed in 3.5% of cases in urologic literature vs 12.5% in radiology reports (p<0.0001).
THE JOURNAL OF UROLOGY®
incidence of diabetes, coronary disease, myocardial infarctation and sudden death. These alterations have been denominated as metabolic syndrome (MS).Our aim was to determine the prevalence of MS in patients under HT for metastatic PC METHODS: Between June and July 2007, 54 patients under HT for metastatic or locally advanced PC were evaluated for the presence of MS. Adult Treatment Panel III was applied. The data was DQDO\]HG LQ GLIIHUHQW JURXSV DFFRUGLQJ WR WKH WLPH RI +7 *URXS Androgen blockade for more than 3 months (long-term group - LTG) and Group 2: Androgen blockade for less than 3 months (short-term group - STG) RESULTS: The population average age was 72 years old (47-82), and 22 of all patients presented MS, of which 5 were in the STG and 17 in the LTG. Average time of blockade in the LTG was 13 PRQWKV )RUW\ ¿YH SDWLHQWV SUHVHQWHG K\SHUWHQVLRQ or developed this condition during the study period, 24 patients (44%) had fasting glucose higher than 110 mg/dl, 12 patients (22%) presented triglycerides higher than 150 mg/dl or HDL lower than 40 mg/dl and 24 patients (44%) had abdominal circumference larger than 102cm. The most used HT was goserelin acetate 3.6 mg every 28 days (41 patients or RQO\SDWLHQWV KDYHKDGVXUJLFDORUFKLHFWRP\'HPRJUD¿F data are presented on table 1. The prevalence of MS in the STG was DQGLQWKH/7* ¿JXUH CONCLUSIONS: MS may has a high prevalence on patients under HT for prostate cancer, causing important adverse effects. Urologists have to attend to these new insights on the treatment of prostate cancer.
143
METHODS: We conducted a Comprehensive Geriatric $VVHVVPHQWRIDOOUHVLGHQWVZKRZHUH\HDUVRIDJHLQDWDQ urban district in the northern part of Japan. The population-based crosssectional survey was conducted using an extensive health interview for each participant. We investigated the incidence of fractures for three years using data from the national health insurance system. The relevant cases were abstracted from medical records of hospitals regarding the cause and the position of the fractures. We compared the risk of fall-related fractures with or without nocturia (2 or more episodes per QLJKW XVLQJDWLPHYDU\LQJPXOWLYDULDWH&R[SURSRUWLRQDOKD]DUGPRGHO adjusted for age, sex, body mass index and physical activity. RESULTS: Of the 788 Japanese people (28.9% participation rate) included, 429 were female and 359 were male. The mean age was 74.9 ± 4.77 years (range 70 to 97). Fractures were observed in 28 cases and fall-related fractures were observed in 23 cases. Arm fractures, lower limb fractures and lumber spine and pelvic fractures comprised 30%, 40% and 20% of the cases, respectively. The odds-ratios and FRQ¿GHQFHLQWHUYDOVRIWKHULVNRIIUDFWXUHVDPRQJWKRVHHOGHUO\ with or without nocturia are presented in Table 1. The multivariate oddsUDWLRV FRQ¿GHQFH LQWHUYDOV UHJDUGLQJ WKH SUHVHQFH RI QRFWXULD among fractures and fall-related fractures were 2.45(1.08-5.54) and 2.63(1.05-6.57), respectively. &21&/86,216 :H FRQFOXGH WKDW WKHUH LV D VLJQL¿FDQW increase in the risk of fractures associated with the presence of two or more episodes of nocturia. +D]DUGUDWLRVRIIDOOIUDFWXUHDFFRUGLQJWRQRFWXULD nocturia Fall-related fractures Person-years of follow up No. of cases Crude model Multivariate adjusted HRs*
<2 (N=426) 1641 8 1.00 1.00
(N=362) 1357 15 2.28(0.97-5.38) 2.63(1.05-6.57)
All fractures Person-years of follow up No. of cases Crude model Multivariate adjusted HRs*
(N=426) 1641 10 1.00 1.00
(N=362) 1357 18 2.19(1.01-4.75) 2.45(1.08-5.54)
*Adjusted for age, sex, body mass index, physical activity
Source of Funding: Grant for Research Conducted by the Japanese Society for Promotion of Science from the Ministry of Education, Culture, Sports, Science and Technology of Japan.
403 Table 1. Patients data and results
Glucose Age (average ABP> > 130-85mmHg 110 mg/ years) (n - %) dl (n - %)
Short-Term 74 Blockage Short-Term 71 Blockage Total 71,8
HDL < 40 mg/dl and/or Abdominal Triglycerides > 200 Circunference mg/dl > 102cm (n- %) (n - %)
16(35,5)
7(29,1)
3(25)
10(41,6)
29(64,5)
17(70,9) 9(75)
14(58,4)
45(83,3)
24(44,4) 12(22,2)
24(44,4)
Source of Funding: None
402 ASSOCIATION BETWEEN NOCTURIA AND FRACTURES IN A COMMUNITY-DWELLING ELDERLY POPULATION AGED 70 YEARS AND OVER: RESULTS OF A 3-YEAR PROSPECTIVE COHORT STUDY IN JAPAN Haruo Nakagawa*, Yoshihiro Ikeda, Yasuhiro Kaiho, Naoki Nakaya, Kaori Omori, Kaijun Niu, Shinichi Kuriyama, Ryoichi Nagatomi, Ichiro Tsuji, Yoichi Arai. Sendai, Japan. INTRODUCTION AND OBJECTIVE: The incidence of fallrelated fractures is associated with high rates of mortality and morbidity in the elderly, and can increase with age. On the other hand nocturia also increases with age. The objective of the present study was to evaluate the association between nocturia and fall-related fractures in a community-based elderly population aged 70 years and over.
SIGNIFICANT DIFFERENCES EXIST IN REPORTING FOR ABLATION OF RENAL MASSES: A COMPARISON OF STUDIES PUBLISHED IN UROLOGY AND RADIOLOGY LITERATURE David A Kunkle*, Robert G Uzzo. Philadelphia, PA. INTRODUCTION AND OBJECTIVE: Ablation of renal masses may be performed under open, laparoscopic or percutaneous guidance. Technical results for ablation have increasingly been reported in the radiology literature. The purpose of this study is to identify differences in outcomes and endpoints between ablation series published in the urologic and radiologic literature. METHODS: A search was performed reviewing the English language literature for renal masses treated by ablation. Series reporting technical aspects of ablation or animal models were excluded as were studies published in journals outside the urology or radiology literature. Median series data were collated and statistically compared using Fisher’s exact and Mann-Whitney tests. RESULTS: In urologic journals, 67% of published ablation studies examine cryoablation while 88% of radiologic reports examine RFA (Table). Nearly 40% of urologic series involved a percutaneous approach. Differences exist in the median follow-up in urologic vs radiologic journals (15.1 vs 11.2 months, p=0.06). Pre-treatment biopsy was performed with a 95% median incidence among urologic reports versus only 71% in radiology literature. No post-ablation biopsies were performed in radiology series, but were routine (12.1%) or for radiographic enhancement (21.2%) in urology journals (p=0.009). Reablation for initial treatment failure was performed in 3.5% of cases in urologic literature vs 12.5% in radiology reports (p<0.0001).