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INTRODUCTION AND OBJECTIVES
Nocturia is a significant healthcare problem in the United States, with associated links to lower quality of life, impaired sleep, and higher rates of depression. Prior studies have documented a correlation between nocturia and obesity and between nocturia and C-reactive protein (CRP), suggesting a possible inflammatory component to the disease process. In this study, we sought to explore whether preventive health measures in the form of exercise could curtail this inflammatory cycle and reduce the prevalence of nocturia.
METHODS
We analyzed cross-sectional data on men and women over age 20 from the National Health and Nutrition Examination Survey between 2005-2010. Data was collected on baseline sociodemographic factors, medical history, laboratory values, exercise history, and medication use. Nocturia was defined as 2 or more episodes a night. Physical activity was by self-report and was analyzed in terms of MET-minutes per week, divided by tertile. CRP was log transformed to achieve a normal distribution for statistical analysis. With nocturia as the primary outcome, we performed univariate and multivariate logistic regression analyses to examine contributing risk factors. Separate models were then run on each of the exercise group tertiles to examine the relationship between logCRP and nocturia. Multivariable logistic regression was then run on the cohort at large to examine the interaction effect between exercise and logCRP on the primary outcome of nocturia
RESULTS
Our study cohort included 10,166 individuals. On univariate analysis, nocturia was significantly more prevalent in patients in the lowest tertile of MET-minutes per week (33%) than those in the middle (22.6%) and highest (19.1%) tertiles (p<0.0001). Patients with nocturia had significantly higher levels of logCRP (p<0.0001). On multivariable logistic regression controlling for sociodemographic and clinical characteristics including sex, highest versus lowest tertile of MET-minutes per week remained inversely correlated with nocturia (OR 0.81, p=0.007). On models run separately on each subgrouping of MET-minutes per week, logCRP was highly correlated with nocturia in middle (p<0.0001) and lower (p<0.0001) tertile exercisers but not in higher tertile exercisers (p=0.48). In the cohort at large, the interaction effect of logCRP with MET-minutes per week on nocturia was also significant (p=0.037), with the highest tertile of exercisers significantly less likely to have any relationship between logCRP and nocturia.
CONCLUSIONS
Individuals who report high levels of exercise are significantly less likely to suffer from nocturia and have lower serum inflammation in the form of CRP. As opposed to the lower exercise groups, these individuals possess no link between CRP and nocturia. Together, this suggests a connection between the anti-inflammatory properties of exercise and its impact on decreasing risk of nocturia and thus presents an important target for patient counseling.