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American Journal of Epidemiology Advance Access originally published online on June 10, 2009
American Journal of Epidemiology 2009 170(3):361-368; doi:10.1093/aje/kwp133
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American Journal of Epidemiology © 2009 The Authors
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ORIGINAL CONTRIBUTIONS

A Systematic Evaluation of Factors Associated With Nocturia—The Population-based FINNO Study

Kari A. O. Tikkinen, Anssi Auvinen, Theodore M. Johnson, II, Jeffrey P. Weiss, Tapani Keränen, Aila Tiitinen, Olli Polo, Markku Partinen and Teuvo L. J. Tammela

Correspondence to Dr. Kari A. O. Tikkinen, Clinical Research Institute HUCH Ltd./Tutkijatilat H3011, Haartmaninkatu 4, P.O. Box 105, FI-00029 HUS, Helsinki, Finland (e-mail: kari.tikkinen{at}fimnet.fi).

Received for publication December 8, 2008. Accepted for publication April 29, 2009.

In a case-control study with prevalence sampling, the authors explored the correlates for nocturia and their population-level impact. In 2003–2004, questionnaires were mailed to 6,000 subjects (aged 18–79 years) randomly identified from the Finnish Population Register (62.4% participated; 53.7% were female). Questionnaires contained items on medical conditions, medications, lifestyle, sociodemographic and reproductive factors, urinary symptoms, and snoring. Nocturia was defined as ≥2 voids/night. In age-adjusted analyses, factors associated with nocturia were entered into a multivariate model. Backward elimination was used to select variables for the final model, with adjustment for confounding. Although numerous correlates were identified, none affected ≥50% of nocturia cases of both sexes. The factors with the greatest impact at the population level were (urinary) urgency (attributable number/1,000 subjects (AN) = 24), benign prostatic hyperplasia (AN = 19), and snoring (AN = 16) for men and overweight and obesity (AN = 40), urgency (AN = 24), and snoring (AN = 17) for women. Moreover, correlates included prostate cancer and antidepressant use for men, coronary artery disease and diabetes for women, and restless legs syndrome and obesity for both sexes. Although several correlates were identified, none accounted for a substantial proportion of the population burden, highlighting the multifactorial etiology of nocturia.

coronary artery disease; diabetes mellitus; life style; obesity; prostatic hyperplasia; prostatic neoplasms; sleep disorders; urinary bladder, overactive

Abbreviations: BPH, benign prostatic hyperplasia; FINNO, Finnish National Nocturia and Overactive Bladder


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