Derivation and validation of a symptom-anchored diagnostic criterion for nocturnal polyuria in women: aligning with aging physiology.

IF 3.9 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Menopause: The Journal of The North American Menopause Society Pub Date : 2026-07-07 DOI:10.1097/GME.0000000000002857

Pei-Chi Wu, Sheng-Mou Hsiao, Ho-Hsiung Lin

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引用次数: 0

Abstract

Objectives: To investigate the physiological validity of current diagnostic criteria for nocturnal polyuria and to derive and validate a symptom-anchored revision consistent with female aging.

Methods: This retrospective cross-sectional study analyzed 3-day bladder diaries from 3,000 women with lower urinary tract symptoms. We assessed age-specific nocturnal polyuria prevalence using current International Continence Society definitions (nocturnal polyuria index ≥33% for women >66 y and ≥20% for women ≤65 y). To address discrepancies with aging physiology, a novel cutoff was derived using the Youden index anchored to symptom bother (King's Health Questionnaire nocturia severity score ≥1). The proposed composite definition (nocturnal polyuria index ≥28% plus symptom score ≥1) was validated using multivariable regression and randomized split-sample validation (training: n=2,500; validation: n=500).

Results: Under current criteria, nocturnal polyuria prevalence was higher in younger women (75.5%) compared with older women (50.5%). Multivariable analysis identified age as a protective factor (odds ratio: 0.96; 95% CI: 0.95-0.97), inconsistent with physiology. Conversely, the proposed new definition identified age as a significant positive risk factor (odds ratio: 1.03; 95% CI: 1.02-1.04). Prevalence remained stable at 26.8% (one-in-four) in premenopausal women, rising linearly to 46.3% (one-in-two) in postmenopausal women. Internal validation confirmed model stability (area under curve: 0.86; 95% CI: 0.83-0.90).

Conclusions: Current age-stratified thresholds of nocturnal polyuria result in discrepancies with aging physiology. The proposed framework establishes a physiologically plausible standard. By anchoring symptom bother score and nocturnal polyuria index of 28%, this definition facilitates the identification of symptomatic women and highlights the distinct impact of menopause.

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基于症状的女性夜间多尿诊断标准的推导和验证：与衰老生理相一致。

目的：探讨当前夜间多尿诊断标准的生理有效性，并推导和验证与女性衰老一致的症状锚定修正。方法：这项回顾性横断面研究分析了3000名有下尿路症状的女性3天膀胱日志。我们使用现行的国际尿失禁协会定义（66岁以下女性的夜间多尿指数≥33%，65岁以下女性的夜间多尿指数≥20%）评估了特定年龄的夜间多尿患病率。为了解决与衰老生理学的差异，使用以症状困扰为基础的约登指数（King's健康问卷夜尿严重程度评分≥1）得出了一个新的截止点。提出的复合定义（夜间多尿指数≥28%加上症状评分≥1）采用多变量回归和随机分样本验证（训练：n=2,500；验证：n=500）进行验证。结果：在现行标准下，年轻女性夜间多尿患病率（75.5%）高于老年女性（50.5%）。多变量分析发现年龄是保护因素（优势比：0.96;95% CI: 0.95-0.97），与生理不一致。相反，提出的新定义将年龄确定为显著的积极风险因素（优势比：1.03;95% CI: 1.02-1.04）。绝经前妇女的患病率稳定在26.8%（四分之一），绝经后妇女的患病率线性上升至46.3%（二分之一）。内部验证证实了模型的稳定性（曲线下面积：0.86;95% CI: 0.83-0.90）。结论：目前夜间多尿的年龄分层阈值与衰老生理学存在差异。拟议的框架建立了一个生理学上合理的标准。通过锚定症状困扰评分和28%的夜间多尿指数，这一定义有助于识别有症状的女性，并突出了更年期的明显影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Menopause: The Journal of The North American Menopause Society 医学-妇产科学

CiteScore

5.40

自引率

7.40%

发文量

330

审稿时长

3-8 weeks

期刊介绍： Menopause, published monthly, provides a forum for new research, applied basic science, and clinical guidelines on all aspects of menopause. The scope and usefulness of the journal extend beyond gynecology, encompassing many varied biomedical areas, including internal medicine, family practice, medical subspecialties such as cardiology and geriatrics, epidemiology, pathology, sociology, psychology, anthropology, and pharmacology. This forum is essential to help integrate these areas, highlight needs for future research, and enhance health care.