Association of polygenic risk scores for depression, anxiety, and neuroticism with lower urinary tract symptoms in women

Background

Observational studies have found that depression and anxiety are prospectively associated with lower urinary tract symptoms (LUTS), but these studies are limited by potential environmental confounding and measurement error. Using genetic liability for psychiatric traits offers an alternative approach.

Objectives

Examine the association of genetic liability for depression, anxiety, and neuroticism with LUTS in women.

Methods

Data: i) Avon Longitudinal Study of Parents and Children (ALSPAC) Mothers Cohort. ii) GWAS (genome-wide association study) summary data on psychiatric traits.

Exposures: Polygenic risk scores (PRS) for depression, anxiety, and neuroticism.

Outcomes: LUTS - assessed in 2002-04 (mean [sd] age = 40.3 [4.6]) and 2011-12 (49.7 [4.5]) using validated questionnaires.

Statistical analysis: Logistic regression adjusted for age and population structure.

Key findings and limitations

The neuroticism PRS was associated with nocturia at both time points [odds ratio and 95% confidence intervals=1.24 (1.10,1.40) and 1.21 (1.07,1.37)], and with any UI, any urgency, and mixed UI (2002-04 only) [1.14 (1.05,1.23), 1.12 (1.02,1.23), and 1.23 (1.07,1.43), respectively]. The depression PRS was associated with nocturia [1.33 (1.17,1.50) and 1.24 (1.09,1.40)] and any UI [1.09 (1.01,1.18); 1.11 (1.02,1.20)] at both timepoints, and with any urgency (2011-12 only) [1.13 (1.03,1.24)]. The anxiety PRS was associated with mixed UI (2002-04 only) [1.20 (1.03,1.39)].

PRS may not capture all genetic liability and cannot account for pleiotropic effects. The ALSPAC cohort includes only parous women and is predominantly affluent and of European ancestry.

Conclusions and clinical implications

Genetic liability for depression, anxiety and neuroticism was associated with LUTS in women, suggesting psychiatric factors may contribute to the aetiology of LUTS.

Patient summary

In this study we looked at whether parous women with a high genetic risk of mental health problems were more likely to have urinary symptoms. We found various associations, with the strongest evidence found for genetic liability to depression and neuroticism increasing the risk of nocturia (waking during the night to pass urine). Our findings suggest that psychiatric factors could be important in understanding urinary symptoms, and more research is needed to find out if this these associations apply to other demographics.