Glycemic disorders are positively associated with asymptomatic pyuria in females but not in males

ObjectiveAsymptomatic pyuria (ASP) is associated with a higher risk of complicated urinary tract infections among diabetic patients. We investigated the association between glycemic status and ASP in an adult population undergoing a health checkup in Hualien, east-central Taiwan.Materials and MethodsWe reviewed the records of 9229 participants who had their first health checkup in this hospital between June 1, 2001 and September 1, 2006. All cases (n = 979) had pyuria as defined by the presence of more than 10 leukocytes per high-power field in urinalysis. Controls (n = 8250) included all other patients who had no pyuria. The glycemic status was classified as normal [fasting blood glucose (FBG) <100 mg/dL and no diabetes history], prediabetic (FBG, 100–125 mg/dL and no diabetes history), and diabetic (FBG >125 mg/dL or a history of diabetes). A case-control analysis was performed. Odds ratios (ORs) were calculated by logistic regression.ResultsThe prevalences of ASP for diabetic, prediabetic, and normal adults were 23.4%, 18.0%, and 13.4% in women, and 5.6%, 4.2%, and 4.6% in men, respectively. Among women, the age-adjusted OR for ASP was 1.34 (p < 0.01) for prediabetics and 1.77 (p < 0.01) for diabetics, relative to the controls (p for trend <0.01). Among men, the corresponding OR was 0.91 (p = 0.59) for prediabetics and 1.15 (p = 0.44) for diabetics. The effects of glycemic status on ASP significantly differed among women versus those among men (p for interaction <0.01). The associations remained unchanged after further adjustments for other potential confounding factors.ConclusionAn abnormal glycemic status has a significant positive dose-response relation with the presence of ASP; however, the association is only in women and not in men. Further research is required to protect diabetic women from this complication.