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Adiponectin can be a good predictor of urodynamic detrusor underactivity: a prospective study in men with lower urinary tract symptoms

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Abstract

Purpose

To investigate whether circulating adiponectin, which is considered a possible marker of anti-atherogenic effects, is a useful predictor of bladder function, especially detrusor underactivity (DU), in men with lower urinary tract symptoms (LUTS).

Methods

A total of 130 treatment-naïve men with non-neurogenic LUTS were prospectively stratified into two groups (the DU and non-DU groups) based on the presence or absence of DU, where DU is defined as a bladder contractility index < 100 and bladder outlet obstruction index (BOOI) < 40. The impact of serum adiponectin levels on urodynamic function, including DU, was assessed using univariate, binomial logistic regression, and receiver operating characteristic (ROC) curve analyses.

Results

In total, data from 118 men were analyzed; 39 (33.0%) had DU (DU group) and 79 (67.0%) did not have DU (non-DU group). The median serum adiponectin in the DU group was significantly lower than in the non-DU group (6.2 vs 12.6 µg/mL, p < 0.001). In the binomial logistic regression analysis, lower adiponectin, smaller intravesical prostatic protrusion, and lower bladder voiding efficiency were significant factors related to DU. In the ROC analyses, serum adiponectin had the highest area under the curve value for DU diagnosis (0.849). Additionally, a cutoff value of 7.9 µg/mL for serum adiponectin level was identified for DU, which yielded a sensitivity and specificity of 79% and 90%, respectively.

Conclusions

The serum adiponectin level was significantly associated with bladder function and may be a useful marker for predicting DU in men with LUTS.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

BCI:

Bladder contractility index

BMI:

Body mass index

BOO:

Bladder outlet obstruction

BOOI:

Bladder outlet obstruction index

BPE:

Benign prostatic enlargement

BVE:

Bladder voiding efficiency

DO:

Detrusor overactivity

DU:

Detrusor underactivity

FDV:

First desire to void

HL:

Hyperlipidemia

HT:

Hypertension

IPP:

Intravesical prostatic protrusion

IPSS:

International prostate symptom score

LUTS:

Lower urinary tract symptoms

MCC:

Maximum cystometric capacity

MetS:

Metabolic syndrome

OAB:

Overactive bladder symptom

OABSS:

Overactive bladder symptom score

PdetQmax:

Detrusor pressure at maximum flow rate

PFS:

Pressure flow study

PVR:

Post-void residual urine volume

Qmax:

Maximum flow rate

QOL:

Quality of life

ROC:

Receiver operating characteristic

References

  1. Osman NI, Chapple CR, Abrams P et al (2014) Detrusor underactivity and the underactive bladder: a new clinical entity? A review of current terminology, definitions, epidemiology, aetiology, and diagnosis. Eur Urol 65:389–98

    Article  PubMed  Google Scholar 

  2. Osman NI, Esperto F, Chapple CR (2018) Detrusor underactivity and the underactive bladder: a systematic review of preclinical and clinical studies. Eur Urol 74:633–643

    Article  PubMed  Google Scholar 

  3. Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the international continence society. Neurourol Urodyn 21:167–178

    Article  PubMed  Google Scholar 

  4. Malde S, Nambiar AK, Umbach R et al (2017) Systematic review of the performance of noninvasive tests in diagnosing bladder outlet obstruction in men with lower urinary tract symptoms. Eur Urol 71:391–402

    Article  PubMed  Google Scholar 

  5. Tan YG, Teo JS, Kuo TLC, Guo L et al (2021) A systemic review and meta-analysis of transabdominal intravesical prostatic protrusion assessment in determining bladder outlet obstruction and unsuccessful trial without catheter. Eur Urol Focus S2405–4569(21):00245–00255

    Google Scholar 

  6. Ponholzer A, Temml C, Wehrberger C, Marszalek M, Madersbacher S (2006) The association between vascular risk factors and lower urinary tract symptoms in both sexes. Eur Urol 50:581–586

    Article  PubMed  Google Scholar 

  7. Smith DP, Weber MF, Soga K et al (2014) Relationship between lifestyle and health factors and severe lower urinary tract symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study. PLoS One 9:e109278

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pashootan P, Ploussard G, Cocaul A, de Gouvello A, Desgrandchamps F (2015) Association between metabolic syndrome and severity of lower urinary tract symptoms (LUTS): an observational study in a 4666 European men cohort. BJU Int 116:124–130

    Article  PubMed  Google Scholar 

  9. Matsumoto S, Kakizaki H (2012) Causative significance of bladder blood flow in lower urinary tract symptoms. Int J Urol 19:20–25

    Article  PubMed  Google Scholar 

  10. Pinggera GM, Mitterberger M, Steiner E et al (2008) Association of lower urinary tract symptoms and chronic ischemia of the lower urinary tract in elderly women and men: assessment using colour Doppler ultrasonography. BJU Int 102:470–474

    Article  PubMed  Google Scholar 

  11. Yamaguchi O, Nomiya M, Andersson KE (2014) Functional consequences of chronic bladder ischemia. Neurourol Urodyn 33:54–58

    Article  PubMed  Google Scholar 

  12. Nomiya M, Yamaguchi O, Andersson KE et al (2012) The effect of atherosclerosis-induced chronic bladder ischemia on bladder function in the rat. Neurourol Urodyn 31:195–200

    Article  CAS  PubMed  Google Scholar 

  13. Azadzoi KM, Tarcan T, Siroky MB, Krane RJ (1999) Atherosclerosis-induced chronic ischemia causes bladder fibrosis and non-compliance in the rabbit. J Urol 161:1626–1635

    Article  CAS  PubMed  Google Scholar 

  14. Funahashi T, Nakamura T, Shimomura I et al (1999) Role of adipocytokines on the pathogenesis of atherosclerosis in visceral obesity. Intern Med 38:202–206

    Article  CAS  PubMed  Google Scholar 

  15. Ouchi N, Parker JL, Lugus JJ, Walsh K (2011) Adipokines in inflammation and metabolic disease. Nat Rev Immunol 11:85–97

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Matsuzawa Y (2006) Therapy insight: adipocytokines in metabolic syndrome and related cardiovascular disease. Nat Clin Pract Cardiovasc Med 3:35–42

    Article  CAS  PubMed  Google Scholar 

  17. Yamauchi T, Kamon J, Waki H, Terauchi Y et al (2001) The fat-derived hormone adiponectin reverses insulin resistance associated with both lipoatrophy and obesity. Nat Med 7:941–946

    Article  CAS  PubMed  Google Scholar 

  18. Yamauchi T, Kamon J, Waki H et al (2003) Globular adiponectin protected ob/ob mice from diabetes and ApoE-deficient mice from atherosclerosis. J Biol Chem 278:2461–2468

    Article  CAS  PubMed  Google Scholar 

  19. Shibata R, Sato K, Pimentel DR et al (2005) Adiponectin protects against myocardial ischemia-reperfusion injury through AMPK- and COX-2-dependent mechanisms. Nat Med 11:1096–1103

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Pischon T, Girman CJ, Hotamisligil GS, Rifai N, Hu FB, Rimm EB (2004) Plasma adiponectin levels and risk of myocardial infarction in men. JAMA 291:1730–1737

    Article  CAS  PubMed  Google Scholar 

  21. Nilsson PM, Engström G, Hedblad B et al (2006) Plasma adiponectin levels in relation to carotid intima media thickness and markers of insulin resistance. Arterioscler Thromb Vasc Biol 26:2758–2762

    Article  CAS  PubMed  Google Scholar 

  22. Schäfer W, Abrams P, Liao L et al (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274

    Article  PubMed  Google Scholar 

  23. Nishimura A, Sawai T (2006) Determination of adiponectin in serum using a latex particle-enhanced turbidimetric immunoassay with an automated analyzer. Clin Chim Acta 371:163–168

    Article  CAS  PubMed  Google Scholar 

  24. Matsukawa Y, Yoshida M, Yamaguchi O et al (2020) Clinical characteristics and useful signs to differentiate detrusor underactivity from bladder outlet obstruction in men with non-neurogenic lower urinary tract symptoms. Int J Urol 27:47–52

    Article  PubMed  Google Scholar 

  25. Gammie A, Kaper M, Dorrepaal C, Kos T, Abrams P (2016) Signs and symptoms of detrusor underactivity: an analysis of clinical presentation and urodynamic tests from a large group of patients undergoing pressure flow studies. Eur Urol 69:361–369

    Article  PubMed  Google Scholar 

  26. Takahashi R, Takei M, Namitome R, Yamaguchi O, Eto M (2021) Symptoms and noninvasive test parameters that clinically differentiate detrusor underactivity from bladder outlet obstruction without a pressure-flow-based diagnosis in men with lower urinary tract symptoms. Neurourol Urodyn 40:303–309

    Article  PubMed  Google Scholar 

  27. Nobe K, Fujii A, Saito K et al (2013) Adiponectin enhances calcium dependency of mouse bladder contraction mediated by protein kinase Cα expression. J Pharmacol Exp Ther 345:62–68

    Article  CAS  PubMed  Google Scholar 

  28. Fu S, Xu H, Gu M et al (2017) Adiponectin deficiency contributes to the development and progression of benign prostatic hyperplasia in obesity. Sci Rep 7:43771

    Article  PubMed  PubMed Central  Google Scholar 

  29. Xia BW, Zhao SC, Chen ZP et al (2020) The underlying mechanism of metabolic syndrome on benign prostatic hyperplasia and prostate volume. Prostate 80:481–490

    Article  CAS  PubMed  Google Scholar 

  30. Hayashi M, Shibata R, Takahashi H et al (2011) Association of adiponectin with carotid arteriosclerosis in predialysis chronic kidney disease. Am J Nephrol 34:249–255

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We thank all patients, who provided data, and all trial investigators for their contribution to data acquisition. This study was supported by a Japan Society for the Promotion of Science KAKENHI Grant-in-Aid for Scientific Research C (Grant Number: 17K11178, Y. Matsukawa).

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Authors and Affiliations

  1. Department of Urology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan

    Tomohiro Ishikawa, Yoshihisa Matsukawa, Yushi Naito, Shohei Ishida, Tsuyoshi Majima & Momokazu Gotoh

Authors
  1. Tomohiro Ishikawa
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  2. Yoshihisa Matsukawa
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  3. Yushi Naito
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  4. Shohei Ishida
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  5. Tsuyoshi Majima
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  6. Momokazu Gotoh
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Contributions

TI contributed to manuscript writing, data collection, and data analysis. YM contributed to protocol/project development, data collection, data analysis, data management, and manuscript writing. YN contributed to data collection. SI contributed to data management and critical revision of the manuscript. TM contributed to data analysis and critical revision of the manuscript. MG contributed to protocol/project development, manuscript editing, and supervision.

Corresponding author

Correspondence to Yoshihisa Matsukawa.

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Conflict of interest

The authors declare that there are no conflict of interests. This study has been not funded and supported by any company.

Research involving human participants and/or animals

The study was conducted in accordance with the ethical principles of the Declaration of Helsinki, and the protocol was approved by the Institutional Review Board of Nagoya University Graduate School of Medicine, Japan (approval number: 2018-0233). This study was registered at https://center.umin.ac.jp (UMIN000033750).

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Informed consent was obtained from all individual participants included in the study. The participant has consented to the submission of the study results to the journal.

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Ishikawa, T., Matsukawa, Y., Naito, Y. et al. Adiponectin can be a good predictor of urodynamic detrusor underactivity: a prospective study in men with lower urinary tract symptoms. World J Urol 41, 1117–1124 (2023). https://doi.org/10.1007/s00345-023-04341-y

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  • DOI: https://doi.org/10.1007/s00345-023-04341-y

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