nach oben

Erschienen in:

23.01.2024 | Original Article

Predictive patterns of lower urinary tract symptoms and bacteriuria in adults with type 2 diabetes

verfasst von: Keiji Sugai, Junko Sasaki, Yuki Wada, Norihiro Shimizu, Takuya Ishikawa, Ketchu Yanagi, Takeshi Hashimoto, Akihiko Tanaka, Hirotsugu Suwanai, Ryo Suzuki, Masato Odawara

Erschienen in: Diabetology International | Ausgabe 2/2024

Einloggen, um Zugang zu erhalten

Abstract

Background

Numerous studies demonstrated the risk factors for urological complications in patients with diabetes before sodium–glucose co-transporter 2 inhibitor (SGLT2i) became commercially available. This study aimed to comprehensively investigate urological characteristics in patients with type 2 diabetes (T2DM) after SGLT2i became commercially available.

Methods

We examined 63 outpatients with T2DM suspected of bacteriuria based on urinary sediment examinations. Urine cultures were performed, and lower urinary tract symptoms (LUTS) were assessed via questionnaires. Patients with bacteriuria were assessed using ultrasonography to measure post-void residual volume (PVR). Utilizing demographic and laboratory data, a random forest algorithm predicted LUTS, bacteriuria, and symptomatic bacteriuria (SB).

Results

Thirty-two patients had LUTS and 31 had bacteriuria. High-density lipoprotein cholesterol level was crucial in predicting LUTS, while age was crucial in predicting bacteriuria. In predicting SB among patients with bacteriuria, creatinine level and estimated glomerular filtration rate were crucial. Our models had high predictive accuracy for LUTS (area under the curve [AUC] = 0.846), followed by bacteriuria (AUC = 0.770) and SB (AUC = 0.938) in receiver operating characteristic curve analysis. These predictors were previously reported as risk factors for urological complications. Although SGLT2i use was not an important predictor in our study, all SGLT2i users with bacteriuria had SB and exhibited higher PVR compared to non-SGLT2i users with bacteriuria.

Conclusion

This study’s random forest model highlighted distinct essential predictors for each urological condition. The predictors were consistent before and after SGLT2i became commercially available.

Nur mit Berechtigung zugänglich

Daneshgari F, Liu G, Birder L, Hanna-Mitchell AT, Chacko S. “Diabetic bladder dysfunction: current translational knowledge,” (in eng). J Urol. 2009;182(6 Suppl):S18-26. https://doi.org/10.1016/j.juro.2009.08.070.CrossRefPubMedPubMedCentral

Xu D, Gao J, Wang X, Huang L, Wang K. Prevalence of overactive bladder and its impact on quality of life in 1025 patients with type 2 diabetes in mainland China. J Diabetes Complications. 2017;31(8):1254–8. https://doi.org/10.1016/j.jdiacomp.2017.05.001.CrossRefPubMed

Kupelian V, et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med. 2006;166(21):2381–7. https://doi.org/10.1001/archinte.166.21.2381.CrossRefPubMed

Jacobson AM, et al. Relationship of urologic complications with health-related quality of life and perceived value of health in men and women with type 1 diabetes: the Diabetes Control and Complications Trial/Epidemiology of Interventions and Complications (DCCT/EDIC) cohort. Diabetes Care. 2015;38(10):1904–12. https://doi.org/10.2337/dc15-0286.CrossRefPubMedPubMedCentral

Hill SR, Fayyad AM, Jones GR. Diabetes mellitus and female lower urinary tract symptoms: a review. Neurourol Urodyn. 2008;27(5):362–7. https://doi.org/10.1002/nau.20533.CrossRefPubMed

Tanaka Y, et al. Association of lower urinary tract symptoms based on the international prostate symptom score and cardiovascular disease. Circ J. 2021;85(11):2092–9. https://doi.org/10.1253/circj.CJ-21-0278.CrossRefPubMed

Akerla J, et al. Lower urinary tract symptoms and mortality among finnish men: the roles of symptom severity and bother. J Urol. 2022;207(6):1285–94. https://doi.org/10.1097/JU.0000000000002450.CrossRefPubMed

Chung MS, Chuang YC, Lee JJ, Lee WC, Chancellor MB, Liu RT. Prevalence and associated risk factors of nocturia and subsequent mortality in 1,301 patients with type 2 diabetes. Int Urol Nephrol. 2014;46(7):1269–75. https://doi.org/10.1007/s11255-014-0669-2.CrossRefPubMed

Lee WC, Wu HP, Tai TY, Liu SP, Chen J, Yu HJ. Effects of diabetes on female voiding behavior. J Urol. 2004;172(3):989–92. https://doi.org/10.1097/01.ju.0000136255.83054.0c.CrossRefPubMed

10.

Appa AA, et al. Clinical predictors and significance of postvoid residual volume in women with diabetes. Diabetes Res Clin Pract. 2013;101(2):164–9. https://doi.org/10.1016/j.diabres.2013.05.005.CrossRefPubMedPubMedCentral

11.

Sorrentino F, et al. “Associations between individual lower urinary tract symptoms and bacteriuria in random urine samples in women,” (in eng). Neurourol Urodyn. 2015;34(5):429–33. https://doi.org/10.1002/nau.22607.CrossRefPubMed

12.

Ishida S, et al. Urodynamic risk factors of asymptomatic bacteriuria in men with non-neurogenic lower urinary tract symptoms. World J Urol. 2022;40(12):3035–41. https://doi.org/10.1007/s00345-022-04194-x.CrossRefPubMed

13.

N. C. Chilelli et al., "Lower urinary tract symptoms (LUTS) in males with type 2 diabetes recently treated with SGLT2 inhibitors-overlooked and overwhelming? A retrospective case series," (in eng), Endocrine, vol. 59, no. 3, pp. 690–693, 03 2018, https://doi.org/10.1007/s12020-017-1301-x.

14.

Tsunoda A. Bidet Toilet Use May Cause Anal Symptoms and Nosocomial Infection. J Anus Rectum Colon. 2021;5(4):335–9. https://doi.org/10.23922/jarc.2021-027.CrossRefPubMedPubMedCentral

15.

S. E. Geerlings et al., "Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group," (in eng), Diabetes Care, vol. 23, no. 6, pp. 744–9, Jun 2000, https://doi.org/10.2337/diacare.23.6.744.

16.

Renko M, Tapanainen P, Tossavainen P, Pokka T, Uhari M. “Meta-analysis of the significance of asymptomatic bacteriuria in diabetes,” (in eng). Diabetes Care. 2011;34(1):230–5. https://doi.org/10.2337/dc10-0421.CrossRefPubMed

17.

Homma Y, et al. Symptom assessment tool for overactive bladder syndrome–overactive bladder symptom score. Urology. 2006;68(2):318–23. https://doi.org/10.1016/j.urology.2006.02.042.CrossRefPubMed

18.

E. Karantanis, M. Fynes, K. H. Moore, and S. L. Stanton, "Comparison of the ICIQ-SF and 24-hour pad test with other measures for evaluating the severity of urodynamic stress incontinence," Int Urogynecol J Pelvic Floor Dysfunct, vol. 15, no. 2, pp. 111–6; discussion 116, Mar-Apr 2004, https://doi.org/10.1007/s00192-004-1123-2.

19.

Okamura K, Usami T, Nagahama K, Maruyama S, Mizuta E. “The relationships among filling, voiding subscores from International Prostate Symptom Score and quality of life in Japanese elderly men and women,” (in eng). Eur Urol. 2002;42(5):498–505. https://doi.org/10.1016/s0302-2838(02)00438-4.CrossRefPubMed

20.

S. Takahashi et al., "Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition)," Int J Urol, vol. 28, no. 5, pp. 474–492, May 2021, doi: https://doi.org/10.1111/iju.14492.

21.

James R, Hijaz A. Lower urinary tract symptoms in women with diabetes mellitus: a current review. Curr Urol Rep. 2014;15(10):440. https://doi.org/10.1007/s11934-014-0440-3.CrossRefPubMed

22.

Dai M, et al. Incidence and risk factors of asymptomatic bacteriuria in patients with type 2 diabetes mellitus: a meta-analysis. Endocrine. 2023;82(2):263–81. https://doi.org/10.1007/s12020-023-03469-6.CrossRefPubMedPubMedCentral

23.

Ishay A, Lavi I, Luboshitzky R. Prevalence and risk factors for asymptomatic bacteriuria in women with Type 2 diabetes mellitus. Diabet Med. 2006;23(2):185–8. https://doi.org/10.1111/j.1464-5491.2005.01758.x.CrossRefPubMed

24.

Tai HC, et al. “Metabolic syndrome components worsen lower urinary tract symptoms in women with type 2 diabetes,” (in eng). J Clin Endocrinol Metab. 2010;95(3):1143–50. https://doi.org/10.1210/jc.2009-1492.CrossRefPubMed

25.

Feng T, et al. Serum cholesterol and risk of lower urinary tract symptoms progression: results from the Reduction by Dutasteride of Prostate Cancer Events study. Int J Urol. 2017;24(2):151–6. https://doi.org/10.1111/iju.13265.CrossRefPubMed

26.

E. Papaefstathiou, K. Moysidis, P. Sarafis, E. Ioannidis, and K. Hatzimouratidis, "The impact of Diabetes Mellitus on Lower urinary tract symptoms (LUTS) in both male and female patients," Diabetes Metab Syndr, vol. 13, no. 1, pp. 454–457, Jan - Feb 2019, doi: https://doi.org/10.1016/j.dsx.2018.11.009.

27.

Nomiya M, Andersson KE, Yamaguchi O. Chronic bladder ischemia and oxidative stress: new pharmacotherapeutic targets for lower urinary tract symptoms. Int J Urol. 2015;22(1):40–6. https://doi.org/10.1111/iju.12652.CrossRefPubMed

28.

Azab S. The impact of atherosclerosis on lower urinary tract function. Aging Male. 2013;16(3):108–11. https://doi.org/10.3109/13685538.2013.795532.CrossRefPubMed

29.

Andersson KE, Boedtkjer DB, Forman A. The link between vascular dysfunction, bladder ischemia, and aging bladder dysfunction. Ther Adv Urol. 2017;9(1):11–27. https://doi.org/10.1177/1756287216675778.CrossRefPubMed

30.

Kasyan G, Berketova TY, Rogozin AK, Pushkar DY. Asymptomatic bacteriuria in postmenopausal women with diabetes mellitus. Cent European J Urol. 2013;66(3):320–6. https://doi.org/10.5173/ceju.2013.03.art17.CrossRefPubMedPubMedCentral

31.

Ligon MM, Joshi CS, Fashemi BE, Salazar AM, Mysorekar IU. Effects of aging on urinary tract epithelial homeostasis and immunity. Dev Biol. 2023;493:29–39. https://doi.org/10.1016/j.ydbio.2022.11.003.CrossRefPubMed

32.

Soma O, et al. Relationship between frailty and lower urinary tract symptoms among community-dwelling adults. Low Urin Tract Symptoms. 2020;12(2):128–36. https://doi.org/10.1111/luts.12292.CrossRefPubMed

33.

Tai HC, Tai TY, Yang WS, Wang SW, Yu HJ. “Associations between lower urinary tract dysfunction and glycemic control in women with type 2 diabetes: a cross-sectional study,” (in eng). J Diabetes Complications. 2016;30(3):415–9. https://doi.org/10.1016/j.jdiacomp.2016.01.002.CrossRefPubMed

34.

V. Hall, J. Kwong, D. Johnson, and E. I. Ekinci, "Caution advised with dapagliflozin in the setting of male urinary tract outlet obstruction," (in eng), BMJ Case Rep, vol. 2017, May 2017, doi: https://doi.org/10.1136/bcr-2017-219335.

35.

Huang Z, Xiao H, Li H, Yan W, Ji Z. Analysis of the incidence and risk factors of male urinary tract infection following urodynamic study. Eur J Clin Microbiol Infect Dis. 2017;36(10):1873–8. https://doi.org/10.1007/s10096-017-3007-7.CrossRefPubMed

36.

Stern JA, Hsieh YC, Schaeffer AJ. Residual urine in an elderly female population: novel implications for oral estrogen replacement and impact on recurrent urinary tract infection. J Urol. 2004;171(2 Pt 1):768–70. https://doi.org/10.1097/01.ju.0000107261.64927.b3.CrossRefPubMed

37.

A. D. Kaze, M. Zhuo, S. C. Kim, E. Patorno, and J. M. Paik, "Association of SGLT2 inhibitors with cardiovascular, kidney, and safety outcomes among patients with diabetic kidney disease: a meta-analysis," Cardiovasc Diabetol, vol. 21, no. 1, p. 47, Mar 23 2022, doi: https://doi.org/10.1186/s12933-022-01476-x.

38.

Li D, Wang T, Shen S, Fang Z, Dong Y, Tang H. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2017;19(3):348–55. https://doi.org/10.1111/dom.12825.CrossRefPubMed

39.

Vasilakou D, et al. “Sodium-glucose cotransporter 2 inhibitors for type 2 diabetes: a systematic review and meta-analysis,” (in eng). Ann Intern Med. 2013;159(4):262–74. https://doi.org/10.7326/0003-4819-159-4-201308200-00007.CrossRefPubMed

40.

Kiuchi T, Asakura K, Nakano M, Omae K. “Bidet toilet use and incidence of hemorrhoids or urogenital infections: A one-year follow-up web survey,” (in eng). Prev Med Rep. 2017;6:121–5. https://doi.org/10.1016/j.pmedr.2017.02.008.CrossRefPubMedPubMedCentral

41.

Tsunoda A, Takahashi T, Arika K, Kubo S, Tokita T, Kameda S. “Survey of electric bidet toilet use among community dwelling Japanese people and correlates for an itch on the anus,” (in eng). Environ Health Prev Med. 2016;21(6):547–53. https://doi.org/10.1007/s12199-016-0578-3.CrossRefPubMedPubMedCentral

42.

Bansal R, Agarwal MM, Modi M, Mandal AK, Singh SK. Urodynamic profile of diabetic patients with lower urinary tract symptoms: association of diabetic cystopathy with autonomic and peripheral neuropathy. Urology. 2011;77(3):699–705. https://doi.org/10.1016/j.urology.2010.04.062.CrossRefPubMed

Titel: Predictive patterns of lower urinary tract symptoms and bacteriuria in adults with type 2 diabetes
verfasst von: Keiji Sugai
Junko Sasaki
Yuki Wada
Norihiro Shimizu
Takuya Ishikawa
Ketchu Yanagi
Takeshi Hashimoto
Akihiko Tanaka
Hirotsugu Suwanai
Ryo Suzuki
Masato Odawara
Publikationsdatum: 23.01.2024
Verlag: Springer Nature Singapore
Erschienen in: Diabetology International / Ausgabe 2/2024
Print ISSN: 2190-1678
Elektronische ISSN: 2190-1686
DOI: https://doi.org/10.1007/s13340-023-00687-1

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Bei Herzinsuffizienz muss „Eisenmangel“ neu definiert werden!

16.05.2024 Herzinsuffizienz Nachrichten

Bei chronischer Herzinsuffizienz macht es einem internationalen Expertenteam zufolge wenig Sinn, die Diagnose „Eisenmangel“ am Serumferritin festzumachen. Das Team schlägt vor, sich lieber an die Transferrinsättigung zu halten.

Herzinfarkt mit 85 – trotzdem noch intensive Lipidsenkung?

16.05.2024 Hypercholesterinämie Nachrichten

Profitieren nach einem akuten Myokardinfarkt auch Betroffene über 80 Jahre noch von einer intensiven Lipidsenkung zur Sekundärprävention? Um diese Frage zu beantworten, wurden jetzt Registerdaten aus Frankreich ausgewertet.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Erstmanifestation eines Diabetes-Typ-1 bei Kindern: Ein Notfall!

16.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Manifestiert sich ein Typ-1-Diabetes bei Kindern, ist das ein Notfall – ebenso wie eine diabetische Ketoazidose. Die Grundsäulen der Therapie bestehen aus Rehydratation, Insulin und Kaliumgabe. Insulin ist das Medikament der Wahl zur Behandlung der Ketoazidose.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2024

Impacts of “Diabetes Theater,” a participative educational workshop for health care professionals, on participants: a patient empowerment perspective

Effects of simultaneous pancreas and kidney transplantation in Japanese individuals with type 1 diabetes and end-stage kidney disease

Mortality in childhood-onset type 1 diabetes mellitus with onset between 1959 and 1996: A population-based study in Hokkaido, Japan

Correction: Patients with gestational diabetes mellitus may be treated in both early and late pregnancy, especially in patients with pre-pregnancy overweight: A cross-sectional study in Japan

Higher childhood weight gain, lower skeletal muscle mass, and higher cereal consumption in normal-weight Japanese women with high-percentage trunk fat: a subanalysis study