To explore whether there was an association between the incidence of overactive bladder (OAB) and diabetes, lead author Qingliu He, who is with the Jinjiang Municipal Hospital in Quanzhou, China, and fellow researchers extracted data for 23,863 study subject participants from the U.S. National Health and Nutrition Examination Survey. The results were published in Frontiers in Endocrinology in April.
Using logistic regression models to analyze the association between diabetes-related markers, inflammatory biomarkers, diabetes, and OAB, the research team observed a 77% higher prevalence of OAB in subjects with diabetes compared with those without diabetes. The team also found that associations between glycohemoglobin, fasting glucose, and insulin with OAB were strongly mediated by white blood cells (7.23%, 8.08%, and 17.74%, respectively) and partially mediated by neutrophils (6.58%, 9.64%, and 17.93%, respectively). Out of all these diabetes-related markers, however, the researchers reported that the observed glycohemoglobin is the most important indicator of OAB.
OAB symptoms are not always accompanied by urgent urinary incontinence, which as the authors note, “negatively affects the quality of life of patients and their interactions with society.” While the pathophysiology of OAB is not fully understood, the involvement of metabolic syndrome has been listed among the potential culprits involved in its manifestation.
Because metabolic syndrome, also a common clinical complication of diabetes, is well recognized to have serious physical consequences that include impairment of organ systems, often those involving the urological system, the likely co-occurrence of OAB and diabetes was not a far-fetched hypothesis. The diagnosis of diabetic bladder dysfunction (DBD), also known as diabetic cystopathy, is common with some estimates suggesting a prevalence rate as high as 90%.
“Our hypothesis based on the analysis results of the association between OAB, diabetes, and systemic inflammation is that diabetes mellitus may increase OAB risk by promoting systemic inflammation,” the authors wrote.
The role of inflammation has been revealed in recent studies to tell a tale of a ruthless cycle of chronic inflammatory reactions that leads to a higher incidence in nephropathy and cystopathy in addition to more potentially visible and clinically measured atherosclerosis markers. The inflammatory proteins and cytokines involved in these reactions are thought to contribute not only to systemic inflammation but also to that within the bladder and urethra, catalyzing the onset of OAB.
The authors concluded “Our research is the first large-population epidemiology that revealed that diabetes mellitus and diabetes-related markers were remarkably associated with OAB in the American general adult population. We also observed systemic inflammation as an important mediator between diabetes-related markers and OAB, which will guide the direction for further study on OAB function and mechanism.”
The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.
