University of Wisconsin School of Medicine and Public Heath, Madison, WI.
Department of Urology, University of Wisconsin, Madison, WI.
Urology. 2022 Jan;159:176-181. doi: 10.1016/j.urology.2021.09.006. Epub 2021 Sep 24.
To investigate the relationship between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) with functional and anatomic changes of the lower urinary tract with MRI.
The bladder and prostate of 95 subjects (56M, 39F) were segmented on T2-weighted pelvic MRI using Materialize Mimics 3D software. Bladder wall volume (BWV), post-void residual (PVR) and prostate volume (PV) were quantified from the 3D renderings. LUTS were quantified using validated questionnaires administered at the time of MRI. Wilcoxin rank sum, win ratio and chi-square tests were used to correlate symptom scores, BWV, PVR and PV in patients 1) without vs with MetS, 2) with mild (IPSS or UDI-6: 0-7) vs moderate-severe (IPSS: 8-35 or UDI-6: ≥8) and 3) normal vs enlarged prostates (>40cm). Multivariate linear regression was used to determine predictors for BWV, PVR and PV.
Men with MetS had increased BWV (66.8 vs 51.1cm, P = .003), higher PVR (69.1 vs 50.5cc, P= .05) and increased PV (67.2 vs 40.1cm, P= .01). Women without and with MetS had similar BWV, PVR and LUTS (P= .3-.78). There was no difference in prevalence of MetS, BWV, PVR or PV in men or women with mild vs moderate-severe LUTS (P = .26-.97). Men with enlarged prostates were more likely to have MetS (P = .003). There was no difference in BWV, PVR and LUTS for men with normal vs enlarged prostates (P= .44-.94). In men, BWV was highly correlated with MetS (P = .005) on regression analysis.
MetS leads to detrusor hypertrophy and may contribute to impaired bladder function, likely related to the effect on the prostate.
通过 MRI 研究代谢综合征（MetS）与下尿路症状（LUTS）与下尿路功能和解剖结构变化的关系。
使用 Materialize Mimics 3D 软件对 95 名受试者（56 名男性，39 名女性）的膀胱和前列腺进行 T2 加权盆腔 MRI 分割。从 3D 渲染中量化膀胱壁体积（BWV）、残余尿量（PVR）和前列腺体积（PV）。在 MRI 时使用经过验证的问卷量化 LUTS。Wilcoxin 秩和检验、赢率检验和卡方检验用于比较以下患者的症状评分、BWV、PVR 和 PV：1）无 MetS 与有 MetS，2）轻度（IPSS 或 UDI-6：0-7 分）与中重度（IPSS：8-35 分或 UDI-6：≥8 分），3）正常前列腺与增大前列腺（>40cm）。多元线性回归用于确定 BWV、PVR 和 PV 的预测因素。
患有 MetS 的男性 BWV 增加（66.8cm 比 51.1cm，P=0.003），PVR 更高（69.1cc 比 50.5cc，P=0.05），PV 增加（67.2cm 比 40.1cm，P=0.01）。无 MetS 和有 MetS 的女性 BWV、PVR 和 LUTS 相似（P=0.3-0.78）。男性轻度与中重度 LUTS 之间 MetS、BWV、PVR 或 PV 的患病率无差异（P=0.26-0.97）。前列腺增大的男性更有可能患有 MetS（P=0.003）。正常前列腺与增大前列腺的男性 BWV、PVR 和 LUTS 无差异（P=0.44-0.94）。在男性中，BWV 与 MetS 高度相关（P=0.005）。
MetS 导致逼尿肌肥大，并可能导致膀胱功能障碍，这可能与前列腺的影响有关。
