Adegbehingbe Olugbenga Olumide, Ayoola Oluwagbemiga, Soyoye David, Adegbehingbe Anthonia
Radiology, Afe Babalola University Multisystem Hospital, Nigeria.
Radiology, Obafemi Awolowo University Teaching Hospital Complex, Nigeria.
J Ultrason. 2022 Feb 8;22(88):e12-e20. doi: 10.15557/JoU.2022.0003. eCollection 2022 Mar.
Diabetes mellitus is an increasing health challenge with accompanying urological complications. Over 50% of men and women with diabetes have bladder dysfunction. According to the current understanding of bladder dysfunction, it refers to a progressive condition encompassing a broad spectrum of lower urinary tract symptoms including urinary urgency, frequency, nocturia, and incontinence. Urinary bladder dysfunction has been classically described as diminished bladder sensation, poor contractility, and increased post-void residual urine, termed bladder cystopathy. Ultrasonography of the urinary bladder, which is a cheap, safe, radiation free, non-invasive and reliable imaging modality, may help to identify diabetes mellitus patients prone to develop urinary bladder dysfunction.
The study population comprised 80 diabetic subjects recruited from the diabetic outpatient clinic and another 80 age- and sex-matched asymptomatic control subjects. Ultrasound scan of their urinary bladder wall was performed using a curvilinear transducer to determine the thickness and other sonographic features.
Out of the 80 diabetic subjects, 30 (37.5%) were males, while 50 (62.5%) were females; of 80 non-diabetic control subjects, 40 (50%) were males and 40 (50%) were females. The mean age of the diabetic subjects was 59.5 ± 10.4 years with a range of 40-82 years, while that of the controls was 60.2 ± 7.4 years with a range of 40-85 years. There was no statistically significant difference ( = 0.637) between the mean age of the diabetic and control subjects. The mean urinary bladder wall thickness in the diabetics was greater than in the non-diabetics in the study subjects. There was a statistically significant difference between the urinary bladder thickness of diabetic subjects and the control group ( <0.001). The mean urinary bladder wall thickness of the male and female subjects included in this study was 2.84 ± 1.31 mm and 2.9 ± 1.37 mm, respectively, with no statistically significant difference between them ( = 0.159). It was statistically significant between diabetic men and women ( = 0.027). Using Spearman's rank correlation to test the relationship between the glycaemic haemoglobin level of diabetic subjects and urinary bladder wall thickness, it was revealed that there was no correlation between these variables (Spearman's rho = 0.119, = 0.309). The relationship between the urinary bladder volume of diabetic subjects and their mean urinary bladder wall thickness showed no correlation either (Spearman's rho = -0.009, = 0.937). Only gender was a statistically significant predictor of urinary bladder wall thickness among other variables.
Mean bladder wall thickness in patients with type 2 diabetes mellitus was greater than in the control subjects, and also greater in diabetic men compared to diabetic women, but the difference did not attain statistical significance. Urinary bladder wall thickness of the diabetics did not correlate with their glycaemic haemoglobin levels. Only gender was found to be a predictor of bladder wall thickness.
糖尿病是一项日益严峻的健康挑战，并伴有泌尿系统并发症。超过50%的糖尿病男性和女性存在膀胱功能障碍。根据目前对膀胱功能障碍的理解，它是一种进行性疾病，包括一系列广泛的下尿路症状，如尿急、尿频、夜尿症和尿失禁。膀胱功能障碍传统上被描述为膀胱感觉减退、收缩力差和排尿后残余尿量增加，即膀胱膀胱病。膀胱超声检查是一种廉价、安全、无辐射、非侵入性且可靠的成像方式，有助于识别易发生膀胱功能障碍的糖尿病患者。
研究人群包括从糖尿病门诊招募的80名糖尿病受试者以及另外80名年龄和性别匹配的无症状对照受试者。使用曲线换能器对他们的膀胱壁进行超声扫描，以确定厚度和其他超声特征。
80名糖尿病受试者中，30名（37.5%）为男性，50名（62.5%）为女性；80名非糖尿病对照受试者中，40名（50%）为男性，40名（50%）为女性。糖尿病受试者的平均年龄为59.5±10.4岁，范围为40 - 82岁，而对照组的平均年龄为60.2±7.4岁，范围为40 - 85岁。糖尿病受试者和对照受试者的平均年龄之间无统计学显著差异（P = 0.637）。研究对象中糖尿病患者的平均膀胱壁厚度大于非糖尿病患者。糖尿病受试者与对照组的膀胱厚度之间存在统计学显著差异（P<0.001）。本研究纳入的男性和女性受试者的平均膀胱壁厚度分别为2.84±1.31毫米和2.9±1.37毫米，两者之间无统计学显著差异（P = 0.159）。糖尿病男性和女性之间存在统计学显著差异（P = 0.027）。使用Spearman等级相关性检验糖尿病受试者的糖化血红蛋白水平与膀胱壁厚度之间的关系，结果显示这些变量之间无相关性（Spearman相关系数rho = 0.119，P = 0.309）。糖尿病受试者的膀胱容量与其平均膀胱壁厚度之间的关系也无相关性（Spearman相关系数rho = -0.009，P = 0.937）。在其他变量中，只有性别是膀胱壁厚度的统计学显著预测因素。
2型糖尿病患者的平均膀胱壁厚度大于对照受试者，且糖尿病男性大于糖尿病女性，但差异未达到统计学显著性。糖尿病患者的膀胱壁厚度与其糖化血红蛋白水平无关。仅发现性别是膀胱壁厚度的预测因素。
