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脂联素可以作为尿动力学逼尿肌活动低下的一个良好预测指标:一项男性下尿路症状患者的前瞻性研究。

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

机构信息

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

出版信息

World J Urol. 2023 Apr;41(4):1117-1124. doi: 10.1007/s00345-023-04341-y. Epub 2023 Feb 24.

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.

摘要

目的

研究循环脂联素(一种可能的抗动脉粥样硬化效应标志物)是否可作为男性下尿路症状(LUTS)患者膀胱功能(尤其是逼尿肌活动不足(DU))的有用预测指标。

方法

130 例未经治疗的非神经源性 LUTS 男性患者前瞻性地根据是否存在 DU 分为两组(DU 组和非 DU 组),DU 的定义为膀胱收缩指数<100 和膀胱出口梗阻指数(BOOI)<40。采用单变量、二项逻辑回归和受试者工作特征(ROC)曲线分析评估血清脂联素水平对尿动力学功能(包括 DU)的影响。

结果

共分析了 118 例男性患者的数据,39 例(33.0%)存在 DU(DU 组),79 例(67.0%)无 DU(非 DU 组)。DU 组血清脂联素中位数明显低于非 DU 组(6.2 比 12.6μg/mL,p<0.001)。在二项逻辑回归分析中,较低的脂联素、较小的前列腺内突和较低的膀胱排空效率是与 DU 相关的显著因素。在 ROC 分析中,血清脂联素对 DU 诊断的曲线下面积值最高(0.849)。此外,血清脂联素水平 7.9μg/mL 可作为 DU 的截断值,其敏感性和特异性分别为 79%和 90%。

结论

血清脂联素水平与膀胱功能显著相关,可能是预测 LUTS 男性 DU 的有用标志物。

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