Abstract：
OBJECTIVE: The aim of this systematic review is to assess urinary biomarkers studied in children with neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD).
METHODS: The systematic review was conducted in accordance with the PRISMA guidelines. The screening was performed on PUBMED without any publication date limitation. Only original articles were included. Parameters related to the following topics were obtained: study design, characteristics of participants, number of participants, age, control group, types of biomarkers, measurement technique in urine, subgroup analysis, urodynamic findings, and outcome. Dutch Cochrane Checklist (DCC) and level of evidence by EBRO platform were used for quality assessment. Meta-analysis was performed with the Comprehensive Meta-Analysis Version 4 program.
RESULTS: A total of 494 studies were screened and 16 studies were included. 11 (68.75%) were conducted in children with non-neurogenic LUTD and 5 (31.25%) neurogenic LUTD. Nerve growth factor (NGF) was evaluated in 12 studies, brain-derived neurotrophic factor (BDNF) in 5, Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) in 2, transforming growth factor beta-1 (TGF Beta-1) in 2, neutrophil gelatinase-associated lipocalin (NGAL) in 1, and Aquaporin-2 in 1. According to DCC, 10 (62.5%) articles were evaluated on 4 (37.5%) items and 4 articles on 5 items. The average score was 3.91+/-0.56. The level of evidence was found as B for 13 (81.25%) articles and C for 3 (18.75%). In meta-analysis, urinary NGF levels in children with non-neurogenic LUTS were significantly higher than in the healthy control group (Hedges\'s g = 1.867, standard error = 0.344, variance = 0.119, p = 0.0001).
CONCLUSIONS: Urinary biomarkers are promising for the future with their noninvasive features. However, prospective studies with larger sample sizes are needed to better understand the potential of urinary biomarkers to reflect urodynamic and clinical findings in children with LUTD.
METHODS: The systematic review was conducted in accordance with the PRISMA guidelines. The screening was performed on PUBMED without any publication date limitation. Only original articles were included. Parameters related to the following topics were obtained: study design, characteristics of participants, number of participants, age, control group, types of biomarkers, measurement technique in urine, subgroup analysis, urodynamic findings, and outcome. Dutch Cochrane Checklist (DCC) and level of evidence by EBRO platform were used for quality assessment. Meta-analysis was performed with the Comprehensive Meta-Analysis Version 4 program.
RESULTS: A total of 494 studies were screened and 16 studies were included. 11 (68.75%) were conducted in children with non-neurogenic LUTD and 5 (31.25%) neurogenic LUTD. Nerve growth factor (NGF) was evaluated in 12 studies, brain-derived neurotrophic factor (BDNF) in 5, Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) in 2, transforming growth factor beta-1 (TGF Beta-1) in 2, neutrophil gelatinase-associated lipocalin (NGAL) in 1, and Aquaporin-2 in 1. According to DCC, 10 (62.5%) articles were evaluated on 4 (37.5%) items and 4 articles on 5 items. The average score was 3.91+/-0.56. The level of evidence was found as B for 13 (81.25%) articles and C for 3 (18.75%). In meta-analysis, urinary NGF levels in children with non-neurogenic LUTS were significantly higher than in the healthy control group (Hedges\'s g = 1.867, standard error = 0.344, variance = 0.119, p = 0.0001).
CONCLUSIONS: Urinary biomarkers are promising for the future with their noninvasive features. However, prospective studies with larger sample sizes are needed to better understand the potential of urinary biomarkers to reflect urodynamic and clinical findings in children with LUTD.
摘要：
目的：本系统评价的目的是评估患有神经源性和非神经源性下尿路功能障碍（LUTD）的儿童的尿生物标志物。
方法：系统评价按照PRISMA指南进行。在PUBMED上进行筛选，没有任何发布日期限制。仅包含原始文章。获得了与以下主题相关的参数：研究设计，参与者的特点，参与人数,年龄,对照组,生物标志物的类型，尿液测量技术，亚组分析，尿动力学发现，和结果。使用荷兰Cochrane清单（DCC）和EBRO平台的证据水平进行质量评估。使用综合荟萃分析第4版程序进行荟萃分析。
结果：共筛选494项研究，纳入16项研究。11例（68.75％）在非神经源性LUTD儿童和5例（31.25％）神经源性LUTD儿童中进行。神经生长因子（NGF）在12项研究中进行了评估，脑源性神经营养因子（BDNF）5，金属蛋白酶组织抑制剂2（TIMP-2）2，转化生长因子β-1（TGFβ-1）2，中性粒细胞明胶酶相关脂质运载蛋白（NGAL）1和水通道蛋白21。根据DCC,对10篇(62.5%)文章进行了4篇(37.5%)和5篇4篇文章的评价。平均得分为3.91+/-0.56。13篇（81.25％）的证据水平为B，3篇（18.75％）的证据水平为C。在荟萃分析中，非神经源性LUTS患儿的尿NGF水平明显高于健康对照组(Hedges\sg=1.867,标准误差=0.344,方差=0.119,p=0.0001).
结论：尿生物标志物具有非侵入性的特点，在未来是有希望的。然而,需要更大样本量的前瞻性研究,以更好地了解尿生物标志物反映LUTD患儿尿动力学和临床表现的潜力.
方法：系统评价按照PRISMA指南进行。在PUBMED上进行筛选，没有任何发布日期限制。仅包含原始文章。获得了与以下主题相关的参数：研究设计，参与者的特点，参与人数,年龄,对照组,生物标志物的类型，尿液测量技术，亚组分析，尿动力学发现，和结果。使用荷兰Cochrane清单（DCC）和EBRO平台的证据水平进行质量评估。使用综合荟萃分析第4版程序进行荟萃分析。
结果：共筛选494项研究，纳入16项研究。11例（68.75％）在非神经源性LUTD儿童和5例（31.25％）神经源性LUTD儿童中进行。神经生长因子（NGF）在12项研究中进行了评估，脑源性神经营养因子（BDNF）5，金属蛋白酶组织抑制剂2（TIMP-2）2，转化生长因子β-1（TGFβ-1）2，中性粒细胞明胶酶相关脂质运载蛋白（NGAL）1和水通道蛋白21。根据DCC,对10篇(62.5%)文章进行了4篇(37.5%)和5篇4篇文章的评价。平均得分为3.91+/-0.56。13篇（81.25％）的证据水平为B，3篇（18.75％）的证据水平为C。在荟萃分析中，非神经源性LUTS患儿的尿NGF水平明显高于健康对照组(Hedges\sg=1.867,标准误差=0.344,方差=0.119,p=0.0001).
结论：尿生物标志物具有非侵入性的特点，在未来是有希望的。然而,需要更大样本量的前瞻性研究,以更好地了解尿生物标志物反映LUTD患儿尿动力学和临床表现的潜力.
