Abstract：
OBJECTIVE: Diabetes is highly prevalent worldwide, with an estimated 536 million living with diabetes in 2021, and that number projected to increase to 783 million by 2045. Diabetic bladder dysfunction is thought to affect up to 60%-90% of individuals with diabetes and can significantly impact quality of life. Despite the prevalence of diabetic bladder dysfunction, the exact pathophysiological mechanism, and resulting clinical presentation, remains debated. Our objective was to compare urodynamic parameters between diabetic and nondiabetic women, assessing the impact of various markers of diabetes severity on bladder function.
METHODS: A retrospective chart review was conducted on female patients aged 18 and above who underwent urodynamic studies at a single tertiary care university hospital system from 2014 to 2020. Patients were categorized based on diabetes status, and diabetes severity including duration of disease, hemoglobin A1c levels, insulin dependence, and markers of end-organ dysfunction. Urodynamic variables, including compliance, bladder voided efficiency, bladder contractility index, postvoid residual, maximum flow rate, capacity, voided volume, and detrusor overactivity, were assessed by two independent reviewers. Statistical analyses were performed to assess the impact of diabetes and diabetic severity on urodynamic parameters.
RESULTS: A total of 652 female patients were included in the study, of which, 152 (23.3%) had diabetes, with an average duration of diagnosis of 82.3 months. Diabetic women were older and had higher body mass index compared to nondiabetic women. Diabetic retinopathy and neuropathy were present in 18% and 54.6% of diabetic patients, respectively. Significant differences in urodynamic parameters were observed between diabetic and nondiabetic women, with diabetic women showing higher rates of detrusor overactivity (p = 0.01), particularly associated with increasing BMI (p = 0.03). However, classic markers of diabetes severity including duration, as well as markers of end-organ damage, showed mixed associations with urodynamic changes.
CONCLUSIONS: Despite the prevalence of diabetic bladder dysfunction and its impact on patient quality of life, the exact mechanisms and clinical presentation remain elusive. Our study highlights the significant differences in urodynamic parameters between diabetic and nondiabetic women, emphasizing the need for further research into the relationship between diabetes and diabetic bladder dysfunction.
METHODS: A retrospective chart review was conducted on female patients aged 18 and above who underwent urodynamic studies at a single tertiary care university hospital system from 2014 to 2020. Patients were categorized based on diabetes status, and diabetes severity including duration of disease, hemoglobin A1c levels, insulin dependence, and markers of end-organ dysfunction. Urodynamic variables, including compliance, bladder voided efficiency, bladder contractility index, postvoid residual, maximum flow rate, capacity, voided volume, and detrusor overactivity, were assessed by two independent reviewers. Statistical analyses were performed to assess the impact of diabetes and diabetic severity on urodynamic parameters.
RESULTS: A total of 652 female patients were included in the study, of which, 152 (23.3%) had diabetes, with an average duration of diagnosis of 82.3 months. Diabetic women were older and had higher body mass index compared to nondiabetic women. Diabetic retinopathy and neuropathy were present in 18% and 54.6% of diabetic patients, respectively. Significant differences in urodynamic parameters were observed between diabetic and nondiabetic women, with diabetic women showing higher rates of detrusor overactivity (p = 0.01), particularly associated with increasing BMI (p = 0.03). However, classic markers of diabetes severity including duration, as well as markers of end-organ damage, showed mixed associations with urodynamic changes.
CONCLUSIONS: Despite the prevalence of diabetic bladder dysfunction and its impact on patient quality of life, the exact mechanisms and clinical presentation remain elusive. Our study highlights the significant differences in urodynamic parameters between diabetic and nondiabetic women, emphasizing the need for further research into the relationship between diabetes and diabetic bladder dysfunction.
摘要：
目的：糖尿病在全球范围内非常普遍，到2021年，估计有5.36亿人患有糖尿病，到2045年，这一数字预计将增加到7.83亿。糖尿病性膀胱功能障碍被认为影响高达60%-90%的糖尿病患者,并且可以显著影响生活质量。尽管糖尿病膀胱功能障碍的患病率，确切的病理生理机制，以及由此产生的临床表现，仍在辩论。我们的目的是比较糖尿病和非糖尿病妇女的尿动力学参数，评估糖尿病严重程度的各种标志物对膀胱功能的影响。
方法：对2014年至2020年在一家三级护理大学系统接受尿动力学研究的18岁及以上女性患者进行了回顾性图表回顾。根据糖尿病状态对患者进行分类，和糖尿病的严重程度，包括疾病的持续时间，血红蛋白A1c水平，胰岛素依赖，和终末器官功能障碍的标志物。尿动力学变量，包括合规性，膀胱排尿效率，膀胱收缩指数,后空隙残留，最大流量,容量,作废的音量，逼尿者过度活动，由两名独立审稿人评估。进行统计分析以评估糖尿病和糖尿病严重程度对尿动力学参数的影响。
结果：本研究共纳入652例女性患者，其中，152人（23.3%）患有糖尿病，平均诊断时间为82.3个月。与非糖尿病妇女相比，糖尿病妇女年龄更大，体重指数更高。18％和54.6％的糖尿病患者存在糖尿病视网膜病变和神经病变，分别。观察到糖尿病和非糖尿病女性之间的尿动力学参数存在显着差异，糖尿病女性逼尿肌过度活动率较高(p=0.01)，特别是与BMI增加相关（p=0.03）。然而,糖尿病严重程度的经典标记，包括持续时间，以及终末器官损伤的标记，显示与尿动力学变化的混合关联。
结论：尽管糖尿病膀胱功能障碍的患病率及其对患者生活质量的影响，确切的机制和临床表现仍然难以捉摸.我们的研究强调了糖尿病和非糖尿病女性尿动力学参数的显著差异，强调需要进一步研究糖尿病与糖尿病膀胱功能障碍之间的关系。
方法：对2014年至2020年在一家三级护理大学系统接受尿动力学研究的18岁及以上女性患者进行了回顾性图表回顾。根据糖尿病状态对患者进行分类，和糖尿病的严重程度，包括疾病的持续时间，血红蛋白A1c水平，胰岛素依赖，和终末器官功能障碍的标志物。尿动力学变量，包括合规性，膀胱排尿效率，膀胱收缩指数,后空隙残留，最大流量,容量,作废的音量，逼尿者过度活动，由两名独立审稿人评估。进行统计分析以评估糖尿病和糖尿病严重程度对尿动力学参数的影响。
结果：本研究共纳入652例女性患者，其中，152人（23.3%）患有糖尿病，平均诊断时间为82.3个月。与非糖尿病妇女相比，糖尿病妇女年龄更大，体重指数更高。18％和54.6％的糖尿病患者存在糖尿病视网膜病变和神经病变，分别。观察到糖尿病和非糖尿病女性之间的尿动力学参数存在显着差异，糖尿病女性逼尿肌过度活动率较高(p=0.01)，特别是与BMI增加相关（p=0.03）。然而,糖尿病严重程度的经典标记，包括持续时间，以及终末器官损伤的标记，显示与尿动力学变化的混合关联。
结论：尽管糖尿病膀胱功能障碍的患病率及其对患者生活质量的影响，确切的机制和临床表现仍然难以捉摸.我们的研究强调了糖尿病和非糖尿病女性尿动力学参数的显著差异，强调需要进一步研究糖尿病与糖尿病膀胱功能障碍之间的关系。
