Correlation Between Advanced Glycation End-Products, Lower Urinary Tract Symptoms and Bladder Dysfunctions in Patients with type 2 Diabetes Mellitus.

OBJECTIVES: To explore whether serum and urinary advanced glycation end-products (AGEs) are related to urinary symptoms and bladder dysfunctions in diabetic patients.

METHODS: Forty-seven patients with type 2 Diabetes mellitus (T2DM) and lower urinary tract symptoms (LUTS) were enrolled. LUTS evaluation was performed by IPSS (International Prostatic Symptoms Score), QoL (quality of life), OAB (overactive bladder). ICI-SF (International Consultation on Incontinence - short form) quaestionneires; ultrasound examination, evaluation of postvoid residual (PVR), uroflowmetry, cystometry with pressure-flow study (PFS) were performed to detect bladder dysfunctions. Serum and urinary AGEs were quantified by ELISA method.

RESULTS: Patients were divided into four subgroups: (i) normal-detrusor-contractility + normal- detrusor-activity (1 ♂ [4.8%] and 4 ♀ [21%]), (ii) impaired-detrusor-contractility + normal-detrusor- activity (4 ♂ [19.1%] and 0 ♀), (iii) normal-detrusor-contractility + detrusor-overactivity (1 ♂ [4.8%] and 6 ♀ [31.6%]), (iv) impaired-detrusor-contractility + detrusor-overactivity (15 ♂ [71.4%] and 9 ♀ [47.4%]). Serum AGEs were 12.2 ± 5.5 in men and 10.4 ± 5.6 in women; urinary AGEs were 1.5 ± 1.1 in men and 2.5 ± 1.6 in women. Serum AGEs exhibited a positive correlation with IPSS (P < 0.05) and OAB-q scores (P < 0.01). Increased serum AGEs were associated with a significant reduction in the parameters reflecting impaired detrusor contractility with simultaneous reductions of urinary AGEs (P < 0.01). A greater correlation was observed between serum AGEs and subgroup 4 (P < 0.05).

CONCLUSIONS: Serum AGEs seem to be early markers of diabetic complications and appear to be related to LUTS and bladder dysfunctions.