Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years

Abstract

metabolic syndrome with LUTS and ED was also evaluated. RESULTSThe mean ( SD , range) age of the patients was 38.9 (6.1, 20-45) years and the mean duration of diabetes was 2.8 (3.1, 0.5-20) years. Compared with controls, men with T2DM had a significantly mean ( SD ) higher IPSS, of 6.1 (5.8) vs 4.1 (4.6) ( P < 0.001), an increased of odds ratio (95% confidence interval) of having moderate to severe LUTS of 1.78 (1.12-2.84) ( P = 0.01), greater voiding volume of 376 (177) vs 326 (102) mL ( P = 0.04), a worse IIEF-5 score of 17.3 (6.4) vs 20.0 (3.8) ( P < 0.001), an increased of odds ratio of having moderate to severe ED of 3.5 (2.1-5.8) ( P < 0.001) but a similar maximum flow rate and postvoid residual. The IIEF-5 score was negatively correlated with the IPSS ( P < 0.0001, coefficient = − 0.23, 0.35-0.11) and glycosylated haemoglobin ( P = 0.02, coefficient = − 0.14, 0.26-0.01). In all, 156 (69%) patients met the criteria for metabolic syndrome. The mean age, duration of diabetes, glycosylated haemoglobin, IPSS, voided volume, maximum urinary flow rate and IIEF-5 score were similar between patients with and without metabolic syndrome. CONCLUSIONSMen with T2DM and aged < 45 years had more LUTS but a similar bladder emptying function than the controls. ED was highly prevalent and was associated with the severity of LUTS. Metabolic syndrome did not aggravate the severity of LUTS, emptying function or ED in the early stage of DM. OBJECTIVETo investigate the association of type 2 diabetes mellitus (T2DM) and metabolic syndrome with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in Taiwanese men aged < 45 years.

Impact of Testosterone Deficiency and Testosterone Therapy on Lower Urinary Tract Symptoms in Men with Metabolic Syndrome

“…The role of Met S components including WC, HDL, triglycerides, and diabetes on the risk of having moderate-to-severe LUTS have been reported [38919293949596]. More specifically, decreasing T levels have been associated with altered release of adenosine triphosphate (ATP) and acetylcholine (ACh) responsiveness to stretch, micturition reflex, and functional factors like bladder capacity [919798].…”

Hyperglycemia and Insulin Resistance and the Risk of BPH/LUTS: an Update of Recent Literature

“…A number of large high-quality studies have demonstrated the association of hyperglycemia and insulin resistance with LUTS [19, 32, 33]. In the past few years, multiple population-based reports linking diabetes with LUTS have been reported [7, 27, 31, 34•, 35, 36]. In the previously mentioned cohort from Michigan, Sarma et al found in a model adjusted for age and race at baseline men with diabetes without medication were more likely to report irritative symptoms (odds ratio (OR) 95 % confidence interval (95 % CI) 2.04 (1.08–3.86)) than men with diabetes on medications (OR 95 % CI 1.46 (1.02–2.08)) or men without diabetes (reference group).…”

“…Patients with diabetes were more likely to have irritative then storage symptoms. In a case-control cohort of Taiwanese men <45, those with diabetes compared to the control group had worse overall International Prostate Symptom Score (IPSS) (6.1 versus 4.1, p <0.001), worse storage (2.7 versus 2.0, p =0.02), and voiding subdomains (3.5 versus 2.1, p <0.001) [35]. Interestingly, overall quality of life, uroflow Q max, and post-void residual were no different between groups.…”

Connections between lower urinary tract symptoms related to benign prostatic enlargement and metabolic syndrome with its components: a systematic review and meta-analysis

“…International Prostate Symptom Score (IPSS) outcomes in patients with MetS were reported in 14 studies [5,6,8,[16][17][18][19][20][21][22][23][24][25][26][27]. There was statistically significant heterogeneity in these studies (…”

“…A total of 7 studies investigated the role of MetS components on the risk of having moderate-to-severe LUTS [5,21,24,30,31,33]. The impact of waist circumference (WC) was showed in three studies [5,30,31].…”