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-detrusorcontractility+ 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.