Do we have enough evidence to propose a urinary biomarker of bladder ischemia? A systematic review and meta-analysis

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-04-19 DOI:10.1111/luts.12443

Efstathios Papaefstathiou, Maria Papaioannou, Eirini Papaefstathiou, Aikaterini Apostolopoulou, Apostolos Apostolidis

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引用次数: 2

Abstract

Objective

Urinary bladder ischemia has been implicated in the pathogenesis of lower urinary tract symptoms (LUTS). However, research regarding urinary molecular markers for diagnosis and prognosis of pelvic ischemia is still premature, hindering further implementation in clinical practice. The aim of this study is to systematically appraise biomarkers associated with bladder ischemia detected in urine.

Methods

We performed a systematic review of PubMed/Medline, Embase, Web of Science, and the Cochrane Library in October 2021 according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. A subsequent reference search of retrieved articles was also performed. The identified reports were reviewed according to Systematic Review Center for Laboratory Animal Experimentation's risk-of-bias tool for animal studies.

Results

Eight publications were selected for this analysis. The included reports used 8-hydroxy-2′-deoxyguanosine (8-OHdG) (in eight studies) as urinary marker of bladder ischemia. The pooled mean difference for urinary 8-OHdG levels between study and control groups was 13.73 ng/mg creatinine (95% CI, 9.79-17.67; P < .001; I² = 69%) for rat studies and 3.71 ng/mg creatinine (95% CI, 2.91-4.51; P < .001; I² = 94%) for rabbit studies. The result remained statistically significant favoring the control group independent of the type of intervention used to achieve bladder ischemia. Regarding secondary outcomes, mean voided volume and micturition interval were significantly lower in the ischemia group.

Conclusion

The lack of human randomized controlled trials is a major limitation. 8-OHdG is a urinary biomarker to be investigated in future studies for diagnosis and prognosis of LUTS in patients with vascular injury or bladder outlet obstruction.

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我们是否有足够的证据来提出膀胱缺血的尿液生物标志物?系统回顾和荟萃分析

目的膀胱缺血与下尿路症状的发病机制有关。然而，关于尿液分子标志物对盆腔缺血的诊断和预后的研究尚不成熟，阻碍了临床实践的进一步实施。本研究的目的是系统地评估尿液中检测到的与膀胱缺血相关的生物标志物。方法根据系统评价和meta分析首选报告项目(PRISMA)声明，我们于2021年10月对PubMed/Medline、Embase、Web of Science和Cochrane Library进行了系统评价。随后对检索到的文章进行参考检索。根据实验室动物实验系统评价中心的动物研究偏倚风险工具对确定的报告进行了审查。结果选取8篇文献进行分析。纳入的报告使用8-羟基-2 ' -脱氧鸟苷(8-OHdG)作为膀胱缺血的尿标志物(8项研究)。研究组和对照组尿8-OHdG水平的汇总平均差异为13.73 ng/mg肌酐(95% CI, 9.79-17.67;P < .001;I2 = 69%)，肌酐为3.71 ng/mg (95% CI, 2.91-4.51;P < .001;I2 = 94%)。结果仍然具有统计学意义，与用于实现膀胱缺血的干预类型无关，有利于对照组。至于次要结果，缺血组的平均排尿量和排尿间隔明显缩短。结论缺乏人体随机对照试验是主要的局限性。8-OHdG是在血管损伤或膀胱出口梗阻患者的LUTS诊断和预后方面有待进一步研究的尿液生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.