Kadınlarda Visseral Adipozite İndeksi İle Aşırı Aktif Mesane Semptomları Arasındaki İlişkinin Değerlendirilmesi

Year 2020, Volume: 12 Issue: 2, 150 - 156, 23.07.2020

Emre Karabay Nejdet Karşıyakalı Kemal Kayar Levent Verim Çağatay Tosun Ömer Yücebaş

Abstract

Amaç: Kadın hastalardaki aşırı aktif mesane semptomları ile visseral adipozite indeksi arasında ilişki olup olmadığını araştırmak.

Gereç ve Yöntemler: Ocak 2017 – Haziran 2019 tarihleri arasında kliniğimizde ürodinamik inceleme yapılan hastaların medikal kayıtları retrospektif olarak tarandı. Aşırı Aktif Mesane Sorgulama Formu (OAB-V8) toplam skoru ≥8 ve ürodinamik olarak dolum fazında detrüsör aşırı aktiviteleri gözlemlenen hastalar ile semptom skoru düşük olan ve detrüsör aşırı aktiviteleri gözlenmeyen hastaların demografik, biyokimyasal ve ürodinamik özellikleri istatistiksel olarak karşılaştırıldı.

Bulgular: Çalışmaya yaş ortalaması 48,66±18,58 yıl olan toplam 58 kadın olgu dahil edildi. Olguların 28 (%48,3)’i aşırı aktif mesane grubunda (Grup 1) yer alırken, 30 (%51,7)’u kontrol grubunda (Grup 2) yer aldı. Gruplar arasında ortalama yaş dağılımları açısından istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Grup 1’de yer alan hasta ağırlığı ortalama değerinin Grup 2’de yer alan hastalara göre istatistiksel olarak anlamlı şekilde daha yüksek olduğu izlendi (p=0,041). Grup 1’de visseral adipozite indeksi (VAİ) ortanca değeri [3,3 (0,7 – 14,5)] Grup 2’deki VAİ ortanca değerinden [2,5 (1,2 – 11,7)] daha yüksek olmasına rağmen gruplar arasında istatistiksel olarak anlamlı farklılık görülmedi (p>0,05).

Sonuç: Aşırı aktif mesane semptomları olan kadınlarda VAİ ortanca değeri aşırı aktif mesane semptomları olmayan kadınlara göre daha yüksek olarak izlense de gruplar arasında istatistiksel olarak anlamlı farklılık görülmemiştir.

Keywords

aşırı aktif mesane, ürodinami, visseral adipozite indeksi

Evaluation of relationship between visceral adiposity ındex and overactivate bladder symptoms in females

Abstract

Objective: To investigate the relationship between overactive bladder syndrome and visceral adiposity index (VAI).
Material and Methods: The results of urodynamic tests performed between January 2017 and June 2019 were evaluated retrospectively. Patients with a total “Overactive Bladder Symptom Score Questionnaire” (OAB-V8) score of 8 and above with overactivated detrusor muscle during the filling phase of urodynamic studies and patients with lower scores of OAB-V8 without overactivation in detrusor muscle were compared in terms of demographic features, biochemical parameters and VAI values. 
Results: The study group comprised of 58 female subjects with a mean age of 48,66±18,58 years. 48,3% (n=28) of the patients were included in the overactive bladder group while 51,7% (n=30) were in the control group. No significant difference was observed between two groups in term of age (p>0,05). Weight measures showed significant difference between two groups and the weight measures of the patients in overactivated bladder group were found to be higher than in healthy controls (p=0,041; p<0,05). Although no significant difference was observed in VAI values between two groups (p>0,05); the VAI values were shown to be higher in overactivated bladder patients than in healthy controls (median [2,5 (1,2 – 11,7)] vs [3,3 (0,7 – 14,5); respectively).
Conclusion: In our study, median VAI values were shown to be higher in females with overactivated bladder symptoms, however the results were not statistically significant. 

Keywords

overactive bladder, urodynamics, visceral adiposity index

References

• 1. Haylen BT, de Ridder D, Freeman RM et al. (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29 (1):4-20. doi:10.1002/nau.20798
• 2. Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P (2011) Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int 108 (7):1132-1138. doi:10.1111/j.1464-410X.2010.09993.x
• 3. Kim SY, Bang W, Choi HG (2017) Analysis of the prevalence of and factors associated with overactive bladder in adult Korean women. PLoS One 12 (9):e0185592. doi:10.1371/journal.pone.0185592
• 4. Link CL, Steers WD, Kusek JW, McKinlay JB (2011) The association of adiposity and overactive bladder appears to differ by gender: results from the Boston Area Community Health survey. J Urol 185 (3):955-963. doi:10.1016/j.juro.2010.10.048 5. Uzun H, Yilmaz A, Kemik A, Zorba OU, Kalkan M (2012) Association of insulin resistance with overactive bladder in female patients. Int Neurourol J 16 (4):181-186. doi:10.5213/inj.2012.16.4.181
• 6. Aung K, Lorenzo C, Hinojosa MA, Haffner SM (2014) Risk of developing diabetes and cardiovascular disease in metabolically unhealthy normal-weight and metabolically healthy obese individuals. J Clin Endocrinol Metab 99 (2):462-468. doi:10.1210/jc.2013-2832
• 7. Després JP (2006) Intra-abdominal obesity: an untreated risk factor for Type 2 diabetes and cardiovascular disease. J Endocrinol Invest 29 (3 Suppl):77-82
• 8. Ferreira FG, Juvanhol LL, Silva-Costa A, Longo GZ (2020) The mediating role of visceral adiposity in the relationship among schooling, physical inactivity, and unhealthy metabolic phenotype. Am J Hum Biol:e23425. doi:10.1002/ajhb.23425
• 9. Amato MC, Giordano C (2013) Clinical indications and proper use of Visceral Adiposity Index. Nutr Metab Cardiovasc Dis 23 (8):e31-32. doi:10.1016/j.numecd.2013.04.006
• 10. Coyne K, Revicki D, Hunt T, Corey R, Stewart W, Bentkover J et al. (2002) Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual Life Res 11 (6):563-574. doi:10.1023/a:1016370925601
• 11. Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM (2003) The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int 92 (1):69-77. doi:10.1046/j.1464-410x.2003.04271.x
• 12. McGrother CW, Donaldson MM, Thompson J, Wagg A, Tincello DG, Manktelow BN (2012) Etiology of overactive bladder: a diet and lifestyle model for diabetes and obesity in older women. Neurourol Urodyn 31 (4):487-495. doi:10.1002/nau.21200
• 13. Chancellor MB, Oefelein MG, Vasavada S (2010) Obesity is associated with a more severe overactive bladder disease state that is effectively treated with once-daily administration of trospium chloride extended release. Neurourol Urodyn 29 (4):551-554. doi:10.1002/nau.20787
• 14. Richter HE, Creasman JM, Myers DL, Wheeler TL, Burgio KL, Subak LL (2008) Urodynamic characterization of obese women with urinary incontinence undergoing a weight loss program: the Program to Reduce Incontinence by Diet and Exercise (PRIDE) trial. Int Urogynecol J Pelvic Floor Dysfunct 19 (12):1653-1658. doi:10.1007/s00192-008-0694-8
• 15. Handa VL, Pierce CB, Muñoz A, Blomquist JL (2015) Longitudinal changes in overactive bladder and stress incontinence among parous women. Neurourol Urodyn 34 (4):356-361. doi:10.1002/nau.22583
• 16. Carroll JF, Chiapa AL, Rodriquez M, Phelps DR, Cardarelli KM, Vishwanatha JK et al. (2008) Visceral fat, waist circumference, and BMI: impact of race/ethnicity. Obesity (Silver Spring) 16 (3):600-607. doi:10.1038/oby.2007.92
• 17. Dursun M, Otunctemur A, Ozbek E, Sahin S, Besiroglu H, Koklu I (2014) Stress urinary incontinence and visceral adipose index: a new risk parameter. Int Urol Nephrol 46 (12):2297-2300. doi:10.1007/s11255-014-0832-9
• 18. Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M et al. (2010) Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes care 33 (4):920-922
• 19. Eren H, Horsanalı MO, Ozbek E (2019) Postmenozal kadınlarda visseral adipozite indeksi ve aşırı aktif mesane: Yeni bir risk belirteci. Kocaeli Tıp Dergisi 8 (2):84-89
• 20. Bunn F, Kirby M, Pinkney E, Cardozo L, Chapple C, Chester K et al. (2015) Is there a link between overactive bladder and the metabolic syndrome in women? A systematic review of observational studies. Int J Clin Pract 69 (2):199-217. doi:10.1111/ijcp.12518
• 21. Uzun H, Zorba O (2012) Metabolic syndrome in female patients with overactive bladder. Urology 79 (1):72-75. doi:10.1016/j.urology.2011.08.050