Metabolic syndrome is linked with an increased frequency and severity of
lower urinary tract symptoms, but weight loss surgery may lessen these
symptoms. The findings, which come from two studies published in BJU
International, indicate that urinary problems may be added to the
list of issues that can improve with efforts that address altered
metabolism.
Lower urinary tract symptoms related to urinary frequency and urgency,
bladder leakage, the need to urinate at night, and incomplete bladder
emptying are associated with obesity in both men and women. To see if
these symptoms might also be linked with metabolic syndrome (a cluster
of abnormalities including hypertension, high cholesterol, high blood
glucose levels, and abdominal obesity), François Desgrandchamps, MD,
PhD, of Saint-Louis Hospital in France, and his colleagues analyzed
information on 4666 male patients aged 55 to 100 years who consulted a
general practitioner during a 12-day period in 2009. Metabolic syndrome
was reported in 51.5 percent of the patients and 47 percent were treated
for lower urinary tract symptoms. There was a significant link between
metabolic syndrome and treated lower urinary tract symptoms. The risk to
be treated for lower urinary tract symptoms also increased with
increasing number of metabolic syndrome components. Also, among
individuals with lower urinary tract symptoms, symptoms were more severe
in those with metabolic syndrome. “The prevention of such modifiable
factors by the promotion of dietary changes and regular physical
activity practice may be of great interest for public health,” the
authors concluded.
In another study, researchers in New Zealand looked to see if weight
loss, or bariatric, surgery in obese individuals might lessen lower
urinary tract symptoms. It’s known that such surgery leads to
improvement or even resolution of a growing list of health problems
commonly associated with obesity such as type 2 diabetes, hypertension,
and sleep apnea. The investigators studied 72 patients who underwent the
surgery and were followed for one year. There was significant weight
loss and a reduction of body mass index after surgery. At six weeks, a
significant reduction in overall symptoms was noted, and this
improvement was sustained at one year. Also, insulin sensitivity
improved, indicating a lessening of individuals’ risk for developing
type 2 diabetes.
"Interestingly, in our study, improvements in lower urinary tract
symptoms were generally seen soon after surgery, and they did not seem
to be related to the time course or degree of weight loss,” said
co-author Richard Stubbs, MD, FRCS, FRACS, of Wakefield Hospital.
“Rather, there is an indication that the improvement in the urinary
symptoms is linked to improvements in insulin resistance, which are now
known to occur almost immediately following bariatric surgery."
The investigators noted that it is not a surprise that many symptoms and
medical problems associated with obesity improve when weight loss
occurs. “What has been a surprise and what is potentially so important
is that so many problems, including issues related to urinary function,
improve so quickly after bariatric surgery, even before great weight
loss has occurred,” said senior author Andrew Kennedy-Smith, FRACS, of
Wellington Hospital. "The relationship we have found between these
symptoms and insulin resistance is of considerable potential importance.
This finding calls into question our fundamental understanding of why
these problems arise, and therefore how they might best be treated."
Traditional thinking sugggests that obesity leads to insulin resistance,
but perhaps insulin resistance is itself a major cause of obesity.
Therefore, developing effective treatments for insulin resistance may
help address a whole raft of conditions, including lower urinary tract
symptoms.
Evelyn Martinez, 201-748-6358
Senior Publicist
sciencenewsroom@wiley.com