https://doi.org/10.4081/aiua.2024.12367

Role of urine glycosaminoglycan levels in the diagnosis and follow-up in men with lower urinary tract symptoms

Vol. 96 No. 2 (2024)
Submitted: February 8, 2024
Accepted: February 18, 2024
Published: May 9, 2024
GAG, bladder outlet obstruction, overactive bladder, biomarker
Abstract Views: 504
PDF: 174
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Authors

Hasan Riza Aydin
hrizaaydin@gmail.com
https://orcid.org/0000-0002-6272-6929
Department of Urology, Trabzon Faculty of Medicine, University of Health Sciences, Trabzon, Turkey.
Cagri Akin Sekerci
Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
Huseyin Kocakgol
https://orcid.org/0000-0002-7683-3282
Department of Urology, Erzurum Training and Research Hospital, Erzurum, Turkey.
Banu Isbilen Basok
https://orcid.org/0000-0002-1483-997X
Department of Biochemistry, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey.
Fevzi Bedir
https://orcid.org/0000-0003-0506-0777
Department of Urology, Erzurum Training and Research Hospital, Erzurum, Turkey.
Ahmet Ozgur Guctas
https://orcid.org/0000-0001-8429-0778
Department of Urology, Marmara Pendik Training and Research Hospital, Istanbul, Turkey.
Firat Akdeniz
https://orcid.org/0000-0003-2331-4945
Medical Park Hospital, Trabzon, Turkey.
Hamit Zafer Aksoy
Department of Urology, Trabzon Faculty of Medicine, University of Health Sciences, Trabzon, Turkey.
Mehmet Akif Ramazanoglu
Department of Urology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.
Yiloren Tanidir
Department of Urology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.

Objective: The aim of this study was to investigate whether urinary glycosaminoglycans (GAG) levels reflect clinical status in men with lower urinary tract symptoms and if they could be used as a marker in management of overactive bladder (OAB).
Methods: A total of 34 patients were recruited who were admitted with LUTS and diagnosed as having clinically bladder outlet obstruction (BOO) due to prostate enlargement. These newly diagnosed, never treated patients underwent routine investigation, consisting of history, physical examination, PSA, ultrasound, uroflowmetry, assessment of symptoms scored by both International Prostate Symptom Score (IPSS) and Marmara- Overactive Bladder Questionnaire (M-OBQ). The patients were divided into two groups as those with an initial M-OBQ score < 12 (group 1) and ≥ 13 (group 2). Alfa blocker was initiated in eligible patients. Further evaluations included prostate volume measurement, pre- and post-treatment urinary GAG levels, IPSS and M-QAOB values and maximum urine flow rate (Qmax).
Results: Before treatment, urinary GAG level was 21.5 mg/gCr (6.1-45.5) in Group 1, and 23.35 mg/gCr (15.6-32.6) in Group 2 (p =0.845). After the treatment, the GAG level in Group 1 and Group 2 were found to be 19.8 mg/gCr (7.4-70.5) and 18 (7.6- 41.7), respectively (p = 0.511). No difference in GAG levels was found in subgroup analysis for patients with or without OAB.
Conclusions: In recent years, there have been many studies investigating the relationship between LUTS and urinary markers. However, in our prospective study, no relationship was found between pre- and post- treatment urinary GAG levels in patients with LUTS with or without OAB.

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Citations

Crossref
Scopus
Google Scholar
Europe PMC
Robertson C, Link CL, Onel E, et al. The impact of lower urinary tract symptoms and comorbidities on quality of life: the BACH and UREPIK studies. BJU Int. 2007; 99:347-54. DOI: https://doi.org/10.1111/j.1464-410X.2007.06609.x
Chapple CR, Wein AJ, Abrams P, et al. Lower urinary tract symptoms revisited: a broader clinical perspective. Eur Urol. 2008; 54:563-9. DOI: https://doi.org/10.1016/j.eururo.2008.03.109
Speakman M, Kirby R, Doyle S, Ioannou C. Burden of male lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) - focus on the UK. BJU Int. 2015; 115:508-19. DOI: https://doi.org/10.1111/bju.12745
Barry MJ, Fowler FJ, Jr., O'Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992; 148:1549-57. DOI: https://doi.org/10.1016/S0022-5347(17)36966-5
Reynard JM, Yang Q, Donovan JL, et al. The ICS-'BPH' Study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction. Br J Urol. 1998; 82:619-23. DOI: https://doi.org/10.1046/j.1464-410x.1998.00813.x
Cornu JN, Gacci M, Hashim H, et al. Eau Guidelines on Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). EAU Guidelines. Edn. presented at the EAU Annual Congress Milan March 2023, EAU Guidelines Office, Arnhem, the Netherlands.
Gravas S, Cornu J, Gacci M, et al. Management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO). 2019. https://uroweb.org/guidelines/management- of-non-neurogenic-male-luts
Suh YS, Ko KJ, Kim TH, et al. Urinary Nerve Growth Factor as a Potential Biomarker of Treatment Outcomes in Overactive Bladder Patients. Int Neurourol J. 2017; 21:270-81. DOI: https://doi.org/10.5213/inj.1732794.397
Cekerci Ç A, Isbilen B, Isman F, et al. Urinary NGF, TGF-b1, TIMP-2 and bladder wall thickness predict neurourological findings in children with myelodysplasia. J Urol. 2014; 191:199-205. DOI: https://doi.org/10.1016/j.juro.2013.08.025
Wang LW, Han XM, Chen CH, et al. Urinary brain-derived neurotrophic factor: a potential biomarker for objective diagnosis of overactive bladder. Int Urol Nephrol. 2014; 46:341-7. DOI: https://doi.org/10.1007/s11255-013-0540-x
Sekerci CA, Tanidir Y, Toprak T, et al. Value of Urinary Brain-Derived Neurotrophic Factor Levels on the Assessment of Botulinum Toxin Type A Treatment for Neurogenic Detrusor Overactivity in Children with Myelodysplasia. J Urol. 2019; 201:174-80. DOI: https://doi.org/10.1016/j.juro.2018.06.065
Alkis O, Zumrutbas AE, Toktas C, et al. The use of biomarkers in the diagnosis and treatment of overactive bladder: Can we predict the patients who will be resistant to treatment? Neurourol Urodyn. 2017; 36:390-3. DOI: https://doi.org/10.1002/nau.22939
Mesane MAA, Formunun S. Constitution and validation of a new symptom assessment tool for overactive bladder: Marmara Overactive Bladder Questionnaire (M-OBQ). Journal of Urological Surgery. 2014; 1:24-7. DOI: https://doi.org/10.4274/jus.141
Mashima R, Sakai E, Tanaka M, et al. The levels of urinary glycosaminoglycans of patients with attenuated and severe type of mucopolysaccharidosis II determined by liquid chromatography-tandem mass spectrometry. Mol Genet Metab Rep. 2016; 7:87-91. DOI: https://doi.org/10.1016/j.ymgmr.2016.03.009
Whitley CB, Ridnour MD, Draper KA, et al. Diagnostic test for mucopolysaccharidosis. I. Direct method for quantifying excessive urinary glycosaminoglycan excretion. Clin Chem. 1989; 35:374-9. DOI: https://doi.org/10.1093/clinchem/35.3.374
Gandhi NS, Mancera RL. The structure of glycosaminoglycans and their interactions with proteins. Chem Biol Drug Des. 2008; 72:455-82. DOI: https://doi.org/10.1111/j.1747-0285.2008.00741.x
Ustundag Y, Huysal K, Guzelsoy M, et al. Urine and serum glycosaminoglycan levels in the diagnosis of urological diseases and conditions: A narrative review of the literature. Urologia. 2021; 88:103-9. DOI: https://doi.org/10.1177/0391560320960003
Costantini E, Lazzeri M, Porena M. GAGs and GAGs diseases: when pathophysiology supports the clinic. Urologia. 2013; 80:173-8. DOI: https://doi.org/10.5301/RU.2013.11500
Nickel JC, Emerson L, Cornish J. The bladder mucus (glycosaminoglycan) layer in interstitial cystitis. J Urol. 1993; 149:716-8. DOI: https://doi.org/10.1016/S0022-5347(17)36191-8
Siracusano S, Cucchi A, Ciciliato S, et al. Urinary levels of glycosaminoglycans in patients with idiopathic detrusor overactivity. Int Urogynecol J Pelvic Floor Dysfunct. 2009; 20:1477-80. DOI: https://doi.org/10.1007/s00192-009-0973-z
Lokeshwar VB, Selzer MG, Cerwinka WH, et al. Urinary uronate and sulfated glycosaminoglycan levels: markers for interstitial cystitis severity. J Urol. 2005; 174:344-9. DOI: https://doi.org/10.1097/01.ju.0000161599.69942.2e
Lucon M, Martins JR, Leite KR, et al. Evaluation of the metabolism of glycosaminoglycans in patients with interstitial cystis. Int Braz J Urol. 2014; 40:72-9. DOI: https://doi.org/10.1590/S1677-5538.IBJU.2014.01.11
Ferrara P, Rigante D, Lambert-Gardini S, et al. Urinary excretion of glycosaminoglycans in patients with isolated nocturnal enuresis or combined with diurnal incontinence. BJU Int. 2000; 86:824-5. DOI: https://doi.org/10.1046/j.1464-410x.2000.00905.x
Budak YU, Huysal K, Guray A. Urinary glycosaminoglycan excretion in patients with primary nocturnal enuresis. Ital J Pediatr. 2010; 36:13. DOI: https://doi.org/10.1186/1824-7288-36-13

How to Cite

Aydin, H. R., Sekerci, C. A., Kocakgol, H., Basok, B. I., Bedir, F., Guctas, A. O., Akdeniz, F., Aksoy, H. Z., Ramazanoglu, M. A., & Tanidir, Y. (2024). Role of urine glycosaminoglycan levels in the diagnosis and follow-up in men with lower urinary tract symptoms. Archivio Italiano Di Urologia E Andrologia, 96(2). https://doi.org/10.4081/aiua.2024.12367
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