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Metabolism of fatty acids and bile acids in plasma is associated with overactive bladder in males: potential biomarkers and targets for novel treatments in a metabolomics analysis

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Abstract

Objectives

The present study was conducted to identify metabolites using a metabolomics approach and investigate the relationship between these metabolites and urgency as a major symptom of overactive bladder (OAB).

Patients and methods

In 47 male participants without any apparent neurological disease, OAB was defined as an urgency score on the International Prostate Symptom Score of 2 and higher (OAB group, n = 26), while patients with a score of 1 or 0 were placed in a control group (n = 21). A comprehensive study on plasma metabolites was conducted, and metabolites were compared between the OAB and control groups.

Results

Age was significantly higher in the OAB group, while prostate volume did not differ between the groups. A 24-h bladder diary revealed that nocturnal urine volume, 24-h micturition frequency, nocturnal micturition frequency, and the nocturnal index were significantly higher in the OAB group, whereas maximum voided volume was significantly lower in this group. The metabolomics analysis identified 79 metabolites from the plasma of participants. The multivariate analysis showed that increases in the fatty acids (22:1), erucic acid and palmitoleic acid, and a decrease in cholic acid correlated with incidence of male OAB. A decrease in acylcarnitine (18:2)-3 and an increase in cis-11-eicosenoic acid also appeared to be associated with OAB in males.

Conclusions

OAB in males may occur through the abnormal metabolism of fatty acids and bile acids. Further studies on these pathways will contribute to the detection of new biomarkers and development of potential targets for novel treatments.

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Fig. 1

Abbreviations

AC:

Acylcarnitine

BAs:

Bile acids

BMI:

Body mass index

CI:

Confidence interval

FA:

Fatty acid

FXR:

Farnesoid X receptor

GPCR:

G protein-coupled receptor

LCFAs:

Long-chain fatty acids

LC–TOF–MS:

Liquid chromatography–time-of-flight–mass spectrometry

LUTS:

Lower urinary tract symptoms

OAB:

Overactive bladder

QoL:

Quality of life

RT:

Retention time

T1D:

Type 1 diabetes

T2D:

Type 2 diabetes

TGR5:

G protein-coupled bile acid captor 5

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Acknowledgements

This work was supported by JSPS KAKENHI - Grant Number 26861263. We would like to thank Editage (www.editage.com) for English language editing.

Funding

This work was supported by JSPS KAKENHI—Grant Number 26861263.

Author information

Correspondence to Takahiko Mitsui.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mitsui, T., Kira, S., Ihara, T. et al. Metabolism of fatty acids and bile acids in plasma is associated with overactive bladder in males: potential biomarkers and targets for novel treatments in a metabolomics analysis. Int Urol Nephrol 52, 233–238 (2020). https://doi.org/10.1007/s11255-019-02299-8

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Keywords

  • Overactive bladder (OAB)
  • Metabolomics
  • Bile acids
  • Fatty acids
  • Metabolic syndrome