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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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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.


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.


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





Bile acids


Body mass index


Confidence interval


Fatty acid


Farnesoid X receptor


G protein-coupled receptor


Long-chain fatty acids


Liquid chromatography–time-of-flight–mass spectrometry


Lower urinary tract symptoms


Overactive bladder


Quality of life


Retention time


Type 1 diabetes


Type 2 diabetes


G protein-coupled bile acid captor 5


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


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

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Correspondence to Takahiko Mitsui.

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