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He Q, Babcook MA, Shukla S, Shankar E, Wang Z, Liu G, Erokwu BO, Flask CA, Lu L, Daneshgari F, MacLennan GT, Gupta S. Obesity-initiated metabolic syndrome promotes urinary voiding dysfunction in a mouse model. Prostate 2016; 76:964-76. [PMID: 27040645 PMCID: PMC4946024 DOI: 10.1002/pros.23185] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/11/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Accumulating evidences suggests that obesity and metabolic syndrome (MetS) contribute towards lower urinary tract symptoms (LUTS) through alterations in the phenotype of bladder and prostate gland. Clinical studies indicate a link between MetS and LUTS. Nevertheless, there is lack of suitable animal model(s) which could illustrate an association linking obesity to LUTS. We examined the lower urinary tract function in an obesity-initiated MetS mouse model. METHODS Male C57BL/6N wild-type and obese B6.V-Lepob/J maintained on regular diet for 28 weeks were subjected to the assessment of body weight (BW), body length (BL), waist circumference (WC), body mass index (BMI), blood glucose (BG), plasma insulin (INS), plasma leptin (LEP), total cholesterol (CHO), free fatty acid (FFA), and measurement of urinary functions. Whole animal peritoneal and subcutaneous adipose tissue measurements as well as prostate and bladder volumes were analyzed by MRI followed by histological evaluation. These parameters were used to draw correlations between MetS and LUTS. RESULTS Obesity parameters such as BW, WC, and BMI were significantly higher in B6.V-Lepob/J mice compared to C57BL/6N mice (P < 0.01). Higher levels of total CHO and FFA were noted in B6.V-Lepob/J mice than C57BL/6N mice (P < 0.05). These results were concurrent with frequency, lower average urine volume and other urinary voiding dysfunctions in B6.V-Lepob/J mice. MRI assessments demonstrate marked increase in body fat and prostate volume in these mice. Compared to C57BL/6N mice, histological analysis of the prostate from B6.V-Lepob/J mice showed increased proliferation, gland crowding, and infiltration of immune cells in the stroma; whereas the bladder urothelium was slightly thicker and appears more proliferative in these mice. The regression and correlation analysis indicate that peritoneal fat (R = 0.853; P < 0.02), CHO (R = 0.729; P < 0.001), BG (R = 0.712; P < 0.001) and prostate volume (R = 0.706; P < 0.023) strongly correlate with LUTS whereas BMI, WC, INS, and FFA moderately correlate with the prevalence of bladder dysfunction. CONCLUSION Our results suggest that LUTS may be attributable in part to obesity and MetS. Validation of an in vivo model may lead to understand the underlying pathophysiological mechanisms of obesity-related LUTS in humans. Prostate 76:964-976, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Qiqi He
- Department of Urology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Second Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Melissa A. Babcook
- Department of Urology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Sanjeev Shukla
- Department of Urology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Eswar Shankar
- Department of Urology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Zhiping Wang
- Department of Urology, Key Laboratory of Disease of Urological Systems, Gansu Nephro-Urological Clinical Center, Second Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Guiming Liu
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109
| | - Bernadette O. Erokwu
- Department of Radiology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Chris A. Flask
- Department of Radiology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106
- Department of Pediatrics, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Lan Lu
- Department of Urology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
- Department of Radiology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Firouz Daneshgari
- Department of Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109
| | - Gregory T. MacLennan
- Department of Pathology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
| | - Sanjay Gupta
- Department of Urology, Case Western Reserve University & University Hospitals Case Medical Center, Cleveland, Ohio 44106
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Majzoub A, Arafa M, Al-Said S, Dabbous Z, Aboulsoud S, Khalafalla K, Elbardisi H. Premature ejaculation in type II diabetes mellitus patients: association with glycemic control. Transl Androl Urol 2016; 5:248-54. [PMID: 27141454 PMCID: PMC4837318 DOI: 10.21037/tau.2016.03.11] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Premature ejaculation (PE) is a highly prevalent sexual dysfunction among patients with diabetes mellitus (DM). Despite this, the underlying mechanism of this association is poorly understood. In this study, we aimed to investigate the prevalence of PE in a group of patients with DM and explore possible associations linking both conditions together. Methods This was a prospective study of subjects recruited with advertisement pamphlets and whose sexual function was assessed using the international index of erectile function-5 (IIEF-5) and the Arabic index of premature ejaculation (AIPE) questionnaires together with stopwatch measured intravaginal ejaculatory latency time (ELT). Participants were divided into two groups; group A subjects had DM and group B were healthy adult males. Results A total of 488 subjects were recruited. Group A included 199 (40.8%) subjects, while group B included 289 (59.2%). The prevalence of PE and ED was significantly higher in group A subjects (P<0.001). Mean ELT ± standard deviation (SD) was 3.6±2.7 in group A versus 4.3±2.8 in group B (P<0.014). Diabetic patients with erectile dysfunction (ED) showed a significantly higher incidence of PE with significantly shorter ELT. Conclusions PE is more prevalent in diabetic patients. DM is a multi-systemic disorder with complications that could help explain the pathophysiology of PE.
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Affiliation(s)
- Ahmad Majzoub
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Arafa
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Sami Al-Said
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Zeinab Dabbous
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Samar Aboulsoud
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Kareim Khalafalla
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
| | - Haitham Elbardisi
- 1 Department of Urology, Hamad Medical Corporation, Doha, Qatar ; 2 Department of Andrology, Cairo University, Cairo, Egypt ; 3 Department of Endocrinology, Hamad Medical Corporation, Doha, Qatar ; 4 Department of Internal Medicine, Cairo University, Cairo, Egypt
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