Links between lower urinary tract symptoms, intermittent hypoxia and diabetes: Causes or cures?

• Published in: Respiratory physiology & neurobiology 2018-10, Vol.256, p.87-96
• Main Authors: Abler, Lisa L., Vezina, Chad M.
• Format: Article
• Language: English
• Subjects: Animals; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; Humans; Hypoxia; Intermittent hypoxia; Lower urinary tract symptoms; Lower Urinary Tract Symptoms - complications; Lower Urinary Tract Symptoms - therapy; LUTS; Obstructive sleep apnea; Prostate; Type 2 diabetes
• ISSN: 1569-9048; 1878-1519
• DOI: 10.1016/j.resp.2017.09.009

•Lower urinary tract symptoms (LUTS) are a group of symptoms that affect urination.•Few therapies eliminate LUTS, meaning a lifetime of treatments for most patients.•Intermittent hypoxia, obesity and type 2 diabetes are common comorbidities of LUTS.•Treatments for intermittent hypoxia, obesity and type 2 diabetes can improve LUTS.•A new mouse model tests Intermittent hypoxia, obesity and type 2 diabetes in concert. Bothersome lower urinary tract symptoms (LUTS) manifest as urinary frequency, urgency, incontinence and incomplete bladder emptying. Existing treatments ameliorate but do not eliminate most symptoms, leading to financial and personal burdens attributable to sustained medical therapies that may last a lifetime. The purpose of this review is to highlight evidence of causal associations between LUTS and several common comorbidities, including intermittent hypoxia (IH) concomitant with obstructive sleep apnea (OSA), obesity, metabolic syndrome and type 2 diabetes. Links between these conditions, including therapies targeted to co-occurring complications that have demonstrated benefits for LUTS, suggest compelling avenues of research and also underscore critical gaps in understanding the mechanisms underlying urinary dysfunction. These gaps are prominent in the IH field, where an acknowledged link between OSA and LUTS has gone largely uninvestigated. New tools, models, or reappropriation of existing ones, especially rodent models, is required to parse the associations between IH/OSA, LUTS and obesity/diabetes and to elucidate their underlying, and potentially shared, etiologies.