Lower urinary tract symptoms (LUTS), including urinary incontinence, urgency and nocturia, affect approximately half of women worldwide. Current diagnostic methods for LUTS are invasive and costly, while available treatments are limited by side effects leading to poor patient compliance. In this study, we aimed to identify urine metabolic signatures associated with LUTS using proton nuclear magnetic resonance (¹H-NMR) spectroscopy. A total of 214 urine samples were collected from women attending tertiary urogynaecology clinics (cases; n=176) and healthy control women attending general gynecology clinics (n=36). Despite high variation in the urine metabolome across the cohort, associations between urine metabolic profiles and BMI, parity, overactive bladder syndrome, frequency, straining and bladder storage were identified using KODAMA (knowledge discovery by accuracy maximization). Four distinct urinary metabotypes were identified, one of which was associated with increased urinary frequency and low BMI. Urine from these patients was characterized by increased levels of isoleucine and decreased levels of hippurate. Our study suggests that metabolic profiling of urine samples from LUTS patients offers the potential to identify differences in underlying aetiology, which may permit stratification of patient populations and the design of more personalized treatment strategies.

中文翻译：

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下尿路症状女性的尿液代谢表型分析

包括尿失禁、尿急和夜尿在内的下尿路症状 (LUTS) 影响着全世界大约一半的女性。目前的 LUTS 诊断方法是侵入性的且成本高昂，而可用的治疗方法受到副作用的限制，导致患者依从性差。在这项研究中，我们旨在使用质子核磁共振（¹H-NMR)光谱。从参加三级泌尿妇科诊所的女性（病例；n = 176）和参加普通妇科诊所的健康对照女性（n = 36）收集了总共 214 份尿液样本。尽管整个队列的尿液代谢组差异很大，但使用 KODAMA（通过准确性最大化发现知识）确定了尿液代谢谱与 BMI、胎次、膀胱过度活动综合征、频率、紧张和膀胱储存之间的关联。确定了四种不同的尿代谢型，其中一种与尿频增加和 BMI 低有关。这些患者的尿液以异亮氨酸水平升高和马尿酸水平降低为特征。