The influence of gut microbiome on progression of overactive bladder symptoms: a community-based 3-year longitudinal study in Aomori, Japan

• Published in: International urology and nephrology Vol. 54; no. 1; pp. 9 - 16
• Main Authors: Okuyama, Yoshiharu, Okamoto, Teppei, Sasaki, Daichi, Ozaki, Kai, Songee, Jung, Hatakeyama, Shingo, Mikami, Tatsuya, Ohyama, Chikara
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.01.2022; Springer Nature B.V
• Subjects: Adult; Aged; Community Health Centers; Digestive system; Disease Progression; Dysbacteriosis; Feces; Female; Gastrointestinal Microbiome; Humans; Intestinal microflora; Irritable bowel syndrome; Japan; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Metabolic syndrome; Microbiomes; Microbiota; Middle Aged; Multivariate analysis; Nephrology; Next-generation sequencing; Proton pump inhibitors; Risk factors; rRNA 16S; Sleep; Streptococcus; Streptococcus - isolation & purification; Time Factors; Urinary Bladder, Overactive - diagnosis; Urinary Bladder, Overactive - microbiology; Urinary incontinence; Urology; Urology - Original Paper; Japan; Urinary urgency; Overactive bladder; Proton pump inhibitors; Urge urinary incontinence; Gut microbiome; Risk factor
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-021-03044-w

Purpose To assess the influence of gut microbiome on overactive bladder (OAB) symptoms progression. Methods This was a 3-year longitudinal study, Hirosaki in Japan. We assessed OAB symptoms and reviewed the medication records of each subject in 2016. We extracted 16S rRNA genes from fecal samples and analyzed gut microbiomes via next-generation sequencing. We evaluated the changes in urinary urgency (UU) and/or urgent urinary incontinence (UUI) from 2016 to 2019. We defined UU/UUI-progression as exacerbation of UU and/or UUI. We compared the clinical backgrounds and microbiota structure between UU/UUI-progression subjects and non-progression (controls). We assessed the impact of gut microbiome on the UU/UUI-progression via multivariate logistic regression analyses. Results Of 669 subjects, 126 were UU/UUI-progression subjects. These subjects had a higher age and prevalence of proton pump inhibitor (PPI) use (14% vs. 5.4%, P  = 0.003), irritable bowel syndrome, sleep disturbance, and metabolic syndrome than those without. We found the different microbiota structures between subjects with UU/UUI-progression and those without. A higher relative abundance of genus Streptococcus (harmful bacterial genus for human health) appeared in UU/UUI-progression subjects (3.8% vs. 2.3%, P  < 0.001). Multivariate analysis revealed that age ≥ 65 years, current smoking, sleep disturbance, metabolic syndrome, and genus Streptococcus (Odds ratio: 1.05, P  = 0.029) were independent risk factors for UU/UUI-progression. PPI use turned to be a significant risk factor on a multivariate analysis without including genus Streptococcus . Conclusions Gut microbiome might be associated with a risk for OAB symptoms progression. PPI use might cause gut dysbiosis and increase this risk.