糖尿病与尿失禁
曾洁;刘娟;陈敦金;
摘要(Abstract):
糖尿病和尿失禁是妇女常见健康问题,两者的发病率随年龄的增长而升高,均可对生活质量产生深远影响。目前,众多尿失禁疾病的研究中糖尿病已被公认是尿失禁发病的独立危险因素,但糖尿病引发尿失禁的机制仍不明确。因此,本文综述了历年文献,通过一些流行病学研究数据,从糖尿病自主神经病变引发的膀胱神经病变及逼尿肌功能异常方面,膀胱尿道周围支持系统肌力的改变和胰岛素抵抗引起的肥胖对尿失禁的影响,阐述了糖尿病与尿失禁发病的关系,提供了几种能合理解释二者关系的证据,并试图为糖尿病尿失禁患者的诊疗提供新思路。
关键词(KeyWords): 糖尿病;尿失禁;自主神经系统;盆底肌肉;肥胖
基金项目(Foundation):
作者(Authors): 曾洁;刘娟;陈敦金;
DOI: 10.13283/j.cnki.xdfckjz.2012.10.004
参考文献(References):
- [1]Alberti KG,Zimmet PZ.Definition,diagnosis and classifi-cation of diabetes mellitus and its complications.Part 1:diagnosis and classification of diabetes mellitus provisionalreport of a WHO consultation[J].Diabet Med,1998,15(7):539-553
- [2]Centers for Disease Control and Prevention.National dia-betes fact sheet:national estimates and general informationon diabetes and prediabetes in the United States,2011[EB/OL].Atlanta,GA:U.S.Department of Health andHuman Services,Centers for Disease Control and Preven-tion,2011.(2011)[2012.04]http://apps.nccd.cdc.gov/DDTSTRS/FactSheet.aspx
- [3]Yang W,Lu J,Weng J,et al.China National Diabetes andMetabolic Disorders Study Group.Prevalence of diabetesamong men and women in China[J].N Engl J Med,2010,362(12):1090-1101
- [4]Abrams P,Cardozo L,Fall M,et,al.The standardisation ofterminology of lower urinary tract function:report from theStandardisation Sub-committee of the International Conti-nence Society[J].Am J Obstet Gynecol,2002,187(1):116-126
- [5]Melville JL,Katon W,Delaney K,et al.Urinary inconti-nence in US women:a population-based study[J].ArchIntern Med,2005,165(5):537-542
- [6]Minassian VA,Stewart WF,Wood GC.Urinary inconti-nence in women:variation in prevalence estimates andrisk factors[J].Obstet Gynecol,2008,111(2 Pt1):324-331
- [7]Wilson L,Brown JS,Shin GP,et al.Annual direct cost ofurinary incontinence[J].Obstet Gynecol,2001,98(3):398-406
- [8]朱兰,郎景和,王宏,等.北京地区成年女性尿失禁的流行病学研究[J].中华医学杂志,2006,86(11):728-731
- [9]叶明,唐家龄,邱秀,等.广州地区成年女性尿失禁发病率及其相关影响因素[J].中国临床康复,2004,27(8):5806-5808
- [10]Shamliyan TA,Wyman JF,Ping R,et al.Male urinary in-continence:prevalence,risk factors,and preventive inter-ventions[J].Rev Urol,2009,11(3):145-165
- [11]Sarma AV,Kanaya AM,Nyberg LM,et al.Diabetes Con-trol and Complications Trial/Epidemiology of DiabetesInterventions and Complications Research Group.Urinaryincontinence among women with type 1 diabetes--howcommon is it?[J].J Urol,2009,181(3):1224-1230
- [12]Brown JS,Vittinghoff E,Lin F,et al.Prevalence and riskfactors for urinary incontinence in women with type 2 dia-betes and impaired fasting glucose:findings from the Na-tional Health and Nutrition Examination Survey(NHANES)2001-2002[J].Diabetes Care,2006,29(6):1307-1312
- [13]Danforth KN,Townsend MK,Curhan GC,et al.Type 2diabetes mellitus and risk of stress,urge and mixed uri-nary incontinence[J].J Urol,2009,181(1):193-197
- [14]Brown JS,Nyberg LM,Kusek JW,et al.Proceedings ofthe National Institute of Diabetes and Digestive and Kid-ney Diseases International Symposium on EpidemiologicIssues in Urinary Incontinence in Women[J].Am J Ob-stet Gynecol,2003,188(6):S77-S88
- [15]Vinik AI,Maser RE,Mitchell BD,et al.Diabetic auto-nomic neuropathy[J].Diabetes Care,2003,26(5):1553-1579
- [16]Kaplan SA,Te AE,Blaivas JG.Urodynamic findings inpatients with diabetic cystopathy[J].J Urol,1995,153(2):342-344
- [17]Daneshgari F,Liu G,Birder L,et al.Diabetic bladderdysfunction:current translational knowledge[J].J Urol,2009,182(6Suppl):S18-S26
- [18]Changolkar AK,Hypolite JA,Disanto M,et al.Diabetesinduced decrease in detrusor smooth muscle force is as-sociated with oxidative stress and overactivity of aldosereductase[J].J Urol,2005,173(1):309-313
- [19]Jundt K,Scheer I,Schiessl B,et al.Incontinence,bladderneck mobility,and sphincter ruptures in primiparouswomen[J].Eur J Med Res,2010,15(6):246-252
- [20]Sayer AA,Dennison EM,Syddall HE,et al.Type 2 dia-betes,muscle strength,and impaired physical function:the tip of the iceberg?[J].Diabetes Care,2005,28(10):2541-2542
- [21]Barbosa AM,Dias A,Marini G,et al.Urinary inconti-nence and vaginal squeeze pressure two years post-cesar-ean delivery in primiparous women with previous gesta-tional diabetes mellitus[J].Clinics(SaoPaulo),2011,66(8):1341-1346
- [22]Choi K,Kim YB.Molecular mechanism of insulin resist-ance in obesity and type 2 diabetes[J].Korean J InternMed,2010,25(2):119-129
- [23]Smyth S,Heron A.Diabetes and obesity:the twin epi-demics[J].Nat Med,2006,12(1):75-80
- [24]Phelan S,Grodstein F,Brown JS.Clinical research in dia-betes and urinary incontinence:what we know and needto know[J].J Urol,2009,182(6 Suppl):S14-S17
- [25]Varela JE,Hinojosa M,Nguyen N.Correlations betweenintra-abdominal pressure and obesity-related co-morbidi-ties[J].Surg Obes Relat Dis,2009,5(5):524-528