Brain-derived neurotrophic factor, nerve growth factor, and high sensitivity C-reactive protein levels in urine in overactive bladder patients: a meta-analysis

Abstract

Background: Overactive bladder (OAB) is a clinical syndrome characterized by a combination of symptoms including urgency, frequency, and nocturia, with or without urinary incontinence. Overactive bladder has a high prevalence especially in those of an older age and women, with diagnosis depending on the patient’s symptoms. This study aims to assess brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and high sensitivity C-reactive protein (HSCRP) in urine as biomarkers in OAB. Methods: Studies were searched from Pubmed, Science Direct, Wiley Online Library, and Google Scholar. All studies assessing BDNF, NGF, and HSCRP in urine in OAB patients were included. The standardized mean difference (SMD) and 95% confidence intervals (CI) were then calculated. Results: A total of 85 studies were included with a total of 11,483 subjects (6,885 OAB patients and 4,598 controls). Based on data analysis results, urinary NGF/Creatinine (NGF/Cr) and NGF level in OAB patients were significantly higher than control (SMD = 1.00, 95%CI = 0.80-1.20, P<0.00001; and SMD = 1.11, 95%CI = 0.79-1.43, P<0.00001). NGF/Cr level was found higher in OAB with incontinence (OAB wet) compared with OAB without incontinence (OAB dry) (SMD = 0.41, 95%CI = 0.23-0.60, P<0.0001), and decreased after treatment (SMD = 0.76, 95%CI = 0.49-1.03, P<0.00001). Urinary BDNF/Cr level was significantly higher in OAB patients compared with controls (SMD = 1.97, 95%CI = 1.14-2.79, P<0.00001), and also decreased significantly after treatment (SMD = 0.75, 95%CI = 0.42-1.08, P<0.00001). The level of HSCRP was significantly higher in OAB patients when compared with controls (SMD = 0.38, 95%CI = 0.12-0.64, P<0.004). Conclusions: The level of BDNF/Cr, NGF/Cr, NGF, and HSCRP in urine were found higher in OAB compared with controls, which means they may be used as a biomarkers for OAB.