MP04-01 LONGITUDINAL SUBPHENOTYPES OF URINARY SYMPTOMS IN TYPE I DIABETES

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2018MP04-01 LONGITUDINAL SUBPHENOTYPES OF URINARY SYMPTOMS IN TYPE I DIABETES Karandeep Singh, Hunter Wessells, J. Quentin Clemens, Rodney L. Dunn, Sarah K. Holt, James Hotaling, Rodica Pop-Busui, William Herman, Alan M. Jacobson, Barbara H. Braffett, Aruna V. Sarma, and for the DCCT/EDIC Research Group Karandeep SinghKarandeep Singh More articles by this author , Hunter WessellsHunter Wessells More articles by this author , J. Quentin ClemensJ. Quentin Clemens More articles by this author , Rodney L. DunnRodney L. Dunn More articles by this author , Sarah K. HoltSarah K. Holt More articles by this author , James HotalingJames Hotaling More articles by this author , Rodica Pop-BusuiRodica Pop-Busui More articles by this author , William HermanWilliam Herman More articles by this author , Alan M. JacobsonAlan M. Jacobson More articles by this author , Barbara H. BraffettBarbara H. Braffett More articles by this author , Aruna V. SarmaAruna V. Sarma More articles by this author , and for the DCCT/EDIC Research Groupfor the DCCT/EDIC Research Group More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.151AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lower urinary tract symptoms (LUTS) in men and urinary incontinence (UI) in women are dynamic conditions with numerous factors contributing to risk and progression. Understanding of natural history of urinary symptoms in diabetes is limited. We describe factors influencing the long-term trajectory of LUTS in men and UI in women with type 1 diabetes (T1DM) using non-parametric statistical methods. METHODS Longitudinal data from 565 men and 523 women in the Epidemiology of Diabetes Interventions and Complications (EDIC) study were used to define LUTS/UI annually over 5 years. Trajectories were identified using a k-means clustering approach on the American Urological Association Symptom Index (AUASI) in men and Sandvik Severity Index in women. Subphenotypes were selected based on cluster quality metrics. A multinomial random forest model was fit to predict subphenotype assignment using information from baseline. Factors associated with LUTS/UI trajectory were identified by permuting each predictor and assessing change in accuracy as compared to the non-permuted data using the fitted model. RESULTS At baseline, mean age was 51.0 (SD 6.4) and 50.1 (SD 7.0) in men and women, respectively. 27.5% of men reported moderate/severe LUTS and 28.7% of women moderate/severe UI. We identified 3 subphenotypes for UI among women and 4 for LUTS among men (Figure 1A, 1B). Subphenotypes D in men and C in women demonstrate a deterioration of function over time in contradistinction to stable patterns and low/moderate severity in other clusters. The classification model achieved a multiclass area-under-the-curve (AUC) of 0.65 for AUASI and 0.61 for Sandvik using 10-fold cross-validation. Based on permutation importance (Figure 1C, 1D), key predictors were age (p = 0.002) and autonomic dysfunction (p < 0.001) for LUTS trajectory and BMI (p = 0.02) for UI. CONCLUSIONS LUTS/UI are prevalent complications in men and women with T1DM. A limited number of factors were identified in delineating subphenotypes of LUTS/UI. These data may be relevant to future investigations of mechanisms for distinct endotypes of LUTS/UI, as well as candidates for interventions targeting metabolic factors contributing to variation in symptoms. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e31-e32 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Karandeep Singh More articles by this author Hunter Wessells More articles by this author J. Quentin Clemens More articles by this author Rodney L. Dunn More articles by this author Sarah K. Holt More articles by this author James Hotaling More articles by this author Rodica Pop-Busui More articles by this author William Herman More articles by this author Alan M. Jacobson More articles by this author Barbara H. Braffett More articles by this author Aruna V. Sarma More articles by this author for the DCCT/EDIC Research Group More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...