Urinary NGF,BDNF And PGE2 As Biomarkers For Diagnosis Of Overactive Bladder: A Meta-analysis

Objective:To systematically evaluate the relationship between urinary nerve growth factor(NGF),brain-derived nerve growth factor(BDNF),prostaglandin E2(PGE2)and overactive bladder symptom(OAB).And evaluate the possibility of using them as biomarkers for diagnosis of OAB,so as to provide reference for clinical practice.Method:All the literatures about the relationship between urinary NGF,BDNF,PGE2 and OAB were retrieved from Pub Med,Web of Science,EMBASE,CNKI,WANFANG DATA and Cochrane library databases by computer.Then,literature screening,data extraction and literature quality evaluation were performed,meta-analysis was carried out by using the Review Management Version 5.3 software.Result:The relationship between urinary NGF and OAB was systematically reviewed in 33 articles.The results showed that urinary NGF(SMD=0.98,95%CI: 0.67～1.29,P<0.00001)and urinary NGF/creatinine(Cr)(SMD=1.09,95%CI: 0.71～1.47,P<0.00001)levels in OAB patients were obvious higher than those in the control group.After treatment,urinary NGF(SMD=2.03,95%CI: 1.54～2.51,P<0.00001)or urinary NGF/Cr(SMD=1.67,95%CI: 1.25～2.10,P<0.00001)were significantly decreased.The levels of urinary NGF(SMD=0.66,95%CI: 0.47～0.85,P<0.00001)and NGF/Cr(SMD=0.50,95%CI: 0.36～0.65,P<0.00001)in patients with OAB with urinary incontinence was significantly higher than that without urinary incontinence.However,there was no significant difference in urinary NGF/Cr(SMD=0.17,95%CI :-0.06～0.40,P=0.16)between patients with interstitial cystitis/bladder pain syndrome(IC/PBS)and OAB patients.A total of 10 articles were included in the systematic evaluation of the relationship between urinary BDNF and OAB.The results showed that the levels of urinary BDNF/Cr(SMD=1.24,95%CI: 1.08～1.41,P<0.00001)in OAB patients were significantly higher than those in the control group.After treatment,urine BDNF/Cr(SMD=1.54,95%CI:1.05～2.04,P<0.00001)in OAB patients decreased significantly.However,there was no significant difference in urinary BDNF/Cr(SMD=0.55,95%CI:-0.54～1.63,P<0.00001)between patients with OAB and patients without urinary incontinence.The relationship between urinary PGE2 and OAB was systematically evaluated.Six articles were included.The results showed that urinary PGE2(SMD=3.85,95%CI:0.96～6.74,P=0.009)levels in OAB patients were significantly higher than those in the control group.There were significant differences in urinary PGE2/Cr(SMD = 0.39,95%CI:0.04～0.74,P=0.03)between OAB patients and IC/PBS patients.Conclusion:The levels of urinary NGF,BDNF and PGE2 in patients with OAB were significantly increased,which may be potential biomarkers for diagnosis of OAB;urinary NGF and BDNF levels in OAB patients decreased significantly after treatment,which may be potential biomarkers for evaluating the therapeutic effect of OAB;urinary NGF level in OAB patients may be a potential biomarker to distinguish OAB with or without urgent urinary incontinence;PGE2 levels in urine of patients with OAB and IC/PBS are statistically different,which provides a new direction for the differentiation of OAB and IC/PBS.