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Central Obesity in Cases of OAB

Primary Purpose

Urologic Diseases, Overactive Bladder Syndrome, Obesity, Abdominal

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
visceral fat obesity (surface area and function)
Sponsored by
Mansoura University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Urologic Diseases focused on measuring abdominal obesity, OAB

Eligibility Criteria

18 Years - 40 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • patients with OAB between 18 and 40 years old.
  • normal variant healthy donor as a control.

Exclusion Criteria:

  • Patients who have any of the following:

    • Age less than 18 or more than 40 years old
    • Neurogenic detrusor overactivity
    • evidence of obstructed flow in absence of prolapse
    • mixed urinary incontinence
    • associated urethral pathology, e.g. Urethral diverticulum
    • Associated bladder pathology e.g. fistula, active urinary tract infection as evidenced by positive urine culture
    • previous exposure for anticholinergics or BTX-A injection.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    patients with OAB

    normal variants healthy without symptoms

    Arm Description

    Patients were asked to fill (OABSS) for more accurate evaluation of bothersome degree. Waist Circumference is evaluated. The surface area of subcutaneous fat (S) and visceral (V) is calculated using slices between L4-L5 and umbilicus according to CT detection fat methods Also bladder wall thickness was calculated by measuring average bladder wall thickness at three different levels. Subcutaneous fat to visceral fat ratio was calculated. Assays for serum total and high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were performed in the hospital's chemistry laboratory with an autoanalyzer. VAI was calculated for females as this formula like the previous study. VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males: VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL

    WC is evaluated crest. The surface area of subcutaneous fat (S) and visceral (V) is calculated using slices between L4-L5 and umbilicus according to ct detection fat methods Also bladder wall thickness was calculated by measuring average bladder wall thickness at three different levels. Subcutaneous fat to visceral fat ratio was calculated. Assays for serum total and high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were performed in the hospital's chemistry laboratory with an autoanalyzer. VAI was calculated for females as this formula like the previous study. VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males:VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL

    Outcomes

    Primary Outcome Measures

    relation between visceral fat and and severity of OAB symptoms.
    using OAB symptoms scores(OABSS) with total score 15(mild<5,mod (5-10),sever>10) in relation to visceral fat surface area in cm2 by NCCT measurement.
    Relation of OAB symptoms to visceral fat function
    using of OABSS total score 15(mild<5, mod(5-10), sever>10) to visceral fat function (VAI)(VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males:VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL)

    Secondary Outcome Measures

    Full Information

    First Posted
    November 9, 2018
    Last Updated
    November 20, 2018
    Sponsor
    Mansoura University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03750604
    Brief Title
    Central Obesity in Cases of OAB
    Official Title
    Central Obesity With Relation in OAB: Is it a Matter of Size or Fat Activity?. Prospective Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    January 1, 2017 (Actual)
    Primary Completion Date
    October 30, 2018 (Actual)
    Study Completion Date
    October 30, 2018 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Mansoura University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Obesity is not a homogeneous condition and that the regional distribution of adipose tissue is important to understanding the relation of obesity to disturbances in glucose and lipid metabolism. Central abdominal fat is composed of abdominal subcutaneous fat and visceral fat. Regional distribution appears to be an important indicator for metabolic alterations since an inconstant correlation between body mass index (BMI) and these disturbances have been found. Visceral obesity is associated with increased adipocytokine production, proinflammatory activity, deterioration of insulin sensitivity, increased risk of developing diabetes, "high-triglyceride/low-HDL cholesterol dyslipidemia," hypertension and atherosclerosis. It might be more precise to divide central abdominal fat into subcutaneous(S) and visceral (V) fat surface area and volume and even ratio (S/V); risk factors for cardiovascular disease, particularly those related to glucose and lipid metabolism and hypertension, being>0.4; with evaluation of visceral fat functionality by visceral adiposity index (VAI) with integration with lipid profile. Adding bladder wall thickness with perivesical fat as a factor may impair bladder function and contribute to dysregulation. The data on the association between central adiposity with OAB symptoms and Urodynamics is not mature.
    Detailed Description
    Overactive bladder (OAB) is defined by international continence society (ICS) as urinary urgency with or without incontinence often associated with frequency and nocturia. As a chronic, unbearable condition, OAB has a deeply negative impact on QoL, including social, physical, psychological, occupational and sexual domains. Overactive bladder (OAB) is a highly prevalent symptom complex that is estimated to affect 12.8% of women and 10.8% of men. The underlying pathophysiological mechanism of OAB and DO is poorly understood. It is thought that not only the detrusor muscle but also urothelium, peripheral afferent terminals, and pelvic blood vessels may play a role. More recently, overweight and central obesity was found to be an independent risk factor for overactive bladder (OAB) in women. The most likely explanation is the occurrence of chronic inflammation in the bladder indicated by increased urinary chemokines. Adipocytes surrounding the human bladder can be affected, thus leading to inflammation and triggering OAB symptoms. Other authors showed that OAB is associated with increased BMI and increase of waist circumference at the upper end of the adiposity distribution for both men and women. Obesity is not a homogeneous condition and that the regional distribution of adipose tissue is important to understanding the relation of obesity to disturbances in glucose and lipid metabolism. Central abdominal fat is composed of abdominal subcutaneous fat and visceral fat. Regional distribution appears to be an important indicator for metabolic alterations since an inconstant correlation between body mass index (BMI) and these disturbances have been found. Visceral obesity is associated with increased adipocytokine production, proinflammatory activity, deterioration of insulin sensitivity, increased risk of developing diabetes, "high-triglyceride/low-HDL cholesterol dyslipidemia," hypertension and atherosclerosis. Away from that anthropometric measures as BMI, waist circumference (WC), waist to hip ratio (WHR) are crude measures for adiposity. WHR has been advocated as a measure of central obesity because BMI does not describe the distribution of obesity. This measurement, however, was found to be associated with SUI but not with OAB or mixed urinary incontinence, further suggesting a non-mechanical mechanism for OAB in obese women. WC is a major clinical parameter used for the indirect evaluation of increased visceral fat, In addition, WC showed shared variance with visceral adipose fat up to 75% (42) (38). Nevertheless, WC alone does not help in distinguishing between subcutaneous and visceral fat mass. So, it might be more precise to divide central abdominal fat into subcutaneous(S) and visceral (V) fat surface area and volume and even ratio (S/V); risk factors for cardiovascular disease, particularly those related to glucose and lipid metabolism and hypertension, being>0.4; with evaluation of visceral fat functionality by visceral adiposity index (VAI) with integration with lipid profile. Adding bladder wall thickness with perivesical fat as a factor may impair bladder function and contribute to dysregulation. The data on the association between central adiposity with OAB symptoms and Urodynamics is not mature. So, the investigators intend to conduct this study evaluating the surface area of both subcutaneous and visceral fat and its functionality with incorporation with lipid profile and bladder wall thickness and perivesical fat.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Urologic Diseases, Overactive Bladder Syndrome, Obesity, Abdominal
    Keywords
    abdominal obesity, OAB

    7. Study Design

    Primary Purpose
    Diagnostic
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    250 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    patients with OAB
    Arm Type
    Active Comparator
    Arm Description
    Patients were asked to fill (OABSS) for more accurate evaluation of bothersome degree. Waist Circumference is evaluated. The surface area of subcutaneous fat (S) and visceral (V) is calculated using slices between L4-L5 and umbilicus according to CT detection fat methods Also bladder wall thickness was calculated by measuring average bladder wall thickness at three different levels. Subcutaneous fat to visceral fat ratio was calculated. Assays for serum total and high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were performed in the hospital's chemistry laboratory with an autoanalyzer. VAI was calculated for females as this formula like the previous study. VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males: VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL
    Arm Title
    normal variants healthy without symptoms
    Arm Type
    Placebo Comparator
    Arm Description
    WC is evaluated crest. The surface area of subcutaneous fat (S) and visceral (V) is calculated using slices between L4-L5 and umbilicus according to ct detection fat methods Also bladder wall thickness was calculated by measuring average bladder wall thickness at three different levels. Subcutaneous fat to visceral fat ratio was calculated. Assays for serum total and high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were performed in the hospital's chemistry laboratory with an autoanalyzer. VAI was calculated for females as this formula like the previous study. VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males:VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL
    Intervention Type
    Diagnostic Test
    Intervention Name(s)
    visceral fat obesity (surface area and function)
    Intervention Description
    WC is evaluated at the midpoint between the lower border of the rib cage and the iliac crest. The surface area of subcutaneous fat (S) and visceral (V) is calculated using slices between L4-L5 and umbilicus according to ct detection fat methods Also bladder wall thickness was calculated by measuring average bladder wall thickness at three different levels. Subcutaneous fat to visceral fat ratio was calculated. Assays for serum total and high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels were performed in the hospital's chemistry laboratory with an autoanalyzer. VAI was calculated for females as this formula like the previous study. VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males: VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL WC: waist circumference, BMI: body mass index, TG: triglyceride, HDL: high-density lipoprotein
    Primary Outcome Measure Information:
    Title
    relation between visceral fat and and severity of OAB symptoms.
    Description
    using OAB symptoms scores(OABSS) with total score 15(mild<5,mod (5-10),sever>10) in relation to visceral fat surface area in cm2 by NCCT measurement.
    Time Frame
    2 years
    Title
    Relation of OAB symptoms to visceral fat function
    Description
    using of OABSS total score 15(mild<5, mod(5-10), sever>10) to visceral fat function (VAI)(VAI: WC/ [36.58 + (1.89 × BMI)] × TG/0.81 × 1.52/HDL. And in males:VAI: WC / [39.68 + (1.88 x BMI)] x TG/ 1.03 x 1.31/ HDL)
    Time Frame
    2 years

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: patients with OAB between 18 and 40 years old. normal variant healthy donor as a control. Exclusion Criteria: Patients who have any of the following: Age less than 18 or more than 40 years old Neurogenic detrusor overactivity evidence of obstructed flow in absence of prolapse mixed urinary incontinence associated urethral pathology, e.g. Urethral diverticulum Associated bladder pathology e.g. fistula, active urinary tract infection as evidenced by positive urine culture previous exposure for anticholinergics or BTX-A injection.

    12. IPD Sharing Statement

    Learn more about this trial

    Central Obesity in Cases of OAB

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