Serum CRP levels linked to LUTS

Research from Taiwan shows that serum C-reactive protein (CRP) levels are associated with storage lower urinary tract symptoms (LUTS) and sensory bladder disorders.

The researchers, led by Hann-Chorng Kuo (Tzu Chi University, Hualien), enrolled 853 men with benign prostatic hyperplasia and LUTS, with a mean age of 66.9 years and a mean serum CRP level of 0.31 mg/dL. In all, 430 (50.4%) patients had voiding predominant LUTS and 423 (49.6%) had storage predominant LUTS.

In multivariate analysis, the storage subscale of the International Prostate Symptoms Score (IPSS) and age were the only independent predictors for elevated serum CRP level. And, patients with a CRP level greater than 0.30 mg/dL were significantly older (69.1 vs 66.2 years), had a higher IPSS voiding subscale score (7.90 vs 6.78), a smaller voided volume (181 vs 241 mL) and smaller IPSS voiding to storage subscore ratio (1.37 vs 1.63) than patients with lower CRP levels.

The team found that serum CRP levels at baseline were significantly higher in patients with storage predominant LUTS than in patients with voiding predominant LUTS (mean 0.35 vs 0.27 mg/dL).

Additionally, CRP level was associated with LUTS severity such that it was 0.40 mg/dL in those with severe LUTS compared with 0.28 and 0.31 mg/dL in those with moderate and mild LUTS, respectively.

Kuo et al found that in 99 patients with voiding predominant LUTS, 3 months of pharmacological treatment resulted in improvement in IPSS parameters, uroflow parameters and prostate-specific antigen levels, but no significant change in CRP levels.

Meanwhile, in 111 patients with storage predominant LUTS, 3 months of treatment led to significant improvements in total IPSS, the IPSS storage subscale and maximal flow rate, as well as in serum CRP levels, from 0.36 mg/dL at baseline to 0.21 mg/dL.

Writing in PLoS One, the authors comment: “Based on these interesting findings, we suggest that serum CRP, which implies the inflammatory condition in subjects, is associated with storage symptoms rather than voiding symptoms in male LUTS.”

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