中文摘要：
本篇論文目標想要驗證體內促性腺激素濃度並不影響使用β3腎上腺素受體促效劑mirabegron治療膀胱過動症的效益。


本實驗納入58名女性，使用β3腎上腺素受體促效劑mirabegron 50mg一天一次治療膀胱過動症，在治療前與追蹤期間均採血檢測體內荷爾蒙濃度，檢測內容包括雌二醇、黃體酯酮、睪固酮、促濾泡激素、黃體激素、促甲狀腺激素及四點甲狀腺素。並使用問卷UDI，UDI_OAB與PFIQ-7來評估膀胱過動症的治療效果。

結果顯示，在以β3腎上腺素受體促效劑mirabegron 50mg治療膀胱過動症兩個月的追蹤中，更年期前婦女及更年期婦女改善效果相當，在問卷UDI，UDI_OAB，和PFIQ-7結果評估都有相等程度的改善。

雖然雌激素的濃度在明顯有療效的受試組較低，但與受試後沒有明顯療效的組別相比並沒有統計學上的意義。其他荷爾蒙濃度在兩組之間都沒有顯著差別。使用邏輯迴歸分析，年齡、之前使用抗膽鹼藥物的與否、多產、更年期、以及局部雌激素的濃度皆與治療後的UDI_OAB評估改善效果無相關性。

結論：雌二醇、黃體酯酮、睪固酮、促濾泡激素、黃體激素、促甲狀腺激素及四點甲狀腺素皆不影響β3腎上腺素受體促效劑mirabegron治療膀胱過動症的效益。所以更年期不能作為是否使用β3腎上腺素受體促效劑mirabegron治療膀胱過動症的決定因素。

英文摘要：
OBJECTIVE:
The aim of this study was to evaluate if levels of gonadotropic and sex steroidal hormones influence the efficacy of mirabegron in the treatment of overactive bladder.

METHODS:
We included 58 female participants who received treatment with mirabegron 50mg once daily and provided a blood sample for hormone profiling before treatment was initiated. Serum hormone concentrations for estradiol, progesterone, testosterone, FSH, LH, TSH, and T4 were analyzed. Urinary Distress Inventory (UDI), (overactive bladder domain: UDIOAB), and the short form Pelvic Floor Impact Questionnaire (PFIQ-7) were used to assess subjective outcomes.

RESULTS:
There were significant overall improvements in UDI, UDIOAB, and the PFIQ from baseline to the 2 months of follow-up (P?=?0.001, 0.001, and 0.008, respectively). The magnitude of the mean difference of improvements was similar between pre- and postmenopausal women. Estrogen levels were nonsignificantly lower in participants who experienced an improvement in UDI and UDIOAB at 2 months of follow-up as compared with those that did not (P?=?0.7). There were no other clinically relevant differences in hormone levels in relation to improvements in UDI, UDIOAB, or PFIQ. In logistic regression analysis there were no associations between UDIOAB outcomes and age, previous use of anticholinergic drugs, parity, menopause, and local estrogen treatment.

CONCLUSIONS:
Estradiol, gonadotropic hormones, thyroid hormones, and testosterone levels did not influence the clinical effects of mirabegron in women with overactive bladder. Menopause status should not be a determinant for mirabegron treatment.
PMID: 27529461 DOI: 10.1097/GME.0000000000000708