A NEW study has uncovered potential biological clues behind why some adults with type II diabetes develop urinary incontinence, a common but often overlooked complication of the disease. The research points to a specific oxidative stress marker, 4-hydroxynonenal (4-HNE), as a possible indicator of the distinct biological processes contributing to incontinence in diabetic patients.
Urinary incontinence affects millions worldwide, and its prevalence is significantly higher among people with diabetes. Scientists have long suspected that the condition in diabetics arises from a combination of nerve damage, oxidative stress, and impaired tissue function. However, the precise molecular pathways have remained unclear.
4-HNE: A Potential Indicator in Diabetic Urinary Incontinence
In this cross-sectional study, researchers from Turkey analysed serum samples from 120 adults divided into three groups: individuals with type II diabetes and urinary incontinence, individuals with urinary incontinence unrelated to diabetes, and healthy controls. The team measured levels of several biomarkers implicated in inflammation, immune regulation, oxidative stress, and neurodegeneration, including LL-37, elafin, the vitamin D receptor (VDR), 4-HNE, and amyloid-β1–42.
Among all biomarkers studied, 4-HNE stood out. The researchers found that levels of this oxidative stress marker were significantly lower in the diabetic incontinence group compared to both non-diabetic incontinence patients and healthy individuals. This distinct pattern suggests that diabetics with incontinence may experience a unique form of oxidative imbalance affecting the bladder or associated nerves.
By contrast, the remaining biomarkers, LL-37, elafin, VDR, and amyloid-β1–42, did not show statistically significant differences between groups once Bonferroni corrections were applied. While these molecules are known to play roles in immune function and neuroinflammation, they did not appear to clearly differentiate diabetic incontinence from other forms of incontinence.
Managing and Identifying Diabetic Urinary Incontinence Early
The authors emphasise that these findings are preliminary but promising. The identification of 4-HNE as a potential distinguishing biomarker opens new avenues for understanding how diabetes alters bladder function at the molecular level. If validated in larger, longitudinal studies, this biomarker could help clinicians better diagnose the underlying causes of incontinence in diabetic patients and eventually tailor more targeted treatments.
For now, the study offers fresh insight into a condition that significantly affects quality of life and remains under-recognised in diabetes care.
Reference
Albaz A et al. Inflammatory and neuroimmune imbalance in diabetic incontinence: insights from serum biomarker profiling. BMC Urol. 2025; 25:297.
