Association Between Stress Urinary Incontinence and the Components of Metabolic Syndrome Among Females 20-59 Years

Approximately 20-52% of women are affected by stress urinary incontinence (SUI) with roughly $13 billion spent annually on medical care, treatments, and nursing home admissions. The association between SUI and obesity is well established, with landmark studies showing a significant reduction in SUI symptoms with weight loss. Obesity prevalence continues to rise which has implications on incontinence but also cardiometabolic sequelae, such as the development of metabolic syndrome. Studies have shown an association between SUI and metabolic syndrome, yet the relationship remains poorly understood. This study aimed to better define the interplay between SUI and metabolic syndrome by assessing the relationship between SUI and the component criteria of metabolic syndrome.

In this study, we used the National Health and Nutrition Examination Survey (NHANES) population-based database between the years of 2013-2016. Women aged 20-59 years were identified and SUI was defined as self-reported “leakage with physical activity.” The National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III was used to define metabolic syndrome, which included three or more of the following risk factors: blood pressure > 130/85, high-density lipoprotein (HDL) levels < 50 mg/dl, triglycerides > 149 mg/dl, abdominal obesity > 88cm, and fasting blood glucose (FBG) > 99 mg/dl.

Among all women, we found the prevalence of SUI to be 38.7% and the prevalence of metabolic syndrome to be 10.2%. More than 50% of women with metabolic syndrome had concurrent SUI. We also found that women with metabolic syndrome and an elevated FBG had a significantly increased risk of SUI. Interestingly, younger women (aged 20-39 years) with a large waistline were found to have a significantly increased risk of SUI.

Given the rising prevalence of obesity and cardiometabolic sequelae, these findings have numerous implications for patient counseling and future research. Among women aged 20-59 years with metabolic syndrome, the management of elevated FBG should be considered a key treatment strategy. In younger women 20-39 years with SUI and metabolic disease, providers should consider weight loss for symptom improvement.

Written by: Stephanie Gleicher, MD, and Natasha Ginzburg, MD, Department of Urology, SUNY Upstate Medical University, Syracuse, NY

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