Diabetes and obesity, components of the metabolic syndrome (MetS), are risk factors for urinary incontinence (UI) and chronic kidney disease (CKD). We interrogated US population-based data to explore independent, sex-specific associations between non-diabetic MetS, with and without obesity, and UI and/or CKD.
We analyzed data from 8586 males and 8420 females ≥20 years from the National Health and Nutrition Examination Survey. Multivariable logistic regression models were used to examine associations of UI or CKD with diabetes and 4 non-diabetic obesity/metabolic phenotypes: non-MetS/non-obese, MetS/non-obese, non-MetS/obese, and MetS/obese. Multinominal logistic regression models were used to assess associations of co-occurring UI/CKD with obesity/metabolic phenotypes.
Male MetS/obese participants had increased odds of any UI (1.25; 95% CI 1.00-1.57) and urgency UI (UUI) (1.36; 1.03-1.80), compared with non-MetS/non-obese participants. Female MetS/obese participants had increased odds of any UI (2.16; 95% CI 1.76-2.66), stress UI (1.51; 1.21-1.87), and mixed UI (1.66; 1.31-2.11) compared with non-MetS/non-obese participants. The odds of co-occurring UI/CKD were increased relative to either condition alone in persons with diabetes, and in males with MetS/obese phenotypes and females with MetS phenotypes as compared to same sex participants with neither obesity nor MetS.
We found novel associations between MetS/obese and UUI in males without diabetes, and between SUI and both MetS and obesity in females without diabetes. Odds estimates for UI/CKD were increased by existing obesity or MetS as compared to those for UI or CKD alone. Improved understanding of modifiable factors associated with UI will inform prevention and treatment opportunities.
The Journal of urology. 2023 Oct 20 [Epub ahead of print]
Chyng-Wen Fwu, Ivonne H Schulman, Jean M Lawrence, Paul L Kimmel, Paul Eggers, Jenna Norton, Kevin Chan, Susan R Mendley, Julia S Barthold
Social & Scientific Systems, Inc., A DLH Holdings Corp (DLH) company, Silver Spring, Maryland., Divisions of Kidney, Urologic & Hematologic Diseases., Divisions of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.