Lawrence Jean M, Lukacz Emily S, Liu In-Lu Amy, Nager Charles W, Luber Karl M
Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena CA 91101, USA.
Diabetes Care. 2007 Oct;30(10):2536-41. doi: 10.2337/dc07-0262. Epub 2007 Jul 9.
We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women.
Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report. Women were categorized hierarchically as nonobese/nondiabetic (reference), nonobese/diabetic, obese/nondiabetic, and obese/diabetic.
Of 3,962 women, 393 (10%) had diabetes. In unadjusted analyses, women with diabetes and women who were obese had greater odds of having PFDs. Among women with diabetes, being obese was associated with SUI and OAB. After adjusting for confounders, we found that obese/diabetic women were at the highest likelihood of having SUI (odds ratio 3.67 [95% CI 2.48-5.43]) and AI (2.09 [1.48-2.97]). The odds of having OAB among obese women was the same for obese/diabetic women (2.97 [2.08-4.36]) and obese/nondiabetic women (2.93 [2.33-3.68]). Nonobese/diabetic women had higher odds of SUI (1.90 [1.15-3.11]) but did not differ significantly in their OAB (1.45 [0.88-2.38]) and AI (1.33 [0.89-2.00]) prevalence from nonobese/nondiabetic women.
Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFDs.
我们研究了社区居住女性中肥胖、糖尿病与女性盆底功能障碍（PFD）、压力性尿失禁（SUI）、膀胱过度活动症（OAB）和肛门失禁（AI）之间的关联。
使用经过验证的邮寄调查问卷对女性进行PFD筛查。从临床数据库中提取糖尿病状态、血糖控制情况和糖尿病治疗信息，而PFD的其他风险因素则通过自我报告获得。女性被分层分类为非肥胖/非糖尿病（参照组）、非肥胖/糖尿病、肥胖/非糖尿病和肥胖/糖尿病。
在3962名女性中，393名（10%）患有糖尿病。在未经调整的分析中，患有糖尿病的女性和肥胖女性患PFD的几率更高。在患有糖尿病的女性中，肥胖与SUI和OAB相关。在对混杂因素进行调整后，我们发现肥胖/糖尿病女性患SUI的可能性最高（优势比3.67 [95%置信区间2.48 - 5.43]）和AI（2.09 [1.48 - 2.97]）。肥胖女性中患OAB的几率在肥胖/糖尿病女性（2.97 [2.08 - 4.36]）和肥胖/非糖尿病女性（2.93 [2.33 - 3.68]）中相同。非肥胖/糖尿病女性患SUI的几率较高（1.90 [1.15 - 3.11]），但其OAB（1.45 [0.88 - 2.38]）和AI（1.33 [0.89 - 2.00]）患病率与非肥胖/非糖尿病女性相比无显著差异。
鉴于PFD女性的生活质量受损，医疗保健提供者应告知女性，肥胖和糖尿病可能是PFD独立的可改变风险因素。
