Ebbesen Marit Helen, Hannestad Yngvild S, Midthjell Kristian, Hunskaar Steinar
Section for General Practice, Department of Public and Primary Health Care, University of Bergen, Norway.
BMC Urol. 2009 Sep 10;9:11. doi: 10.1186/1471-2490-9-11.
Previous studies have shown an association between diabetes mellitus (DM) and urinary incontinence (UI) in women, especially severe UI. The purpose of this study was to investigate whether diabetes related variables could explain this association.
The study is part of the EPINCONT study, which is based on the large Nord-Trøndelag Health Study 2 (HUNT 2), performed in the county of Nord-Trøndelag, Norway, during the years 1995 - 1997. Questions on diabetes and UI were answered by a total of 21 057 women aged 20 years and older. Of these 685 were identified as having diabetes, and thus comprise the population of our study. A variety of clinical and biochemical variables were recorded from the participants.
Blood-glucose, HbA1c, albumine:creatinine ratio (ACR), duration of diabetes, diabetes treatment, type of diabetes, cholesterol and triglycerides did not significantly differ in women with and without UI in crude analyses. However, the diabetic women with UI had more hospitalizations during the last 12 months, more homecare, and a higher prevalence of angina and use of oestrogene treatment (both local and oral/patch). After adjusting for age, BMI, parity and smoking, there were statistically significant associations between any UI and angina (OR 1.89; 95% CI: 1.22 - 2.93), homecare (OR 1.72; 95% CI: 1.02 - 2.89), and hospitalization during the last 12 months (OR 1.67; 95% CI: 1.18 - 2.38). In adjusted analyses severe UI was also significantly associated with the same variables, and also with diabetes drug treatment (OR 2.10; 95% CI: 1.07 - 4.10) and stroke (OR 2.47; 95% CI: 1.09 - 5.59).
No single diabetes related risk factor seems to explain the increased risk for UI among women with diabetes. However, we found associations between UI and some clinical correlates of diabetes.
既往研究表明,糖尿病(DM)与女性尿失禁(UI)之间存在关联,尤其是严重尿失禁。本研究旨在调查与糖尿病相关的变量是否能解释这种关联。
本研究是EPINCONT研究的一部分,该研究基于1995 - 1997年在挪威北特伦德拉格郡进行的大型北特伦德拉格健康研究2(HUNT 2)。共有21057名20岁及以上的女性回答了有关糖尿病和尿失禁的问题。其中685名被确定患有糖尿病,因此构成了我们的研究人群。记录了参与者的各种临床和生化变量。
在粗分析中,有尿失禁和无尿失禁的女性在血糖、糖化血红蛋白、白蛋白:肌酐比值(ACR)、糖尿病病程、糖尿病治疗、糖尿病类型、胆固醇和甘油三酯方面无显著差异。然而,患有尿失禁的糖尿病女性在过去12个月内住院次数更多、接受家庭护理更多,心绞痛患病率更高且雌激素治疗(局部和口服/贴片)的使用率更高。在调整年龄、体重指数、产次和吸烟因素后,任何类型的尿失禁与心绞痛(比值比1.89;95%可信区间:1.22 - 2.93)、家庭护理(比值比1.72;95%可信区间:1.02 - 2.89)以及过去12个月内的住院治疗(比值比1.67;95%可信区间:1.18 - 2.38)之间存在统计学上的显著关联。在调整分析中,严重尿失禁也与相同变量显著相关,还与糖尿病药物治疗(比值比2.10;95%可信区间:1.07 - 4.10)和中风(比值比2.47;95%可信区间:1.09 - 5.59)相关。
似乎没有单一的糖尿病相关危险因素能解释糖尿病女性尿失禁风险增加的原因。然而,我们发现尿失禁与糖尿病的一些临床相关因素之间存在关联。