Kinesiology Department, California Polytechnic State University, San Luis Obispo, California 93407-0386, USA.
J Urol. 2012 Mar;187(3):939-44. doi: 10.1016/j.juro.2011.10.139. Epub 2012 Jan 20.
We determined the effect of weight loss on the prevalence, incidence and resolution of weekly or more frequent urinary incontinence in overweight/obese women with type 2 diabetes after 1 year of intervention in the Look AHEAD (Action for Health in Diabetes) trial.
Women in this substudy (2,739, mean ± SD age 57.9 ± 6.8 years, body mass index 36.5 ± 6.1 kg/m(2)) were randomized into an intensive lifestyle weight loss intervention or a diabetes support and education control condition.
At baseline 27% of participants reported urinary incontinence on a validated questionnaire (no significant difference by intensive lifestyle intervention vs diabetes support and education). After 1 year of intervention the intensive lifestyle intervention group in this substudy lost 7.7 ± 7.0 vs 0.7 ± 5.0 kg in the diabetes support and education group. At 1 year fewer women in the intensive lifestyle intervention group reported urinary incontinence (25.3% vs 28.6% in the diabetes support and education group, p = 0.05). Among participants without urinary incontinence at baseline 10.5% of intensive lifestyle intervention and 14.0% of diabetes support and education participants experienced urinary incontinence after 1 year (p = 0.02). There were no significant group differences in the resolution of urinary incontinence (p >0.17). Each kg of weight lost was associated with a 3% reduction in the odds of urinary incontinence developing (p = 0.01), and weight losses of 5% to 10% reduced these odds by 47% (p = 0.002).
Moderate weight loss reduced the incidence but did not improve the resolution rates of urinary incontinence at 1 year among overweight/obese women with type 2 diabetes. Weight loss interventions should be considered for the prevention of urinary incontinence in overweight/obese women with diabetes.
我们旨在探讨超重/肥胖 2 型糖尿病女性患者在经过为期 1 年的干预后，体重减轻对每周或更频繁发生的尿失禁的患病率、发病率和缓解率的影响。
这项亚组研究的参与者（2739 人，平均年龄 57.9 ± 6.8 岁，体重指数 36.5 ± 6.1kg/m²）被随机分配到强化生活方式减肥干预组或糖尿病支持和教育对照组。
在基线时，27%的参与者在经过验证的问卷中报告有尿失禁（强化生活方式干预组与糖尿病支持和教育组之间无显著差异）。在 1 年的干预后，本亚组研究中强化生活方式干预组的体重减轻了 7.7 ± 7.0kg，而糖尿病支持和教育组仅减轻了 0.7 ± 5.0kg。在 1 年时，较少的强化生活方式干预组女性报告有尿失禁（25.3%比糖尿病支持和教育组的 28.6%，p = 0.05）。在基线时没有尿失禁的参与者中，10.5%的强化生活方式干预组和 14.0%的糖尿病支持和教育组在 1 年后出现了尿失禁（p = 0.02）。两组在尿失禁的缓解率方面无显著差异（p＞0.17）。每减轻 1 公斤体重，发生尿失禁的几率降低 3%（p = 0.01），体重减轻 5%至 10%可将这种几率降低 47%（p = 0.002）。
在超重/肥胖 2 型糖尿病女性中，适度的体重减轻可降低 1 年后尿失禁的发病率，但对其缓解率无改善。对于超重/肥胖的糖尿病女性，应考虑进行减肥干预以预防尿失禁。
