Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, USA.
San Francisco Veterans Affairs Healthcare System, California, USA.
J Gerontol A Biol Sci Med Sci. 2021 Aug 13;76(9):1600-1607. doi: 10.1093/gerona/glab118.
Physical activity and macronutrient intake, important contributors to energy balance, may be independently associated with female urinary incontinence (UI).
We evaluated the association of baseline self-reported physical activity and macronutrient intake, via food frequency questionnaire, with incident UI subtypes after 3 years among 19 741 postmenopausal women in the Women's Health Initiative Observational Study. Odds ratios (ORs) for incident urgency, stress, and mixed UI were calculated using multivariable logistic regression.
Women who reported total physical activity (metabolic equivalent task [MET]-hours/week) ≥30 versus <0.1 were 16% less likely to develop urgency UI (OR = 0.84; 95% CI 0.70, 1.00) and 34% less likely for mixed UI (OR = 0.66; 95% CI 0.46, 0.95), although linear trends were no longer statistically significant after adjusting for baseline weight and weight change (p trend = .15 and .16, respectively). The association between physical activity and incident stress UI was less consistent. Higher uncalibrated protein intake was associated with increased odds of incident urgency UI (≥19.4% vs <14.1% of energy intake OR = 1.14; 95% CI 0.99, 1.30; p trend = .02), while CIs were wide and included 1.0 for calibrated protein intake. Other macronutrients were not associated with urgency UI and macronutrient intake was not associated with incident stress or mixed UI (p trend > .05 for all).
Among postmenopausal women, higher physical activity was associated with lower risk of incident urgency and mixed UI, but not stress UI, independent of baseline weight and weight change. Higher protein intake was associated with increased risk of urgency UI, but no associations were observed between other macronutrient and UI subtypes.
体力活动和宏量营养素摄入是能量平衡的重要因素，它们可能与女性尿失禁（UI）独立相关。
我们评估了基线自我报告的体力活动和宏量营养素摄入（通过食物频率问卷）与 19741 名绝经后妇女中 3 年后出现的女性尿失禁（UI）亚型之间的关联。使用多变量逻辑回归计算了新发急迫性、压力性和混合性 UI 的比值比（OR）。
与体力活动<0.1MET-h/周相比，体力活动≥30MET-h/周的女性发生急迫性 UI 的可能性降低 16%（OR=0.84；95%CI 0.70，1.00），发生混合性 UI 的可能性降低 34%（OR=0.66；95%CI 0.46，0.95），尽管调整基线体重和体重变化后线性趋势不再具有统计学意义（趋势 p 值分别为 0.15 和 0.16）。体力活动与新发压力性 UI 的关联不太一致。未校准的蛋白质摄入较高与新发急迫性 UI 的几率增加相关（≥19.4%与<14.1%能量摄入 OR=1.14；95%CI 0.99，1.30；趋势 p 值=0.02），而校准后的蛋白质摄入 CI 较宽，包括 1.0。其他宏量营养素与急迫性 UI 无关，宏量营养素摄入与新发压力性或混合性 UI 无关（所有趋势 p 值>0.05）。
在绝经后妇女中，较高的体力活动与新发急迫性和混合性 UI 的风险降低相关，但与压力性 UI 无关，且独立于基线体重和体重变化。较高的蛋白质摄入与急迫性 UI 的风险增加相关，但其他宏量营养素与 UI 亚型之间无关联。
