Clinical Medical Center, National Research Institute for Family Planning, Beijing, China.
Department of Epidemiology and Biostatistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
BMC Public Health. 2023 Mar 11;23(1):471. doi: 10.1186/s12889-023-15324-4.
The objective of this study was to analyze the association between calf circumference and incontinence in Chinese elderly, and to find out the maximal cut-off point by gender for the use of calf circumference in screening for incontinence.
In this study, participants were from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The maximal calf circumference cut-off point and other incontinence-related risk factors were explored using receiver operating characteristic (ROC) curves and logistic regression analysis.
The study included 14,989 elderly people (6,516 males and 8,473 females) over 60. The prevalence of incontinence in elderly males was 5.23% (341/6,516), significantly lower than females, which was 8.31% (704/8,473) (p < 0.001). There was no correlation between calf circumference < 34 cm in males and < 33 cm in females and incontinence after adjusting the confounders. We further stratified by gender to predict incontinence in elderly based on the Youden index of ROC curves. We found the association between calf circumference and incontinence was the strongest when the cut-off points were < 28.5 cm for males and < 26.5 cm for females, with an odds rate (OR) value of 1.620 (male, 95%CI: 1.197-2.288) and 1.292 (female, 95%CI: 1.044-1.600) after adjusting the covariates, respectively.
Our study suggests that calf circumference < 28.5 cm in males and < 26.5 cm in females is a risk factor for incontinence in the Chinese elderly population. Calf circumference should be measured in routine physical examination, and timely interventions should be made to reduce the risk of incontinence in subjects with calf circumference less than the threshold.
本研究旨在分析中国老年人小腿围与尿失禁的关系，并确定男女小腿围的最大截断点，以便将其用于筛查尿失禁。
本研究对象来自 2018 年中国老年健康长寿调查（CLHLS）。采用受试者工作特征（ROC）曲线和 logistic 回归分析探讨最大小腿围截断点和其他与尿失禁相关的危险因素。
本研究共纳入 14989 名 60 岁以上老年人（男性 6516 人，女性 8473 人）。男性老年人尿失禁的患病率为 5.23%（341/6516），明显低于女性（8.31%，704/8473）（p<0.001）。在校正混杂因素后，男性小腿围<34cm 与女性小腿围<33cm 与尿失禁均无相关性。我们进一步按性别分层，根据 ROC 曲线的约登指数预测老年人尿失禁。我们发现，当男性的截断点为<28.5cm，女性的截断点为<26.5cm 时，小腿围与尿失禁之间的关联最强，调整协变量后，男性的优势比（OR）值为 1.620（95%CI：1.197-2.288），女性的 OR 值为 1.292（95%CI：1.044-1.600）。
本研究表明，男性小腿围<28.5cm，女性<26.5cm 是中国老年人群尿失禁的危险因素。在常规体检中应测量小腿围，对于小腿围小于阈值的人群，应及时进行干预，降低尿失禁的风险。
