Department of Obstetrics and Gynaecology, Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China.
Neurourol Urodyn. 2024 Nov;43(8):2039-2051. doi: 10.1002/nau.25564. Epub 2024 Jul 31.
The purpose of this study was to find out the relation between visceral adipose index (VAI) levels and stress urinary incontinence (SUI) in adult women.
From the National Health and Nutrition Examination Survey (NHANES) 2007-2020, females aged 20 or above were identified for this study. Visceral adiposity was determined using the VAI score, and the assessment of urinary incontinence was carried out through a correlation questionnaire. Logistic regression models and restricted cubic spline (RCS) regression were employed to analyze the relationship between VAI levels and SUI.
Among the 6522 participants, 2672 (41.0%) were reported SUI. Multivariate logistic regression revealed significantly higher odds of SUI with increasing VAI levels (Q4 vs. Q1), adjusted odds ratio (aOR) = 1.53 (CI: 1.29-1.81, p < 0.001). RCS regression indicated a curvilinear relationship between VAI and SUI (p = 0.003). In threshold analysis, aOR for developing SUI was 1.18 (CI: 1.11-1.26, p < 0.001) for participants with VAI < 4.73, suggesting an 18% increased risk of SUI with each unit increase in VAI. No association between VAI and SUI was observed when VAI was ≥4.73.
Our study has revealed a significant curvilinear relationship between VAI and SUI within a large and representative sample of women. Future research is necessary to evaluate the relationship between the two and explicate the underlying mechanisms of this relationship.
本研究旨在探讨成年女性内脏脂肪指数(VAI)水平与压力性尿失禁(SUI)之间的关系。
本研究从 2007 年至 2020 年的全国健康与营养调查(NHANES)中确定了年龄在 20 岁及以上的女性。使用 VAI 评分来确定内脏肥胖,通过相关问卷调查来评估尿失禁。采用 logistic 回归模型和限制性立方样条(RCS)回归分析 VAI 水平与 SUI 之间的关系。
在 6522 名参与者中,有 2672 名(41.0%)报告有 SUI。多变量 logistic 回归显示,随着 VAI 水平的升高(Q4 与 Q1 相比),SUI 的发生几率显著增加,调整后的优势比(aOR)=1.53(95%CI:1.29-1.81,p<0.001)。RCS 回归表明,VAI 与 SUI 之间存在曲线关系(p=0.003)。在阈值分析中,对于 VAI<4.73 的参与者,VAI 每增加 1 单位,发生 SUI 的 aOR 为 1.18(95%CI:1.11-1.26,p<0.001),表明 VAI 每增加 1 单位,SUI 的风险增加 18%。当 VAI≥4.73 时,VAI 与 SUI 之间无关联。
本研究在一个大型且具有代表性的女性样本中发现了 VAI 与 SUI 之间存在显著的曲线关系。需要进一步研究来评估两者之间的关系,并阐明这种关系的潜在机制。