Zhang Fan, Li Wenjian
Changzhou Clinical College, Xuzhou Medical University, Changzhou, Jiangsu, People's Republic of China.
Department of Endocrinology, Changzhou Third People's Hospital, Changzhou, Jiangsu, People's Republic of China.
Int J Womens Health. 2024 Sep 30;16:1607-1624. doi: 10.2147/IJWH.S489959. eCollection 2024.
This study examined the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and urinary incontinence in adult women and evaluated the potential contribution of the fatty liver index (FLI) in this context.
The study utilized data from the National Health and Nutrition Examination Survey (NHANES) database, spanning from 2001 to 2018. The study included 17,221 adult female participants. Individuals exhibiting FLI values of 60 or greater were diagnosed with hepatic steatosis. Incontinence type and MASLD status were evaluated by analyzing questionnaire data and calculating the FLI. Logistic regression models were employed to examine the correlation between FLI, MASLD, and urinary incontinence, with potential confounding variables controlled through multivariate adjustment models. Furthermore, restricted cubic spline curve (RCS) modeling and subgroup analysis were employed to elucidate the relationship between variables further.
The median age of participants in the MASLD group was higher than that of the non-MASLD group (53 vs 46 years, P < 0.001). The findings indicated a positive association between FLI and MASLD and the risk of urinary incontinence. Specifically, the risk of stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI) all increased significantly with increasing quartiles of FLI (OR 2.44, 1.91, 2.30, respectively, P < 0.001). In the multivariate-adjusted model, SUI, UUI, and MUI risk was 76%, 50%, and 69% higher in patients with MASLD than those without MASLD. RCS analysis demonstrated a significant nonlinear positive correlation between FLI and the risk of SUI, UUI, and MUI, respectively.
This study's findings indicate a significant association between MASLD and the risk of developing urinary incontinence. Additionally, the results suggest that FLI and MASLD may act as independent risk factors for urinary incontinence.
本研究探讨了成年女性代谢功能障碍相关脂肪性肝病（MASLD）与尿失禁之间的关系，并评估了在此背景下脂肪肝指数（FLI）的潜在作用。
本研究利用了2001年至2018年的美国国家健康与营养检查调查（NHANES）数据库中的数据。该研究纳入了17221名成年女性参与者。FLI值≥60的个体被诊断为肝脂肪变性。通过分析问卷数据和计算FLI来评估失禁类型和MASLD状态。采用逻辑回归模型来检验FLI、MASLD与尿失禁之间的相关性，并通过多变量调整模型控制潜在的混杂变量。此外，采用受限立方样条曲线（RCS）建模和亚组分析进一步阐明变量之间的关系。
MASLD组参与者的年龄中位数高于非MASLD组（53岁对46岁，P<0.001）。研究结果表明，FLI与MASLD以及尿失禁风险之间呈正相关。具体而言，随着FLI四分位数的增加，压力性尿失禁（SUI）、急迫性尿失禁（UUI）和混合性尿失禁（MUI）的风险均显著增加（OR分别为2.44、1.91、2.30，P<0.001）。在多变量调整模型中，与无MASLD的患者相比，有MASLD的患者发生SUI、UUI和MUI的风险分别高76%、50%和69%。RCS分析表明，FLI与SUI、UUI和MUI风险之间分别存在显著的非线性正相关。
本研究结果表明，MASLD与发生尿失禁的风险之间存在显著关联。此外，结果提示FLI和MASLD可能是尿失禁的独立危险因素。
