Wang Jiameng, Wang Boyu, Li Chengjia, Meng Tianwei, Zhou Yue, Chen Jia, Cong Huifang
Heilongjiang University of Chinese Medicine, Harbin 150040, China.
The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001, China.
Eur J Obstet Gynecol Reprod Biol. 2025 Jun;310:113990. doi: 10.1016/j.ejogrb.2025.113990. Epub 2025 Apr 22.
Urinary incontinence (UI) is closely related to metabolic conditions. The cardiometabolic index (CMI) is a novel and easily obtainable indicator used to assess metabolic status. This study aims to explore the potential relationship between CMI and female UI.
Data from the NHANES spanning seven consecutive survey cycles from 2005 to 2018 were used, including adult women who self-reported UI and had complete CMI calculation information. The CMI calculation formula is triglycerides(TG)/high-density lipoprotein cholesterol (HDL-C) × waist-to-height ratio (WHtR, WHtR = waist circumference/height). A multivariate logistic regression model was used to examine the linear relationship between CMI and UUI, SUI, and MUI, and subgroup analyses were conducted to explore potential influencing factors. Additionally, RCS curves were used to plot and analyze nonlinear relationships and threshold effects.
A total of 6,628 adult women were enrolled in this study. Multivariate logistic regression showed that in the fully adjusted model, compared to subjects with the lowest CMI, those with the highest CMI had an increased association with UUI, SUI, and MUI by 1.14 times (OR = 2.14; 95 % CI, 1.83-2.50, P < 0.0001), 0.38 times (OR = 1.38; 95 % CI, 1.17-1.63, P = 0.0001), and 0.83 times (OR = 1.83; 95 % CI, 1.49-2.23, P < 0.0001), respectively. Subgroup analysis revealed significant interaction between multiple subgroups and UUI, SUI, and MUI. Additionally, the association between CMI and UUI, SUI, and MUI was nonlinear, with inflection points at 2.98, 3.21, and 2.98, respectively.
Elevated CMI levels are closely associated with UI and suggest that CMI may serve as a useful reference indicator for assessing UI risk; however, larger prospective cohort studies are needed to validate these findings and clarify the causal relationship between CMI and UI to advance its potential clinical application.
尿失禁(UI)与代谢状况密切相关。心脏代谢指数(CMI)是一种用于评估代谢状态的新型且易于获得的指标。本研究旨在探讨CMI与女性尿失禁之间的潜在关系。
使用了2005年至2018年连续七个调查周期的美国国家健康与营养检查调查(NHANES)数据,包括自我报告有尿失禁且有完整CMI计算信息的成年女性。CMI计算公式为甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)×腰高比(WHtR,WHtR =腰围/身高)。采用多因素逻辑回归模型检验CMI与急迫性尿失禁(UUI)、压力性尿失禁(SUI)和混合性尿失禁(MUI)之间的线性关系,并进行亚组分析以探索潜在影响因素。此外,使用限制立方样条(RCS)曲线绘制和分析非线性关系及阈值效应。
本研究共纳入6628名成年女性。多因素逻辑回归显示,在完全调整模型中,与CMI最低的受试者相比,CMI最高的受试者与UUI、SUI和MUI的关联分别增加1.14倍(OR = 2.14;95%CI,1.83 - 2.50,P < 0.0001)、0.38倍(OR = 1.38;95%CI,1.17 - 1.63,P = 0.0001)和0.83倍(OR = 1.83;95%CI,1.49 - 2.23,P < 0.0001)。亚组分析显示多个亚组与UUI、SUI和MUI之间存在显著交互作用。此外,CMI与UUI、SUI和MUI之间的关联是非线性的,拐点分别为2.98、3.21和2.98。
CMI水平升高与尿失禁密切相关,提示CMI可能作为评估尿失禁风险的有用参考指标;然而,需要更大规模的前瞻性队列研究来验证这些发现并阐明CMI与尿失禁之间的因果关系,以推进其潜在的临床应用。