Lv Tingxuan, Liu Yonghui, Yang Jinhui, Wang Mingyue, Bo Cheng
Department of Urology, School of Clinical Medicine, Shandong Second Medical University, Weifang, China.
Department of Urology, Shengli Oilfield Central Hospital, Dongying, China.
Sci Rep. 2025 May 24;15(1):18132. doi: 10.1038/s41598-025-02574-y.
This study aims to investigate the relationships among a novel inflammatory biomarker, the red blood cell distribution width-to-albumin ratio (RAR), and three different types of urinary incontinence (UI) while evaluating the potential clinical significance of the biomarker. The National Health and Nutrition Examination Survey (NHANES)-which spanned 2007-2018-was used in this investigation. The relationship between the RAR and the prevalence of UI was assessed by logistic regression modeling, restricted cubic spline curve (RCS) analysis, and subgroup analysis. Fully adjusted models revealed a significant positive correlation between the RAR and all three types of UI (SUI: OR 1.23, 95% CI 1.12-1.35; UUI: OR 1.43, 95% CI 1.31-1.56; MUI: OR 1.44, 95% CI 1.27-1.62; all p < 0.05). Dividing the RAR into quartiles illustrated that an increased RAR was positively correlated with UI compared with a decreased RAR (SUI: OR 1.40, 95% CI 1.22-1.60; UUI: OR 1.85, 95% CI 1.60-2.14; MUI: OR 1.81, 95% CI 1.47-2.21; all p < 0.05). A nonlinear, inverted "U"-shaped relationship between the RAR and UI was demonstrated using restricted cubic spline analysis, suggesting that the RAR impacted UI only until reaching a threshold. Additionally, subgroup analysis revealed a stronger link between the RAR and SUI in women than in men (p < 0.05). An increased RAR was correlated with a heightened risk of UI, and RAR was more strongly associated with stress urinary incontinence (SUI) in women than in men. Systematic epidemiologic evidence suggests that the novel inflammatory marker RAR is associated with UI, but more research is needed to determine causality.
本研究旨在探讨一种新型炎症生物标志物——红细胞分布宽度与白蛋白比值(RAR)与三种不同类型尿失禁(UI)之间的关系,同时评估该生物标志物的潜在临床意义。本研究使用了2007年至2018年的美国国家健康与营养检查调查(NHANES)。通过逻辑回归建模、受限立方样条曲线(RCS)分析和亚组分析评估RAR与UI患病率之间的关系。完全调整模型显示,RAR与所有三种类型的UI之间存在显著正相关(压力性尿失禁[SUI]:比值比[OR]1.23,95%置信区间[CI]1.12 - 1.35;急迫性尿失禁[UUI]:OR 1.43,95% CI 1.31 - 1.56;混合性尿失禁[MUI]:OR 1.44,95% CI 1.27 - 1.62;所有p < 0.05)。将RAR分为四分位数表明,与RAR降低相比,RAR升高与UI呈正相关(SUI:OR 1.40,95% CI 1.22 - 1.60;UUI:OR 1.85,95% CI 1.60 - 2.14;MUI:OR 1.81,95% CI 1.47 - 2.21;所有p < 0.05)。使用受限立方样条分析证明了RAR与UI之间存在非线性倒“U”形关系,表明RAR仅在达到阈值之前影响UI。此外,亚组分析显示,女性中RAR与SUI之间的联系比男性更强(p < 0.05)。RAR升高与UI风险增加相关,且女性中RAR与压力性尿失禁(SUI)的关联比男性更强。系统的流行病学证据表明,新型炎症标志物RAR与UI相关,但需要更多研究来确定因果关系。