Jing Weixing, Wei Cailiu, Huang Yiqi, Fu Tianxiao, Shen Weigang, Xiao Weicheng
Department of Emergency, Shaoxing Second Hospital, Shaoxing, Zhejiang, China.
Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China.
Medicine (Baltimore). 2025 Jun 20;104(25):e42996. doi: 10.1097/MD.0000000000042996.
This study investigated the relationship between the weight-adjusted-waist index (WWI), calculated as waist circumference (WC) divided by the square root of weight, and the risk of 3 types of urinary incontinence (UI) in women. Data from the National Health and Nutrition Examination Survey spanning 2007 to 2020 were analyzed, including 7236 female participants aged 20 years and older. UI types (stress UI [SUI], urgency UI [UUI], and mixed UI [MUI]) were classified based on self-reported questionnaires. Multivariate logistic regression models were used to assess the association between WWI and UI, adjusting for covariates such as age, race, marital status, education level, and comorbidities. Subgroup analyses were conducted to evaluate the consistency of associations across different age groups, body mass index (BMI) categories, and racial backgrounds. Additionally, dose-response relationships were examined, and receiver operating characteristic curve analysis was performed to compare the predictive ability of WWI, BMI, and WC for UI. The results revealed that the prevalence rates of SUI, UUI, and MUI were 47.55%, 29.09%, and 18.14%, respectively. Higher WWI was significantly associated with increased risks of all 3 UI types. In the fully adjusted model (Model 4), the odds ratios for SUI, UUI, and MUI were 1.28 (95% confidence interval [CI]: 1.18-1.37), 1.17 (95% CI: 1.08-1.28), and 1.23 (95% CI: 1.13-1.34), respectively. Subgroup analyses confirmed consistent associations across various demographic and clinical subgroups. Receiver operating characteristic curve analysis demonstrated that WWI had superior discrimination ability compared to BMI and WC, with higher area under the curve (AUC) values for SUI (AUC = 0.601), UUI (AUC = 0.630), and MUI (AUC = 0.628). In conclusion, this study highlights a significant association between higher WWI and increased risks of SUI, UUI, and MUI in women. WWI may serve as a more effective anthropometric indicator for assessing UI risk compared to traditional measures like BMI and WC, offering potential utility in clinical and public health settings for identifying individuals at higher risk of UI and guiding targeted prevention strategies.
本研究调查了体重调整腰围指数（WWI，计算方法为腰围[WC]除以体重的平方根）与女性三种尿失禁（UI）类型风险之间的关系。分析了2007年至2020年美国国家健康与营养检查调查的数据，包括7236名20岁及以上的女性参与者。根据自我报告问卷对UI类型（压力性尿失禁[SUI]、急迫性尿失禁[UUI]和混合性尿失禁[MUI]）进行分类。使用多变量逻辑回归模型评估WWI与UI之间的关联，并对年龄、种族、婚姻状况、教育水平和合并症等协变量进行调整。进行亚组分析以评估不同年龄组、体重指数（BMI）类别和种族背景之间关联的一致性。此外，还检查了剂量反应关系，并进行了受试者工作特征曲线分析，以比较WWI、BMI和WC对UI的预测能力。结果显示，SUI、UUI和MUI的患病率分别为47.55%、29.09%和18.14%。较高的WWI与所有三种UI类型风险增加显著相关。在完全调整模型（模型4）中，SUI、UUI和MUI的比值比分别为1.28（95%置信区间[CI]：1.18 - 1.37）、1.17（95%CI：1.08 - 1.28）和1.23（95%CI：1.13 - 1.34）。亚组分析证实了在不同人口统计学和临床亚组中的一致关联。受试者工作特征曲线分析表明，与BMI和WC相比，WWI具有更好的辨别能力；对于SUI（曲线下面积[AUC]=0.601）、UUI（AUC = 0.630）和MUI（AUC = 0.628），其AUC值更高。总之，本研究强调了较高的WWI与女性SUI、UUI和MUI风险增加之间的显著关联。与BMI和WC等传统指标相比，WWI可能是评估UI风险更有效的人体测量指标，在临床和公共卫生环境中具有潜在用途，可用于识别UI风险较高的个体并指导针对性的预防策略。
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