Association of Obesity, Metabolic Syndrome, and Diabetes With Urinary Incontinence and Chronic Kidney Disease: Analysis of the National Health and Nutrition Examination Survey, 2003-2020

No AccessJournal of UrologyOriginal Research Articles1 Jan 2024Association of Obesity, Metabolic Syndrome, and Diabetes With Urinary Incontinence and Chronic Kidney Disease: Analysis of the National Health and Nutrition Examination Survey, 2003-2020This article is commented on by the following:Editorial Comment Chyng-Wen Fwu, Ivonne H. Schulman, Jean M. Lawrence, Paul L. Kimmel, Paul Eggers, Jenna Norton, Kevin Chan, Susan R. Mendley, and Julia S. Barthold Chyng-Wen FwuChyng-Wen Fwu Social & Scientific Systems, Inc, A DLH Holdings Corp (DLH) Company, Silver Spring, Maryland , Ivonne H. SchulmanIvonne H. Schulman Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , Jean M. LawrenceJean M. Lawrence Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , Paul L. KimmelPaul L. Kimmel Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , Paul EggersPaul Eggers Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , Jenna NortonJenna Norton Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , Kevin ChanKevin Chan Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , Susan R. MendleySusan R. Mendley Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland , and Julia S. BartholdJulia S. Barthold *Corresponding Author: Julia S. Barthold, MD, Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Two Democracy Plaza, Room #6081, 6707 Democracy Blvd, Bethesda, MD 20892-5458 ( E-mail Address: [email protected] Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland View All Author Informationhttps://doi.org/10.1097/JU.0000000000003761AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Diabetes and obesity, components of the metabolic syndrome (MetS), are risk factors for urinary incontinence (UI) and chronic kidney disease (CKD). We interrogated US population-based data to explore independent, sex-specific associations between nondiabetic MetS, with and without obesity, and UI and/or CKD. Materials and Methods: We analyzed data from 8586 males and 8420 females ≥20 years from the National Health and Nutrition Examination Survey. Multivariable logistic regression models were used to examine associations of UI or CKD with diabetes and 4 nondiabetic obesity/metabolic phenotypes: non-MetS/nonobese, MetS/nonobese, non-MetS/obese, and MetS/obese. Multinominal logistic regression models were used to assess associations of co-occurring UI/CKD with obesity/metabolic phenotypes. Results: Male MetS/obese participants had increased odds of any UI (1.25; 95% CI 1.00-1.57) and urgency UI (1.36; 1.03-1.80), compared with non-MetS/nonobese participants. Female MetS/obese participants had increased odds of any UI (2.16; 95% CI 1.76-2.66), stress UI (1.51; 1.21-1.87), and mixed UI (1.66; 1.31-2.11) compared with non-MetS/nonobese participants. The odds of co-occurring UI/CKD were increased relative to either condition alone in persons with diabetes, and in males with MetS/obese phenotypes and females with MetS phenotypes as compared to same sex participants with neither obesity nor MetS. Conclusions: We found novel associations between MetS/obese and urgency UI in males without diabetes, and between SUI and both MetS and obesity in females without diabetes. Odds estimates for UI/CKD were increased by existing obesity or MetS as compared to those for UI or CKD alone. Improved understanding of modifiable factors associated with UI will inform prevention and treatment opportunities. REFERENCES 1. . Association between stress urinary incontinence and the components of metabolic syndrome among females 20-59 years. Urology. 2020; 145:100-105. Crossref, Medline, Google Scholar 2. . The relationship between BMI and urinary incontinence subgroups: results from EpiLUTS. Neurourol Urodyn. 2014; 33(4):392-399. 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Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: In lieu of a formal ethics committee, the principles of the Helsinki Declaration were followed. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBrown H and McAchran S (2024) Editorial CommentJournal of Urology, VOL. 211, NO. 1, (133-133), Online publication date: 1-Jan-2024.Related articlesJournal of Urology1 Jan 2024Editorial Comment Volume 211Issue 1January 2024Page: 124-133 Peer Review Report Patient Summary Open Patient Summary Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordsurinary incontinencechronic kidney diseaseobesitymetabolic diseasediabetesMetrics Author Information Chyng-Wen Fwu Social & Scientific Systems, Inc, A DLH Holdings Corp (DLH) Company, Silver Spring, Maryland More articles by this author Ivonne H. Schulman Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Jean M. Lawrence Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Paul L. Kimmel Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Paul Eggers Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Jenna Norton Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Kevin Chan Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Susan R. Mendley Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland More articles by this author Julia S. Barthold Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland *Corresponding Author: Julia S. Barthold, MD, Division of Kidney, Urologic & Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Two Democracy Plaza, Room #6081, 6707 Democracy Blvd, Bethesda, MD 20892-5458 ( E-mail Address: [email protected] More articles by this author Expand All Support: This work was supported by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) contracts HHSN275201700074U and 75N94022F00050. The opinions expressed in this paper do not necessarily reflect those of the National Institute of Diabetes, Digestive and Kidney Diseases, the National Institutes of Health, the Department of Health and Human Services, and the government of the United States. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: In lieu of a formal ethics committee, the principles of the Helsinki Declaration were followed. Advertisement PDF downloadLoading ...