Relationship between Central Obesity, General Obesity, Overactive Bladder Syndrome and Urinary Incontinence Among Male and Female Patients Seeking Care for their Lower Urinary Tract Symptoms

To describe the relationship between metabolic factors and lower urinary tract symptoms (LUTS), overactive bladder syndrome (OAB) and urinary incontinence (UI).

Adult male and female patients who presented to a clinician from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) were recruited. Urinary symptoms (presence of OAB, any UI, stress UI (SUI), urgency UI (UUI), urgency, frequency, and nocturia) were assessed with the LUTS Tool. Metabolic factors assessed included central obesity (waist circumference, using the Adult Treatment Panel III, the International Diabetes Federation thresholds, and waist circumference as a continuous variable), general obesity (body mass index [BMI] as dichotomous or continuous variables), diabetes mellitus, hypertension, and dyslipidemia. Multivariable logistic regression was used to test for associations.

920 participants were studied. In multivariable analyses, central obesity (per 10cm larger waist) was associated with higher odds of UI in both sexes (OR=1.16, p=0.008), SUI in females (OR=1.27, p=0.008), UUI in both sexes (OR=1.24, p=0.001), OAB in females (OR=1.248, p=0.003), as well as frequency and nocturia. General obesity (5-unit increase in BMI) was associated with UI, UUI, urgency and frequency in both sexes, and with SUI and OAB in females. We did not find associations between central or general obesity and OAB in males. Dyslipidemia was associated with nocturia ≥2.

In patients, central and general obesity were key metabolic factors associated with UI in both males and females, and with OAB in females but not in males. The association between dyslipidemia and nocturia ≥2 needs further research.

Urology. 2018 Oct 27 [Epub ahead of print]

H Henry Lai, Margaret E Helmuth, Abigail R Smith, Jonathan B Wiseman, Brenda W Gillespie, Ziya Kirkali, Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)

Division of Urologic Surgery, Washington University School of Medicine, St. Louis, MO. Electronic address: ., Arbor Research Collaborative for Health, Ann Arbor, MI., Department of Biostatistics, University of Michigan, Ann Arbor, MI., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.