Body Composition Modulates Risk for Stress Urinary Incontinence in Women < 60

Stress urinary incontinence (SUI) is prevalent among obese women. We hypothesize that body composition modulates the risk of SUI among nonobese women.

The National Health and Nutrition Examination survey, a nationally representative examination of adults in the United States, was used to test correlates for the presence of SUI in women aged 20-59 in two cohorts: (1) nonobese and (2) obese. Demographic data, medical comorbidities, body composition (measured by dual energy X-ray absorptiometry [DXA]), laboratory values, and macronutrient intake (24-h dietary diary; per kg lean body mass) were compared between participants with and without SUI. Data were compared using the SurveyLogistic procedure to include NHANES sample weighting for univariate and multivariate logistic regression.

We analyzed 6,276 women, 19.3% with SUI. Our univariate analysis identified that in nonobese women, increasing total body fat mass, truncal and visceral fat, and decreasing subcutaneous fat proportion were associated with risk of SUI, as were increasing total cholesterol, triglycerides, and Hgb A1c. Multivariable analysis identified that the most significant correlates in both cohorts were higher BMI, increasing age, smoking history, and increasing vaginal parity. Additionally, on multivariable analysis of the nonobese cohort, increased saturated fat intake and increased total moderate or vigorous physical activity were significant. In comparison, the obese cohort was also found to have a significant increased correlation with increased caloric intake and increased serum triglyceride levels.

Increased visceral fat distribution and cardiovascular risk factors modulate the risk for SUI in both obese and nonobese women.