Association between imaging-derived fat distribution and stress urinary incontinence: a cross-sectional study in US adult women.

OBJECTIVE

To investigate the relationship between android-to-gynoid fat ratio (A/G ratio) and stress urinary incontinence (SUI) in US adult women.

METHODS

The study employed data from the National Health and Nutrition Examination Survey (NHANES) database, encompassing the 2005-2006 and 2011-2018 cycles. We utilized multivariable-adjusted logistic regression models to examine the independent effect of the A/G ratio on SUI. Additionally, refined subgroup analyses were conducted to assess the impact of effect modifiers, along with sophisticated smooth curve fitting methods to delve into the potential non-linear relationship between the A/G ratio and SUI.

RESULTS

Of the 6779 women participants with an average age of 40.812, 2565 (37.8%) self-reported SUI. A non-linear relationship between the A/G ratio and SUI has been detected, with the threshold (A/G ratio = 0.446). Above and below this threshold, the effect sizes and the 95% confidence intervals were 1.464 (0.775-2.766) and 10.308 (3.558-29.863), respectively. Subgroup analyses showed that the positive association was more pronounced among young women who were premenopausal, living alone, hypertensive and with normal or low body mass index (BMI).

CONCLUSION

There was a non-linear relationship between the A/G ratio and SUI. In individuals with a lower A/G ratio, even small increases in the A/G ratio substantially elevated the risk of SUI. Results of this study indicate that A/G ratio, as a measure of fat distribution, is of great importance for clinicians in assessing SUI risk and timely intervening.