Association between triglyceride glucose body mass index and urinary incontinence: a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) 2001 to 2018

Abstract

Background: Urinary incontinence (UI) is a prevalent, health-threatening condition that causes isolation and psychological strain, leading to significant personal distress. The connection between the triglyceride glucose body mass index (TyG-BMI) and UI remains elusive. The purpose of the current research was to investigate any possible relationships between raised TyG-BMI levels and a higher likelihood of UI.

Methods: For a thorough examination, adults 20 years and older with UI were included in cross-sectional research using the data obtained from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. Our investigation centred on three of the significant varieties of UI: Urgent Urinary Incontinence (UUI), Mixed Urinary Incontinence (MUI), and Stress Urinary Incontinence (SUI), employing weighted multivariate logistic regression models for an in-depth evaluation. The TyG-BMI, a possible biomarker, was arranged in increasing order among participants and then assessed with a trend test (P for trend). Moreover, this investigation delved into the non-linear relationships using advanced smoothed curve fitting techniques. Meticulous subgroup analyses were executed to verify the uniformity of the UI and TyG-BMI relationship across diverse demographic groups.

Results: A thorough investigation was conducted with 18,751 subjects to analyze the prevalence and types of UI, showing that 23.59% of individuals suffered from SUI, 19.42% from UUI, and 9.32% from MUI. Considering all possible confounding variables, Multivariate logistic regression analysis showed a substantial relationship between elevated TyG-BMI values and a greater likelihood across all UI categories. Specifically, stratifying the TyG-BMI into quartiles revealed a pronounced positive correlation in the top quartile relative to the bottom, reflected in increased odds ratios for SUI, UUI, and MUI (SUI: OR = 2.36, 95% CI 2.03-2.78, P < 0.0001; UUI: OR = 1.86, 95% CI 1.65-2.09, P < 0.0001; MUI: OR = 2.07, 95% CI 1.71-2.51, P < 0.0001).

Conclusions: Among US adults, an association has been observed wherein increased TyG-BMI values correlate with a higher chance of UI. This suggests that TyG-BMI might be a helpful marker for identifying individuals at risk of UI, providing novel insights into its assessment and management.

Keywords: Cross-sectional study; Insulin resistance; NHANES; Triglyceride glucose body mass index; Urinary incontinence.

Fig. 1

Flowchart of participants selection from NHANES 2001–2018

Fig. 2

Smooth curve fitting for the relationship between TyG-BMI and three UI types. A, B, and C represent the linear associations between TyG-BMI and SUI, UUI, and MUI, respectively. The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. The Y-axis represents the probability of occurrence of each of the three UI types

Fig. 3

Subgroup analysis of the association between TyG-BMI and three UI types. A, B and C represent the subgroup analysis results for the relationships between TyG-BMI and SUI, UUI, and MUI in different stratifications

Fig. 4

Receiver operating characteristic (ROC) curve analysis for assessing the association with UI. A TyG-BMI was assessed to identify SUI. B TyG-BMI was assessed to identify MUI. (C) TyG-BMI was assessed to identify UUI