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Association Between Added Sugar Intake and Urinary Incontinence in Females: A Cross-sectional Population-based Study

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Abstract

Introduction and hypothesis

Urinary incontinence (UI) is a widespread issue in women that severely impacts quality of life. The addition of sugar is associated with multiple adverse effects on health. This study examined the potential association between added sugar intake and UI.

Methods

Adult females from the National Health and Nutrition Examination Survey database (2005–2018) were included in this study. The primary outcomes were the prevalence of stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI). Weighted logistic regression, stratified logistic regression, restricted cubic spline regression, and sensitivity analyses were utilized to determine whether added sugar was associated with UI after multivariate adjustment.

Results

A total of 14,927 participants met the inclusion criteria. The results revealed a heightened prevalence of SUI, UUI, and MUI in the fourth quartile of added sugar energy percentage (OR = 1.304, 95% confidence interval [CI] = 1.105–1.539; OR = 1.464, 95% CI = 1.248–1.717; OR = 1.657, 95% CI = 1.329–2.065 respectively). The effect was more pronounced in young women and the subgroup analyses did not reveal any noteworthy interaction effects. According to the sensitivity analyses, the results for SUI and the MUI were consistent with those of the primary analyses.

Conclusions

The excessive intake of added sugar among women may increase their risk of SUI and MUI. Our study highlights the negative effects of added sugar on female genitourinary health and highlights the need for universal access to healthy diets.

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Data Availability

The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.

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Acknowledgements

We thank all the contributors and participants in the National Health and Nutrition Examination Survey. We also thank Zhang Jing (Shanghai Tongren Hospital) for his work on the NHANES database. His outstanding work, nhanesR package, and webpage, made it easier for us to explore the NHANES database.

Funding

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Author information

Authors and Affiliations

  1. Urology Department, the Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China

    Ye Yuan, Yinchao Huang, Hao Huang, Shengjie Zeng & Zili Hu

Authors
  1. Ye Yuan
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  2. Yinchao Huang
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  3. Hao Huang
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  4. Shengjie Zeng
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  5. Zili Hu
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Contributions

Y.Y.: project development, data collection, manuscript writing; Y.H. and H.H.: data analysis; S.Z.: data collection; Z.H.: project development.

Corresponding author

Correspondence to Zili Hu.

Ethics declarations

Declarations

The studies involving humans were approved by the National Institute of Health Research Ethics Review Board. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Conflicts of interest

None.

Additional information

Handling Editor: Catherine Matthews

Editor in Chief: Maria A. Bortolini

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Supplementary information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 15 KB)

Supplementary file2 (DOCX 20 KB)

Supplementary file3 (DOCX 25 KB)

192_2024_5794_MOESM4_ESM.tif

Supplementary file4 The participants selected flow chart from NHANES (2005–2018). NHANES National Health and Nutrition Examination Survey. (TIF 2432 KB)

192_2024_5794_MOESM5_ESM.tiff

Supplementary file5 Subgroup analysis for SUI (forest plots). Above adjusts for age, ethnicity, educational attainment, marital status, PIR, BMI, physical activity, smoking, eGFR, SII, cholesterol, triglyceride, creatinine, uric acid, total energy intake, total water intake, protein intake, fat intake, alcohol, DM, hypertension, CVD, menopause/hysterectomy, and vaginal deliveries. In each case, the model was not adjusted for the stratification variable itself. SUI stress urinary incontinence, PIR poverty-to-income ratio, BMI body mass index, eGFR estimated glomerular filtration rate, SII systemic immune-inflammatory, DM diabetes mellitus, hypertension, CVD cardiovascular disease. (TIFF 376 KB)

192_2024_5794_MOESM6_ESM.tiff

Supplementary file6 Subgroup analysis for UUI (forest plots). Above adjusts for age, ethnicity, educational attainment, marital status, PIR, BMI, physical activity, smoking, eGFR, SII, cholesterol, triglyceride, creatinine, uric acid, total energy intake, total water intake, protein intake, fat intake, alcohol, DM, hypertension, CVD, menopause/hysterectomy, and vaginal deliveries. In each case, the model was not adjusted for the stratification variable itself. UUI urge urinary incontinence, PIR poverty-to-income ratio, BMI body mass index, eGFR estimated glomerular filtration rate, SII systemic immune-inflammatory, DM diabetes mellitus, hypertension, CVD cardiovascular disease. (TIFF 374 KB)

192_2024_5794_MOESM7_ESM.tiff

Supplementary file7 Subgroup analysis for MUI (forest plots). Above adjusts for age, ethnicity, educational attainment, marital status, PIR, BMI, physical activity, smoking, eGFR, SII, cholesterol, triglyceride, creatinine, uric acid, total energy intake, total water intake, protein intake, fat intake, alcohol, DM, hypertension, CVD, menopause/hysterectomy, and vaginal deliveries. In each case, the model was not adjusted for the stratification variable itself. MUI mixed urinary incontinence, PIR poverty-to-income ratio, BMI body mass index, eGFR estimated glomerular filtration rate, SII systemic immune-inflammatory, DM diabetes mellitus, hypertension, CVD cardiovascular disease. (TIFF 377 KB)

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Yuan, Y., Huang, Y., Huang, H. et al. Association Between Added Sugar Intake and Urinary Incontinence in Females: A Cross-sectional Population-based Study. Int Urogynecol J (2024). https://doi.org/10.1007/s00192-024-05794-4

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