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.