By Shazia Qureshi
ROTTERDAM, NETHERLANDS -- August 23, 2007 -- In a population-based survey in Finland, obesity was found to be associated with increased nocturia in both men and women and increased incontinence in women, but not with urinary urgency or frequency in either sex.
The findings were presented here on August 22 in a poster at the 37th Annual Meeting of the International Continence Society (ICS).
The lead author was Kari Tikkinen, MD, urologist, Tampere University Hospital, and researcher, Medical School, University of Tampere, Tampere, Finland.
The investigators noted that previous studies of the relationship between obesity and urinary storage symptoms were conducted mainly in women. Dr. Tikkinen and colleagues performed their evaluation in both men and women aged 18 to 79 years.
For the study, 3,000 men and 3,000 women were randomly selected from the Finnish Population Register and were sent questionnaires by post. Women who were pregnant or who had given birth in the previous 6 weeks were excluded, as were people with urinary tract infections.
A total of 3,729 people responded, resulting in a 62.2% response rate. Of these, 3,287 questionnaires were completed in full (1,576 men and 1,711 women) and used by the investigators for their analysis.
Participants were asked to report their current body weight and height. They also answered questions about voiding symptoms based on the Danish Prostatic Symptom Score (DAN-PSS) questionnaire, and additional questions about frequency and nocturia based on the American Urological Association symptom index (AUA-SI).
A body-mass index (BMI; body weight in kg divided by the square of height in m) of 30 kg/m2 or higher was defined as obesity. According to the age-standardised results, 13.9% of men and 13.6% of women were obese.
The questionnaire identified urgency incontinence and stress incontinence by responses of "often" or "always" on the relevant questions during the previous 2 weeks. Nocturia was defined as more than 1 void/night. Urgency meant a response on the questionnaire of "often" or "always" during the previous 2 weeks. Frequency was defined as more than eight voids per day.
Multivariate analyses showed that, in women, obesity was strongly associated with urgency incontinence (odds ratio [OR] 2.9; 95% confidence interval [CI] 1.2-7.2) and stress incontinence (OR 2.3; 95% CI 1.4-3.7). Among men, these two symptoms were reported infrequently, which meant that any possible association with BMI could not be analysed, the researchers noted.
Obesity was associated with increased nocturia in both women (OR 2.3; 95% CI 1.4-3.7) and men (OR 2.1; 95% CI 1.2-3.5).
No association between obesity and either urinary urgency or frequency was apparent in women or men.
While the study did not test for cause-and-effect associations between obesity and urinary storage symptoms, its results do suggest that obesity may explain many cases of nocturia.
Dr. Tikkinen and colleagues concluded that the "validity of these results was strengthened by high response rate, representative study population, and adjustment for major confounding factors."
The study was partially funded by Pfizer.
[Presentation title: Obesity Is Associated With Incontinence and Nocturia But Not With Other Urinary Storage Symptoms. Abstract 145]
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