For many women navigating midlife, urinary incontinence could become a challenge. A new 4-year study may offer insights into a common but modifiable risk factor for urinary incontinence: abdominal fat.
Investigators tracked 376 Finnish women aged 47 to 55 years, examining how body composition might shape the risk of pelvic floor disorders. The participants underwent dual x-ray absorptiometry (DXA) and multifrequency bioelectrical impedance analysis (BIA) to measure total and regional fat mass. Body mass index (BMI) and waist circumference were also recorded.
At baseline, 41.3% of the participants reported symptoms of stress urinary incontinence (SUI), defined as unintentional urine loss during physical activity, sneezing, or coughing. At follow-up, 36.7% reported these symptoms.
Several body fat measures were significantly associated with SUI, including total fat mass, trunk fat, android fat (abdominal), and visceral fat area. Higher BMI and waist circumference were also linked to an increased risk of SUI. Android fat mass had the strongest effect, with a 33% increase in the risk of SUI for every additional kg.
Other fat indicators showed significant associations: total fat mass, trunk fat, visceral fat, BMI, and waist size were all independently linked to SUI.
However, changes in fat mass over the 4-year period weren't associated with changes in pelvic floor symptoms, suggesting that current fat levels, rather than changes over time, may be more relevant to SUI risk in this population.
No statistically significant associations were found between body composition and other pelvic floor conditions such as urgency urinary incontinence, fecal incontinence, or the sensation of pelvic organ prolapse. The investigators noted the limited number of cases for these conditions may have reduced statistical power.
Models were adjusted for menopausal status, age, physical activity, parity, hysterectomy history, and height. Women with BMI over 35 kg/m² were excluded.
The findings underscored the relevance of regional fat distribution in relation to pelvic floor function. While DXA and BIA offered detailed body composition analysis, simpler measures such as BMI and waist circumference were also effective in identifying women at higher risk for SUI.
Although the investigators doesn't establish causation, the observed associations suggested that abdominal fat may be a clinically important factor in assessing SUI risk in middle-aged women.
The study was funded by the Research Council of Finland. Aside from a single lecture honorarium disclosed by one author, no financial conflicts of interest were reported.
Source: Menopause