Type 2 diabetes mellitus and risk of developing urinary incontinence
Type 2 diabetes mellitus and risk of developing urinary incontinence
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DOI：
10.1111/j.1532-5415.2005.53565.x
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发表时间：
2005-11-01
影响因子：
6.3
通讯作者：
Grodstein, F
中科院分区：
文献类型：
--
作者：
Lifford, KL;Curhan, GC;Grodstein, F
目的：评价2型糖尿病(DM)与女性尿失禁发生的关系。设计：前瞻性、观察性研究。设置：护士健康研究队列。对照：81,845名报告尿路功能信息的女性。测量：1976年至1996年，采用问卷调查和标准标准确定自报的医生诊断的糖尿病。自我报告的尿失禁，定义为至少每周渗漏，在1996年和2000年被证实。用Logistic回归模型计算糖尿病与尿失禁之间的多因素调整相对危险度(RR)和95%可信区间(CI)。结果：糖尿病患者发生尿失禁(多变量RR=1.28，95%CI=1.18~1.39)和偶发性尿失禁(多变量RR=1.21，95%CI=1.02~1.43)的风险显著高于非DM女性。使用验证的严重程度指数，糖尿病女性发生严重尿失禁的风险甚至比非糖尿病女性更大(渗漏足以弄湿内裤的多变量RR=1.40，95%CI=1.15-1.71；渗漏足以弄湿外衣的RR=1.97，95%CI=1.24-3.12)。此外，尿失禁的风险随着糖尿病病程的延长而增加(对于流行的尿失禁，P趋势=.03；对于偶发性尿失禁，P=.001)。由于大小便失禁的风险似乎与糖尿病持续时间较长有关，因此即使推迟糖尿病的发病也可能对公共卫生产生重要影响。
OBJECTIVES: To evaluate the association between type 2 diabetes mellitus (DM) and development of urinary incontinence in women.DESIGN: Prospective, observational study.SETTING:The Nurses' Health Study cohort.PARTICIPANTS: Eighty-one thousand eight hundred forty-five women who reported information on urinary function in 1996.MEASUREMENT: Self-reported, physician-diagnosed DM was ascertained using questionnaire from 1976 to 1996 and confirmed using standard criteria. Self-reported urinary incontinence, defined as leakage at least weekly, was ascertained in 1996 and 2000. Logistic regression models were used to calculate multivariate-adjusted relative risks (RRs) and 95% confidence intervals (CIs) for the relationship between DM (as of 1996) and prevalent and incident incontinence.RESULTS:The risk of prevalent incontinence (multivariate RR=1.28, 95% CI=1.18-1.39) and incident incontinence (multivariate RR=1.21, 95% CI=1.02-1.43) was significantly greater in women with DM than women without. Using a validated severity index, risk of developing severe incontinence was even more substantial in women with DM than in those without (multivariate RR=1.40, 95% CI=1.15-1.71 for leakage enough to wet the underwear; RR=1.97, 95% CI=1.24-3.12 for leakage enough to wet the outer clothing). In addition, risk of incontinence increased with duration of DM (P-trend=.03 for prevalent incontinence; P=.001 for incident incontinence).CONCLUSION: DM independently increases risk of urinary incontinence in women. Because risk of incontinence appeared associated with longer duration of DM, even delaying the onset of DM could have important public health implications.