A positive association between the prevalence of circadian syndrome and overactive bladder in United States adults

Relationship between the systemic immune-inflammatory index and overactive bladder risk: A cross-sectional assessment involving United States Adults

AIMS

This study aimed to evaluate the association between the systemic immune-inflammatory index (SII) and the risk of overactive bladder (OAB) in the adult United States population.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 were analyzed. A non-pregnant cohort aged ≥20 years with available SII and OAB data was included. Weighted univariate and multivariate logistic regression analyses were performed to assess the association between SII and OAB risk. Additionally, subgroup, interaction, and restricted cubic spline analyses were conducted.

RESULTS

A total of 4,545 participants were included, of whom 16.13% had OAB, with a mean SII of 5.75 ± 0.07. OAB risk increased with higher SII tertiles. In the fully adjusted model (Model 2), individuals in the highest SII tertile exhibited a 41% higher risk of OAB compared to those in the lowest tertile (OR: 1.41, 95% CI: 1.13-1.76, P = 0.004). Two-piece-wise regression analysis identified an SII breakpoint at 3.40, where a significant positive association was found for SII ≥ 3.40 (OR = 1.06, P < 0.0001), whereas no significant association was detected for SII < 3.40 (P = 0.06). Subgroup and interaction analyses revealed a consistent relationship between SII and OAB across different population strata, except for diabetes mellitus.

CONCLUSION

SII, an easily accessible biomarker, was independently associated with an increased risk of OAB, highlighting its potential utility in diagnostic prediction.

Association between triglyceride glucose-waist height ratio index and overactive bladder: based on NHANES 2005-2018

Background

The triglyceride glucose-waist height ratio (TyG-WHtR) index is a useful marker for predicting the risk of cardiovascular and metabolic diseases. Metabolic diseases are known to be high-risk factors for overactive bladder (OAB). However, no studies have explored the association between the TyG-WHtR index and the risk of developing OAB.

Methods

Data from the National Health and Nutrition Examination Survey (NHANES) was utilized, and a weighted multivariate logistic regression analysis was conducted to investigate the relationship between TyG-WHtR and OAB. Subgroup analyses and interaction tests were also performed. Additionally, sensitivity analyses were conducted to validate the robustness of the findings. A smooth curve fitting and threshold effect analysis explored the nonlinear relationship between TyG-WHtR and the risk of developing OAB. The predictive value of the TyG-WHtR index for OAB was assessed using Receiver Operating Characteristic (ROC) curves, and the area under the ROC curve (AUC) was calculated.

Results

A total of 14,652 adults aged 20 and above were included in this study. After weighting, the population size was estimated to be 197,598,146.7, among which 37,872,284.55 individuals were diagnosed with OAB. The median TyG-WHtR for the entire population was 4.98, while it was 5.44 for those with OAB. Weighted logistic regression analysis revealed a significant positive association between TyG-WHtR and the occurrence of OAB (OR=1.646; 95% CI: 1.562, 1.735; P<0.001). This positive association remained significant even after adjusting for confounding factors (OR=1.310; 95% CI: 1.157, 1.484; P<0.001). Sensitivity analysis demonstrated the robustness of the results. Subgroup and interaction analyses indicated that the impact of the TyG-WHtR index on OAB might be influenced by gender (OR=1.323; 95% CI: 1.138, 1.538; P<0.001) and age (OR=1.426; 95% CI: 1.180, 1.724; P<0.001). Smooth curve fitting and threshold effect analysis revealed a threshold of 3.579. ROC curve analysis demonstrated that the TyG-WHtR index has a good predictive ability for OAB (AUC=0.647; 95% CI: 0.636, 0.657).

Conclusions

The TyG-WHtR index is significantly positively associated with the occurrence of OAB and could potentially serve as a novel risk predictor for OAB. Future research is needed to validate findings, explore causality, and improve early detection through multifactorial models across diverse populations.

Association of cancer with overactive bladder and impact of overactive bladder on mortality among cancer survivors: NHANES 1999-2018

BACKGROUND

Cancer is one of the leading causes of death worldwide. There is little knowledge on the association between cancer and risk of overactive bladder (OAB). Additionally, the impact of OAB on mortality among cancer survivors remains unknown. We aimed to examine the association between cancer and risk of OAB and investigate OAB associations with mortality outcomes in cancer survivors.

METHODS

We analyzed data of the National Health and Nutrition Examination Survey from 1999 to 2018. Cancer status was identified through the NHANES questionnaire. OAB was diagnosed with a cumulative OAB Symptom Score ≥  3. Multivariable logistic analysis was performed to examine the relationship between cancer and OAB. Cox regression analysis was carried out to investigate the relationship between OAB and mortality in subjects with cancer.

RESULTS

In total, this study included a cohort of 32,166 participants. Within the study population, the occurrence of cancer was observed in 9.606%, and OAB was prevalent in 20.167%. The findings from the logistic regression analyses indicated a heightened risk of OAB among individuals with cancer in comparison to those devoid of cancer. Results from subgroup analyses also revealed affirmative correlations between cancer and OAB. Furthermore, the diagnosis of cancer, irrespective of whether it was genitourinary, non-genitourinary, pelvic, or non-pelvic in nature, was found to be correlated with an increased risk of OAB. Within the cohort comprising 3,090 participants diagnosed with cancer, a total of 850 all-cause deaths were recorded during a median follow-up duration of 76 months. After accounting for multiple covariates, OAB was linked to an elevated risk of all-cause and cancer-specific mortality. Moreover, the influence of OAB on mortality from all causes was observed across various cancer types, including both genitourinary and non-genitourinary, as well as pelvic and non-pelvic cancers.

CONCLUSIONS

The investigation identified a noteworthy positive correlation between cancer and the likelihood of OAB. Moreover, OAB was significantly correlated with an elevated risk of mortality among individuals who had received a cancer diagnosis.

The association between serum albumin-globulin ratio and overactive bladder in American adults: a cross-sectional study

OBJECTIVES

The albumin-globulin ratio (AGR) is considered an important indicator reflecting an individual's immune function and nutritional status, and it is closely associated with various health conditions. However, despite its widely studied correlations in numerous health fields, the link between AGR and Overactive Bladder (OAB) is still not completely comprehended.

METHODS

Data were sourced from the National Health and Nutrition Examination Survey (NHANES) database, selecting adult samples spanning from 2007 to 2018. Through comprehensive questionnaires and laboratory tests, we gathered data pertinent to OAB and the AGR. To explore the association between AGR levels and the likelihood of developing OAB, we utilized advanced statistical techniques, such as weighted multivariate logistic regression and restricted cubic spline (RCS) models. Furthermore, we carried out subgroup analyses to assess the uniformity of this association across various demographics.

RESULTS

After adjusting for relevant covariates, we discovered a marked negative correlation between AGR levels and the risk of OAB. As AGR increased, the incidence of OAB showed a declining trend (OR = 0.69; 95% CI 0.56-0.85). Furthermore, significant nonlinear dose-response relationship was observed between AGR levels and the risk of OAB (P < 0.001), and this association remained stable in stratified analyses.

CONCLUSIONS

Our results indicate that elevated AGR levels could be linked to a reduced risk of OAB. This observation highlights the potential role of AGR in assessing and preventing the occurrence of OAB.

Association between cardiovascular health and overactive bladder

Life's Essential 8 (LE8) is an emerging composite metric of cardiovascular health encompassing diet, physical activity, smoking, sleep, weight, cholesterol, blood glucose, and blood pressure. Mounting evidence suggests lifestyle factors may play an important role in overactive bladder (OAB), however the link between LE8 and OAB remains unexplored. We aimed to examine the correlation between the two. We analyzed data on 23,187 individuals from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Participants were stratified into low, moderate and high LE8 groups. Logistic regression examined the association between LE8 and OAB. Restricted cubic splines (RCS) and weighted quantile sum (WQS) regression further probed this relationship. Higher LE8 scores were associated with lower OAB risk, independent of covariate adjustment. The inverse correlation between LE8 and OAB was validated by RCS and WQS analyses. Of LE8 components, glycemic control conferred the greatest contribution. Higher LE8 scores may be protective against OAB. Optimization of cardiovascular health metrics could represent a novel OAB prevention strategy.

The relationship between oxidative balance score and circadian syndrome: evidence from the NHANES 2005-2018

Background

The oxidative balance score (OBS) is a composite indicator that evaluates the balance between pro-oxidants and antioxidants in one's diet and lifestyle. However, the relationship between OBS and circadian syndrome (CircS) has remained unexplored. This investigation aimed to determine a correlation between OBS and CircS.

Methods

This population-based study examined 7,202 participants from the 2005 to 2018 National Health and Nutrition Examination Survey (NHANES), 1,433 of whom had CircS. We utilized weighted multivariate logistic regression, trend tests, subgroup analysis, and interaction tests to evaluate the correlation between OBS (total OBS, dietary OBS, and lifestyle OBS) and CircS. Restricted cubic splines (RCS) models and threshold effect analysis were used to explore nonlinear relationships.

Results

Multivariate logistic regression analysis indicated that the protective factor for CircS was a high OBS level (total OBS: Odds ratio (OR) = 0.95, 95% Confidence interval (CI): 0.93-0.97; dietary OBS: OR = 0.98, 95% CI: 0.96-1.00; lifestyle OBS: OR = 0.65, 95% CI: 0.61-0.69). Compared to the quartile 1 group, OBS (total OBS, dietary OBS, and lifestyle OBS) was negatively and statistically significantly associated with the risk of developing Circs in the quartile 4 group (total OBS: OR = 0.47, 95% CI: 0.32-0.70; dietary OBS: OR = 0.69, 95% CI: 0.48-0.99; lifestyle OBS: OR = 0.07, 95% CI: 0.04-0.11). According to subgroup analysis and interaction tests, there was an interaction effect between the association of lifestyle OBS and CircS in terms of education level (p for interaction = 0.01). Furthermore, we observed a nonlinear negative relationship between lifestyle OBS and CircS prevalence, with inflection points at 6 (p for nonlinearity = 0.002).

Conclusion

The results showed a substantial negative connection between OBS and CircS. Encouraging foods filled with antioxidants and antioxidant-rich lifestyles may reduce the risk of CircS.

Nocturia, nocturnal polyuria, and nocturnal enuresis in adults: What we know and what we do not know

Nocturia is defined as the nocturnal frequency of one or more voiding episodes per night. It increases with aging and has an impact on sleep quality and the risks of falling and mortality. Nocturia disorder involves nighttime frequency, nocturnal polyuria, and nocturnal enuresis. In older adults with nocturia disorder, multiple factors could contribute to nocturia severity and characteristics, including poor sleep quality, lower urinary tract dysfunction, and excessive fluid output. Several nonurological medical diseases have been found to result in nocturia, such as hypertension, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease, metabolic syndrome, and diabetes. Urological and medical assessments should be performed to diagnose nocturia disorder. A frequency volume chart to evaluate the nocturnal polyuria index, functional bladder capacity, and urodynamic study can reveal the presence of nocturnal polyuria and lower urinary tract dysfunction. Treatment should be based on multiple nocturia etiologies, and a combination of multiple therapies for individual pathophysiology will achieve a better treatment outcome.

Intake of dietary flavonoids in relation to overactive bladder among U.S. adults: a nutritional strategy for improving urinary health

Background

The increasing influence of overactive bladder (OAB) on physical as well as mental health of individuals is becoming more pronounced annually, as evidenced by the urge urinary incontinence and nocturia. Symptoms in OAB patients may be influenced by inflammation and oxidative stress. Flavonoids are recognized as significant anti-inflammatory and antioxidant agents, which are commonly available in fruits, tea, vegetables, etc. Previous research has demonstrated the therapeutic potential of flavonoids and their subclasses in treating inflammation, and oxidative stress. Despite this, there remains a paucity of research exploring the potential correlation between flavonoid consumption, specifically within distinct subclasses, and OAB. Thus, our study aims to investigate the relationship between flavonoid intake and OAB to identify possible dietary interventions for OAB management.

Methods

We utilized the survey data from the National Health and Nutrition Examination Survey (NHANES) and the USDA Food and Nutrient Database for Dietary Studies (FNDDS) to investigate the relationship between dietary intake of total and subclass flavonoids and the risk of OAB based on 13,063 qualified American adults. The dietary flavonoid intake was estimated from two 24-h dietary recalls. Weighted multivariate logistic regression model, quantile-based g-computation, restricted cubic spline model, and stratified analysis were used to explore the association between flavonoid intake and OAB, respectively.

Results

The participants diagnosed with OAB exhibited a higher percentage of being female, older, Non-Hispanic Black, unmarried, former drinkers, having a lower annual household income, lower poverty to income ratio, lower educational attainment, and a higher likelihood of being obese and smokers. Upon adjusting for confounding factors, the weighted logistic regression models revealed that the third quartile of consumption of anthocyanidin and the second quartile of consumption of flavone were significantly associated with the reduced odds of OAB, while total flavonoid consumption did not show a significant correlation with the risk of OAB. The quantile-based g-computation model indicated that flavone, anthocyanidin and flavonol were the primary contributors to the observed negative correlation. Furthermore, the restricted cubic spline models demonstrated a J-shaped non-linear exposure-response association between anthocyanidin intake and the risk of OAB (P nonlinear = 0.00164). The stratified and interaction analyses revealed that the relationship between anthocyanidin intake and the risk of OAB was significantly influenced by age (P interaction = 0.01) and education level (P interaction = 0.01), while the relationship between flavone intake and the risk of OAB was found to vary by race (P interaction = 0.02) and duration of physical activity (P interaction = 0.05).

Conclusion

Our research suggests that consuming a diet rich in flavonoid subclass anthocyanidin and flavone is associated with a reduced risk of OAB, potentially offering clinical significance in the prevention of OAB development. This underscores the importance of dietary adjustments in the management of OAB symptoms.

Association between body roundness index and overactive bladder: results from the NHANES 2005-2018

BACKGROUND AND AIM

An increasing amount of research has indicated obesity greatly affects individuals with overactive bladder (OAB). However, traditional anthropometric methods present challenges in accurately assessing the likelihood of OAB. Hence, this study's objective was to identify the correlation between the body roundness index (BRI) and OAB.

METHODS

The research included 12,401 individuals who participated in the National Health and Nutrition Examination Survey spanning 2005-2018. The correlation between BRI and OAB was explored by using weighted multiple logistic regression and weighted restricted cubic spline (RCS). Subgroup analyses showed the associations based on different population types. The study also analyzed the predictive capability of various anthropometric indices, including BRI, body mass index, waist circumference, and weight, in assessing the likelihood of OAB through Receiver-operating characteristic (ROC) curves.

RESULTS

An independent positive correlation between OAB and BRI was identified after adjusting for potential confounders in weighted multivariate logistic models[odds ratio (OR) = 1.15, 95% confidence interval (CI), 1.12-1.17]. Weighted RCS analysis found a positive dose-response correlation between OAB and BRI. The effect size of BRI on OAB remained stable across all prespecified subgroups (all P for interactions > 0.05). In ROC analysis, BRI showed better discriminatory ability for OAB compared with other anthropometric measures for both genders (all P < 0.01). The best BRI cutoff for predicting OAB was lower for men (5.151) than for women (5.383), suggesting that men were more susceptible to changes in BRI than women.

CONCLUSIONS

This study demonstrated that a raised BRI is correlated with a higher likelihood of OAB. Due to the effectiveness and non-invasiveness of BRI in predicting OAB, it is expected to become the preferred method for early detection and management strategies.

The association between wet overactive bladder and consumption of tea, coffee, and caffeine: Results from 2005-2018 National Health and Nutrition Examination Survey

BACKGROUND & AIMS

Previous studies have reported an inconsistent relationship between overactive bladder (OAB) and the consumption of tea, coffee, and caffeine. Our study aims to determine these associations in a large and nationally representative adult sample.

METHODS

This cross-sectional study included 15,379 participants from the 2005-2018 US National Health and Nutrition Examination Survey (NHANES) database. The outcome was the risk of wet OAB that was diagnosed when the OAB symptom score was ≥3 with urgent urinary incontinence and excluded other diseases affecting diagnosis. The exposures were the consumption of tea, coffee, and caffeine. Weighted logistic regression models were established to explore these associations by calculating odds ratios (OR) and 95% confidence intervals (CI), as did restricted cubic splines (RCS) used to analyze the nonlinear associations.

RESULT

Of all the participants (n = 15,379), 2207 had wet OAB. Mean [SE] consumption of tea, total coffee, caffeinated coffee, decaffeinated coffee, and caffeine was 233.6 [15.7] g/day, 364.3 [15.5] g/day, 301.6 [14.9] g/day, 62.7 [7.9] g/day, 175.5 [6.6] mg/day in participants with wet OAB, respectively. In the fully adjusted model, compared to those without tea consumption, the high consumption of tea (>481 g/day) was associated with an increased risk of wet OAB (OR: 1.29; 95%CI: 1.01-1.64). Low decaffeinated coffee (0.001-177.6 g/day) had a negative association with the risk (OR: 0.66; 95%CI: 0.49-0.90). In the RCS analysis, tea consumption showed a positive linear association with the risk of wet OAB, and decaffeinated coffee showed a nonlinear relationship with the risk and had a turning point of 78 g/day in the U-shaped curve between 0 and 285 g/day. Besides, total coffee, caffeinated coffee, and caffeine consumption had no significant association with the risk. Interestingly, in the high tea consumption, participants with high total coffee consumption [>527.35 g/day, OR and 95%CI: 2.14(1.16-3.94)] and low caffeine consumption [0.1-74.0 mg/day, OR and 95%CI: 1.50(1.03-2.17)] were positively associated with the risk of wet OAB.

CONCLUSION

High tea consumption was associated with the increased risk of wet OAB, especially intake together with high total coffee and low caffeine consumption, but no significant association with the single consumption of total coffee and caffeine. Low decaffeinated coffee was associated with a decreased risk of wet OAB. It is necessary to control tea intake when managing the liquid intake of wet OAB patients.

The association between overactive bladder and systemic immunity-inflammation index: a cross-sectional study of NHANES 2005 to 2018

Current research indicate that inflammation is linked to the development of overactive bladder (OAB). The aim of this study was to examine the correlation between OAB and the systemic immunity-inflammation index (SII) in the USA. We analyzed data from 31,881 participants in the National Health and Nutrition Examination Survey 2005-2018. SII, calculated as platelet count × neutrophil count/lymphocyte count, was categorized into quartiles. OAB was defined by the presence of urge urinary incontinence and nocturia. Weighted logistic regression models were used to examine the independent relationship between SII and OAB, adjusting for demographic factors, kidney function, and diabetes status. The results showed that each tenfold increase in log-transformed SII was associated with an 18% higher odds of OAB (OR 1.18, 95% CI 1.08-1.28) in the fully adjusted model. Compared to the lowest SII quartile, the highest quartile had a 28% increased OAB risk (OR 1.28, 95% CI 1.12-1.47). The positive association between SII and OAB risk was consistently observed across subgroups stratified by age, sex, race, marital status, education, and poverty level. Our study reveals a positive correlation between SII levels and OAB, indicating that higher SII levels are associated with an increased likelihood of developing OAB.

Unfavorable Mealtime, Meal Skipping, and Shiftwork Are Associated with Circadian Syndrome in Adults Participating in NHANES 2005-2016

The concept of Circadian Syndrome (CircS) aims to emphasize the circadian disruptions underlying cardiometabolic conditions. Meal timing and shiftwork may disrupt circadian rhythms, increasing cardiometabolic risk. This study aimed to assess the associations of meal timing, meal skipping, and shiftwork with CircS in US adults and explore effect modifications by sociodemographic and lifestyle factors. CircS was defined using Metabolic Syndrome components in addition to short sleep and depression symptoms. Data from 10,486 participants of the National Health and Nutrition Examination Survey 2005-2016 were analyzed cross-sectionally. Mealtime was assessed by calculating the midpoint of intake between breakfast and dinner and dichotomizing it into favorable mealtime (between 12:30 and 13:15) and unfavorable mealtime using a data-driven approach. Meal skippers were categorized separately. Participants working evening, night, or rotating shifts were classified as shift workers. In the multivariable logistic regression analysis, an unfavorable mealtime, meal skipping, and shiftwork were associated with a higher likelihood of CircS (OR = 1.24; 95%CI 1.07-1.44, OR = 1.39; 95%CI 1.16-1.67, and OR = 1.37; 95%CI 1.01-1.87, respectively). Subgroup analyses revealed no significant interactions between meal timing, meal skipping, or shiftwork and socioeconomic status or lifestyle regarding CircS. These findings highlight the importance of aligning mealtimes with circadian rhythms for improved circadian health.

Examining the safety of mirabegron: an analysis of real-world pharmacovigilance data from the US FDA adverse event reporting system (FAERS) database

Background: Mirabegron, the first β-3 adrenergic receptor agonist, received approval from the Food and Drug Administration (FDA) in 2012 for the treatment of overactive bladder (OAB). This pharmacovigilance study investigated the safety profile of mirabegron treatment using the US FDA Adverse Event Reporting System (FAERS) database. Methods: This study employed disproportionality analyses, including the reporting odds ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) algorithm, to quantify signals of adverse events associated with mirabegron. Results: From the first quarter of 2012 to the third quarter of 2023, a comprehensive total of 14,356,234 adverse event (AE) reports were submitted to the FDA Adverse Event Reporting System database. Within this dataset, encompassing 18,763 reports specifically associated with mirabegron, healthcare professionals notably contributed 2,902 of these reports. A total of 80 preferred terms (PTs) of interest were identified using both the ROR and information component algorithms. The most common AEs included blood pressure increased, urinary retention, atrial fibrillation, dry mouth, and tachycardia, which were consistent with the product instructions. Unexpected significant AEs, such as arrhythmia, palpitations, dementia, transient ischemic attack, Parkinson's disease, anti-neutrophil cytoplasmic antibody positive vasculitis, lip swelling, and swollen tongue, were also identified. The study findings indicated that the majority of onset time occurred within 30 days (n = 358, 55.68%). However, AEs were still possible after 1 year of mirabegron treatment. Conclusion: This study provided valuable evidence for the real-world safety of mirabegron, helping clinical professionals enhance their understanding of mirabegron's safety in clinical practice. It also contributed valuable evidence for further safety studies on mirabegron.