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Objectives: To describe the relationship between metabolic factors and lower urinary tract symptoms (LUTS), overactive bladder syndrome (OAB) and urinary incontinence (UI). Methods: Adult male and female patients who presented to a clinician from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) were recruited. Urinary symptoms (presence of OAB, any UI, stress UI (SUI), urgency UI (UUI), urgency, frequency, and nocturia) were assessed with the LUTS Tool. Metabolic factors assessed included central obesity (waist circumference, using the Adult Treatment Panel III, the International Diabetes Federation thresholds, and waist circumference as a continuous variable), general obesity (body mass index [BMI] as dichotomous or continuous variables), diabetes mellitus, hypertension, and dyslipidemia. Multivariable logistic regression was used to test for associations. Results: 920 participants were studied. In multivariable analyses, central obesity (per 10cm larger waist) was associated with higher odds of UI in both sexes (OR=1.16, p=0.008), SUI in females (OR=1.27, p=0.008), UUI in both sexes (OR=1.24, p=0.001), OAB in females (OR=1.248, p=0.003), as well as frequency and nocturia. General obesity (5-unit increase in BMI) was associated with UI, UUI, urgency and frequency in both sexes, and with SUI and OAB in females. We did not find associations between central or general obesity and OAB in males. Dyslipidemia was associated with nocturia ≥2. Conclusions: In patients, central and general obesity were key metabolic factors associated with UI in both males and females, and with OAB in females but not in males. The association between dyslipidemia and nocturia ≥2 needs further research.

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Purpose To examine how mental health measures, sleep, and physical function are associated with presence and type of urinary incontinence (UI) and severity in women seeking treatment for lower urinary tract symptoms (LUTS). Methods This is a baseline cross-sectional analysis in treatment-seeking women with LUTS. All participants completed the LUTS Tool, which was used to classify women based on UI symptoms and measure severity. Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires for depression, anxiety, sleep disturbance, and physical function; the Perceived Stress Scale (PSS); and the International Physical Activity Questionnaire Short Form (IPAQ-SF) were administered. Multivariable regression modeling was used to assess associations with the presence, type, and severity of urinary symptoms. Results We studied 510 women; mean age was 56±14 years, 82% were Caucasian, 47% were obese, and 14% reported diabetes. Most women (n=420, 82.4%) reported UI (70 stress UI, 85 urgency UI, 240 mixed UI, 25 other UI). In adjusted analyses, there were no differences in any of the mental health, sleep, or physical function measures based on presence versus absence of UI. Among those with UI, PROMIS anxiety and sleep disturbance scores were higher for those with mixed UI compared to stress UI. Increasing UI severity was associated with higher PROMIS depression and anxiety, and higher PSS scores, though higher UI severity was not associated with differences in sleep or physical function. Conclusions Among treatment-seeking women with LUTS, increasing UI severity, rather than presence or type of UI, is associated with increased depression, anxiety, and stress.

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