Correlation Between Metabolic Dysfunction-Associated Steatotic Liver Disease and the Risk of Urinary Incontinence in Adult Women

Fan Zhang,1– 3 Wenjian Li1,4 1Changzhou Clinical College, Xuzhou Medical University, Changzhou, Jiangsu, People’s Republic of China; 2Department of Endocrinology, Changzhou Third People’s Hospital, Changzhou, Jiangsu, People’s Republic of China; 3Department of Clinical Nutrition, Changzhou Third People’s Hospital, Changzhou, Jiangsu, People’s Republic of China; 4Department of Urology, Changzhou Third People’s Hospital, Changzhou, Jiangsu, People’s Republic of ChinaCorrespondence: Wenjian Li, Department of Urology, Changzhou Third People’s Hospital, 300 Lanling North Road, Changzhou, Jiangsu, 213001, People’s Republic of China, Tel +86-0519-82009011, Email 760020240117@xzhmu.edu.cnObjective: This study examined the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and urinary incontinence in adult women and evaluated the potential contribution of the fatty liver index (FLI) in this context.Methods: The study utilized data from the National Health and Nutrition Examination Survey (NHANES) database, spanning from 2001 to 2018. The study included 17,221 adult female participants. Individuals exhibiting FLI values of 60 or greater were diagnosed with hepatic steatosis. Incontinence type and MASLD status were evaluated by analyzing questionnaire data and calculating the FLI. Logistic regression models were employed to examine the correlation between FLI, MASLD, and urinary incontinence, with potential confounding variables controlled through multivariate adjustment models. Furthermore, restricted cubic spline curve (RCS) modeling and subgroup analysis were employed to elucidate the relationship between variables further.Results: The median age of participants in the MASLD group was higher than that of the non-MASLD group (53 vs 46 years, P < 0.001). The findings indicated a positive association between FLI and MASLD and the risk of urinary incontinence. Specifically, the risk of stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI) all increased significantly with increasing quartiles of FLI (OR 2.44, 1.91, 2.30, respectively, P < 0.001). In the multivariate-adjusted model, SUI, UUI, and MUI risk was 76%, 50%, and 69% higher in patients with MASLD than those without MASLD. RCS analysis demonstrated a significant nonlinear positive correlation between FLI and the risk of SUI, UUI, and MUI, respectively.Conclusion: This study’s findings indicate a significant association between MASLD and the risk of developing urinary incontinence. Additionally, the results suggest that FLI and MASLD may act as independent risk factors for urinary incontinence.Keywords: metabolic dysfunction-associated steatotic liver disease, urinary incontinence, fatty liver index, adult women, correlation study