Visceral Adipose Index and Stress Urinary Incontinence in US Adult Women

Overview

This cross-sectional analysis of NHANES data from 2001 to 2018 investigated the association between visceral adipose index (VAI) and stress urinary incontinence (SUI) in adult women in the United States. The study found that higher VAI levels were significantly associated with increased odds of SUI, including more frequent episodes.

Background

Stress urinary incontinence (SUI) affects approximately 40–46% of adult women in the USA and significantly impairs quality of life. Obesity, particularly visceral fat accumulation, is a known risk factor for urinary incontinence. Traditional measures like BMI do not capture fat distribution, prompting the use of the visceral adipose index (VAI), which incorporates waist circumference, triglycerides, and HDL cholesterol, as a more sensitive marker of visceral fat function. Prior small studies suggested higher VAI in women with SUI, but large-scale evidence has been limited.

Data Highlights

Key Findings

• Higher VAI levels were independently associated with increased odds of overall SUI in adult women.
• Associations remained significant after adjusting for age, race, socioeconomic factors, lifestyle, and comorbidities including diabetes and hypertension.
• Women with higher VAI had increased likelihood of experiencing SUI at least weekly and at least daily.
• VAI provided a more specific measure of visceral fat-related risk than BMI or waist circumference alone.
• The study supports VAI as a useful indicator for assessing SUI risk related to visceral adiposity.

Clinical Implications

Clinicians should consider visceral adiposity, as measured by VAI, when evaluating risk factors for stress urinary incontinence in adult women. Targeting visceral fat reduction through lifestyle or medical interventions may help reduce SUI incidence or severity. Incorporating VAI into routine assessments could improve identification of women at higher risk beyond traditional obesity measures.

Conclusion

This large cross-sectional study demonstrates a significant association between higher visceral adipose index and stress urinary incontinence in adult women, highlighting the importance of visceral fat distribution in SUI pathophysiology. VAI may serve as a valuable tool for risk stratification and guiding preventive strategies.

References

1. International Continence Society -- Definition of Stress Urinary Incontinence
2. NHANES 2001-2018 -- National Health and Nutrition Examination Survey Data
3. Previous Small Sample Study 201X -- VAI Levels in Women with SUI