Obesity and Overactive Bladder: Is It a Matter of Body Weight, Fat Distribution or Function? A Preliminary Results

Urology. 2020 Sep:143:91-96. doi: 10.1016/j.urology.2020.04.115. Epub 2020 May 28.

Abstract

Objective: To determine the relationship between subcutaneous fat, visceral fat surface area (VFA), bladder wall fat distribution, and visceral adiposity index (VAI) as risk factors for overactive bladder (OAB) occurrence.

Patients and methods: A cross-sectional study involved 157 participants was conducted. The participants were divided into 2 groups; study group (87 patients diagnosed with OAB) and control group (70 healthy participants). All participants were evaluated for OAB using short-form OABSS version. Physical examination including waist circumference (WC) measurement in addition to metabolic laboratory investigations (eg, High density lipoprotein (HDL), cholesterol, etc) were done. Study group underwent urodynamic testing. Using noncontrast spiral CT abdomen and pelvis, trunkal fat measurements and bladder wall fat distribution were detected. VAI was calculated for both females and males. Univariate and multivariate analyses were done to detect risk factors for OAB occurrence. Correlation between all factors and total OABSS and urodynamics was done.

Results: The mean age ± SD was 40.4 ± 9 years. In multivariate analysis, increased VFA, higher cholesterol level, increased VAI and focal fat distribution at bladder wall were associated with 9.4, 1.98, 5.5, and 1.6 times higher risk for OAB occurrence. VAI and VFA were strongly correlated with total OABSS, DLPP, amplitude, and frequency of bladder detrusor contractions. On the other hand, WC and body mass index were not correlated significantly.

Conclusion: Body mass index and WC are crude inaccurate methods correlated with OAB presence. Focal bladder wall fat distribution, higher VAI, higher VFA are novel risk factors for OAB occurrence. Both VAI and VFA are correlated significantly to total OABSS and urodynamics findings in patients with OAB.

MeSH terms

  • Adiposity*
  • Adult
  • Body Fat Distribution / methods*
  • Body Mass Index
  • Body Weight*
  • Cholesterol / blood*
  • Correlation of Data
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intra-Abdominal Fat
  • Male
  • Obesity* / blood
  • Obesity* / diagnosis
  • Risk Factors
  • Tomography, Spiral Computed / methods
  • Urinary Bladder* / diagnostic imaging
  • Urinary Bladder* / pathology
  • Urinary Bladder* / physiopathology
  • Urinary Bladder, Overactive* / diagnosis
  • Urinary Bladder, Overactive* / physiopathology
  • Urodynamics / physiology
  • Waist Circumference

Substances

  • Cholesterol