title: Enuresis--an unattended comorbidity of childhood obesity.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA), attention deficit/hyperactivity disorder (ADHD), type 2 diabetes mellitus and psychopathological problems co-occur at increased rates among both obese and enuretic children. We hypothesized that the prevalence of enuresis will be increased in obese children and adolescents.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  281 children and adolescents aged 7-18 years, who completed a questionnaire regarding enuresis, medical conditions and sociodemographic parameters; 158 were normal weight, 37 overweight (85thBMI (body mass index)<95th percentiles) and 86 obese (BMI95th percentile).
  
  
  METHODS
  Occurrence of enuresis among obese children and adolescents.
  
  
  RESULTS
  Enuresis was reported in 14 (8.8%) normal weight, 6 (16%) overweight and 26 (30%) obese youth. Odds ratio (OR)=6.5, 95% confidence interval (CI)=2.67-15.78 for enuresis among obese compared with normal weight (P<0.0001). Each increment of one BMI-Z score unit was associated with an increased risk of enuresis, OR of 2.14, 95% CI (1.46-3.12), P=0.00008. Male gender (OR 2.84, 95% CI (1.10-5.58), P=0.028), first-degree relative with current/past enuresis (OR 4.24, 95% CI (1.62-11.08), P=0.003), voiding dysfunction symptoms (OR 3.067, 95% CI (1.05-9.00), P=0.041) and ADHD (OR 2.31, 95% CI (0.99-5.34), P=0.051) increased the risk of enuresis. OSA-related symptoms, academic achievements in school, sharing a bedroom, family size relative to number of rooms in home, parental education, family status and religious observance were not found to increase the risk for enuresis.
  
  
  CONCLUSIONS
  Obese children are at increased risk for enuresis. Enuresis should be clarified during the primary workup of every obese child and adolescent.
authors: Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel. dryaelw@gmail.com
authors: Y
authors: Y
authors: Weintraub
authors: S
authors: S
authors: Singer
authors: D
authors: D
authors: Alexander
authors: S
authors: S
authors: Hacham
authors: G
authors: G
authors: Menuchin
authors: R
authors: R
authors: Lubetzky
authors: D M
authors: DM
authors: Steinberg
authors: O
authors: O
authors: Pinhas-Hamiel
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity; D015992:Body Mass Index; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D053206:Nocturnal Enuresis / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D010809:Physical Fitness; D011237:Predictive Value of Tests; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires