title: Insulin Resistance Is Associated with Prevalence of Physician-Diagnosed Urinary Incontinence in Postmenopausal Non-Diabetic Adult Women: Data from the Fourth Korea National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  To investigate the association between insulin resistance (IR) and urinary incontinence in Korean adult women by analyzing the data from the Korea National Health and Nutrition Examination Survey IV (KNHANES) 2007-2009.
  
  
  METHODS
  A nationally representative sample of 5318 non-diabetic Korean women ≥19-years-of-age (3043 premenopausal and 2275 postmenopausal women) was included from KNHANES 2008-2010. IR was measured using the homeostasis model assessment of IR (HOMA-IR). Participants in the highest and lowest quartile of HOMA-IR were defined as insulin-resistant and insulin-sensitive respectively. Women who have current physician-diagnosed urinary incontinence were classified as having urinary incontinence.
  
  
  RESULTS
  Incontinence was found in 9.18% of the total population, 8.51% of the premenopausal population, and 10.86% of the postmenopausal population. The prevalence of incontinence increased with age, reaching a peak at 60-69-years-of-age. The prevalence of urinary incontinence increased significantly with higher HOMA-IR quartiles in pre- and post-menopausal women (p for linear association = 0.0458 and 0.0009 respectively). Among post-menopausal women, those in the highest quartile of HOMA-IR were significantly more likely to have urinary incontinence compared to those in the lowest quartile [adjusted odds ratio, 1.72; 95% confidence interval, 1.07-2.77]. However premenopausal population exhibited no association between incontinence and HOMA-IR quartiles.
  
  
  CONCLUSIONS
  Our results suggest that the prevalence of incontinence increased across HOMA-IR in non-diabetic adult women, and especially, IR might be a risk factor for incontinence in postmenopausal non-diabetic women.
authors.affiliation: Department of Urology, The Catholic Kwandong University of Korea, International St Mary's hospital, Incheon, Korea.
authors.forename: Byung Il
authors.initials: BI
authors.lastname: Yoon
authors.affiliation: Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyung-Do
authors.initials: KD
authors.lastname: Han
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, St Paul's hospital, Seoul, Korea.
authors.forename: Kyu Won
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Yeoido St Mary's hospital, Seoul, Korea.
authors.forename: Hyuk Sang
authors.initials: HS
authors.lastname: Kwon
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Yeoido St Mary's hospital, Seoul, Korea.
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Yeoido St Mary's hospital, Seoul, Korea.
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Sohn
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Yeoido St Mary's hospital, Seoul, Korea.
authors.forename: Yong-Hyun
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Department of Urology, College of Medicine, The Catholic University of Korea, Yeoido St Mary's hospital, Seoul, Korea.
authors.forename: U-Syn
authors.initials: US
authors.lastname: Ha
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D017698:Postmenopause; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000453:epidemiology*