Protective Role of High-Density Lipoprotein Cholesterol in Stress Urinary Incontinence with Special Emphasis on Overweight/Obese Individuals
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Increasing evidence shows that lipid metabolism is closely related to the pathogenesis of stress urinary incontinence (SUI).This study aimed to investigate the association between high-density lipoprotein cholesterol (HDL-C) levels and female SUI, evaluate dose-response relationships, and determine the causal effect of HDL-C on SUI risk.Materials and methods: Utilizing cross-sectional data from the National Health and Nutrition Examination Survey (2001-2020, n = 18,415), we assessed the dose-response relationship between HDL-C and SUI using restricted cubic splines and weighted logistic regression.Mendelian randomization (MR) analyses leveraged genetic instruments from European cohorts (HDL-C: n = 9,796; SUI: 5,926 cases/211,672 controls) to infer causality.Subgroup analyses emphasized interactions between HDL-C and BMI.Results: A 1 mg/dL increase in HDL-C was linearly associated with a 0.5% reduction in SUI risk (OR = 0.995, 95% CI: 0.986-0.991,P < 0.001).Participants in the highest HDL-C quartile (Q4) exhibited a 25.1% lower SUI risk compared to Q1 (OR = 0.749, 95% CI: 0.652-0.859).Notably, the protective effect of HDL-C was markedly stronger in overweight/obese individuals (BMI ≥ 25 kg/m²: OR = 0.992, P = 0.006; BMI ≥ 30 kg/m²: OR = 0.991, P = 0.001), with significant interaction (P for interaction = 0.015).MR analyses confirmed a causal protective effect of HDL-C on SUI (IVW OR = 0.842, 95% CI: 0.744-0.953),and sensitivity analyses supported robustness.Conclusions: Elevated HDL-C levels are causally linked to reduced SUI risk, with amplified protection in overweight/obese populations.These findings highlight the importance of maintaining healthy HDL-C levels as a targeted strategy for SUI prevention, especially in high-BMI individuals.
DOI: 10.7150/ijms.116324
Institution: Third Affiliated Hospital of Sun Yat-sen University
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,337
OpenAlex ID: W4412901639