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

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 ≥9-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 Conclusion: Our results suggest that the prevalence of incontinence increased across HOMA-IR in nondiabetic adult women, and especially, IR might be a risk factor for incontinence in postmenopausal non-diabetic women.