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已发表论文
女性的生物衰老与压力性尿失禁之间呈倒 J 型关系
Authors Wei L, Cao X, Wang S, Kang X, Ma Y, Shi J, Guo J, Liu X
Received 16 September 2025
Accepted for publication 17 December 2025
Published 23 December 2025 Volume 2025:17 Pages 5597—5607
DOI https://doi.org/10.2147/IJWH.S567903
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Lingyun Wei,1,* Xinfang Cao,1,* Shuyu Wang,1 Xiameng Kang,1 Yingjie Ma,1 Jie Shi,2 Jiahui Guo,2 Xiaochun Liu1
1Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China; 2Shanxi Medical University, Taiyuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaochun Liu, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China, Email liuxiaochun@sxbqeh.com.cn
Background: Biological aging is a systemic driver of chronic disease, yet its relationship with female urinary incontinence (UI) remains unexamined. We leveraged three conceptually distinct metrics-PhenoAge (PA), Klemera-Doubal Method (KDM), and Homeostatic Dysregulation (HD)-to quantify biological age and assessed their associations with stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) in a nationally representative cohort.
Methods: This cross-sectional study included 8,561 women ≥ 20 years from NHANES 2005– 2010 and 2015– 2018. After outlier exclusion and covariate selection via LASSO regression, multivariable logistic regression and restricted cubic splines (RCS) were used to estimate ORs and dose-response shapes. Subgroup analyses, mediation analyses, and sensitivity analyses were performed.
Results: PA and KDM were positively associated with UI. The third quartile of PA and KDM conferred the highest risk for SUI (PA: Q3 OR = 1.58, 95% CI 1.33– 1.88; KDM: Q3 OR = 1.39, 95% CI 1.20– 1.62). Higher quartiles were also linked to greater UI severity. Fully adjusted RCS models revealed inverted J-shaped relationships for SUI (PA inflection: 43.6; KDM: 34.7) and inverted U-shaped relationships for UUI and MUI with KDM (UUI inflections: 40.7 and MUI inflections: 40.5). Associations were robust across most subgroups but attenuated with increasing reproductive risk factors. No significant mediation by sex steroids or α-Klotho was observed.
Conclusion: Biological aging is significantly positively associated with UI, and its relationship with SUI follows an inverted J-shaped curve. Interventions that slow biological aging may offer a novel strategy for UI prevention; however, longitudinal studies are required to establish causality.
Plain Language Summary: We examined whether faster biological aging increases urinary incontinence (UI) in women. Using three aging-metrics (PhenoAge, KDM, HD) in 8,561 NHANES women we found higher biological age raised the odds of stress, urgency and mixed UI, with a clear inverted-J shape for stress UI. Associations persisted across subgroups but weakened with more reproductive risk factors. Slowing biological aging may help prevent UI, yet longitudinal work is needed.
Keywords: aging, prevalence, urinary incontinence, stress urinary incontinence, urgency urinary incontinence
1Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China; 2Shanxi Medical University, Taiyuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Xiaochun Liu, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People’s Republic of China, Email liuxiaochun@sxbqeh.com.cn
Background: Biological aging is a systemic driver of chronic disease, yet its relationship with female urinary incontinence (UI) remains unexamined. We leveraged three conceptually distinct metrics-PhenoAge (PA), Klemera-Doubal Method (KDM), and Homeostatic Dysregulation (HD)-to quantify biological age and assessed their associations with stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) in a nationally representative cohort.
Methods: This cross-sectional study included 8,561 women ≥ 20 years from NHANES 2005– 2010 and 2015– 2018. After outlier exclusion and covariate selection via LASSO regression, multivariable logistic regression and restricted cubic splines (RCS) were used to estimate ORs and dose-response shapes. Subgroup analyses, mediation analyses, and sensitivity analyses were performed.
Results: PA and KDM were positively associated with UI. The third quartile of PA and KDM conferred the highest risk for SUI (PA: Q3 OR = 1.58, 95% CI 1.33– 1.88; KDM: Q3 OR = 1.39, 95% CI 1.20– 1.62). Higher quartiles were also linked to greater UI severity. Fully adjusted RCS models revealed inverted J-shaped relationships for SUI (PA inflection: 43.6; KDM: 34.7) and inverted U-shaped relationships for UUI and MUI with KDM (UUI inflections: 40.7 and MUI inflections: 40.5). Associations were robust across most subgroups but attenuated with increasing reproductive risk factors. No significant mediation by sex steroids or α-Klotho was observed.
Conclusion: Biological aging is significantly positively associated with UI, and its relationship with SUI follows an inverted J-shaped curve. Interventions that slow biological aging may offer a novel strategy for UI prevention; however, longitudinal studies are required to establish causality.
Plain Language Summary: We examined whether faster biological aging increases urinary incontinence (UI) in women. Using three aging-metrics (PhenoAge, KDM, HD) in 8,561 NHANES women we found higher biological age raised the odds of stress, urgency and mixed UI, with a clear inverted-J shape for stress UI. Associations persisted across subgroups but weakened with more reproductive risk factors. Slowing biological aging may help prevent UI, yet longitudinal work is needed.
Keywords: aging, prevalence, urinary incontinence, stress urinary incontinence, urgency urinary incontinence