Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study

Abstract Purpose Clinical observations suggest a correlation between metabolic syndrome (Mets) and overactive bladder (OAB). However, the absence of evidence for a direct causal relationship between them limits the development of effective treatment strategies. This study aimed to explore the associ...

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Main Authors: Zhihao Liu, Xiaotong Sun, Chunlei Liu, Che Wang, Rujie Zheng, Xiaoyu Du, Wenjuan Song, Chengzhi Lu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01883-6
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author Zhihao Liu
Xiaotong Sun
Chunlei Liu
Che Wang
Rujie Zheng
Xiaoyu Du
Wenjuan Song
Chengzhi Lu
author_facet Zhihao Liu
Xiaotong Sun
Chunlei Liu
Che Wang
Rujie Zheng
Xiaoyu Du
Wenjuan Song
Chengzhi Lu
author_sort Zhihao Liu
collection DOAJ
description Abstract Purpose Clinical observations suggest a correlation between metabolic syndrome (Mets) and overactive bladder (OAB). However, the absence of evidence for a direct causal relationship between them limits the development of effective treatment strategies. This study aimed to explore the association between Mets and OAB in the U.S. population and elucidate their causal relationships. Methods A cross-sectional study was conducted using data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES). OAB symptoms were assessed using the OAB symptom score (OABSS), and Mets was diagnosed based on the NCEP-ATP III criteria. Multivariate logistic regression was used to evaluate the relationship between Mets and OAB. Subgroup analyses and interaction tests were performed to assess the consistency of this association. Mendelian randomization (MR) analysis was conducted to investigate the causal effects of Mets components or risk factors on OAB symptoms, including bladder calcification /contracture/ overactivity (BCCO) and urinary frequency/incontinence (UFI). Results The cross-sectional study involved 7,596 participants. After adjusting for covariates, individuals with Mets had a significantly higher risk of OAB (OR: 2.27, 95% CI: 1.89–2.72, p = 0.035). Gender subgroup analysis revealed that females had 51% higher odds of developing OAB compared to the reference group (OR: 1.51, 95% CI: 1.13–2.02, p = 0.008), while this association was not observed in males (OR: 0.95, 95% CI: 0.63–1.43, p > 0.05). MR analysis found no significant causal relationship between Mets and OAB symptoms; however, certain Mets components or risk factors, including BMI, waist circumference (WC), fasting blood glucose (FBG), and hypertension, were associated with an increased risk of OAB. The sensitivity analysis excluded the influence of potential heterogeneity and horizontal pleiotropy. Conclusion This study highlighted a positive association between Mets and OAB in the U.S. population, with significant gender differences. Furthermore, it provided evidence suggesting a potential causal role of Mets components in the development of OAB and highlighted the importance of therapeutic strategies targeting Mets for managing OAB symptoms.
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spelling doaj-art-ce5c92e313b34edaa72fd89c3a3305f02025-08-24T11:41:44ZengBMCDiabetology & Metabolic Syndrome1758-59962025-08-0117111210.1186/s13098-025-01883-6Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization studyZhihao Liu0Xiaotong Sun1Chunlei Liu2Che Wang3Rujie Zheng4Xiaoyu Du5Wenjuan Song6Chengzhi Lu7School of Medicine, Nankai UniversityThe First Central Clinical School, Tianjin Medical UniversitySchool of Medicine, Nankai UniversitySchool of Medicine, Nankai UniversityThe First Central Clinical School, Tianjin Medical UniversityThe First Central Clinical School, Tianjin Medical UniversityThe First Central Clinical School, Tianjin Medical UniversitySchool of Medicine, Nankai UniversityAbstract Purpose Clinical observations suggest a correlation between metabolic syndrome (Mets) and overactive bladder (OAB). However, the absence of evidence for a direct causal relationship between them limits the development of effective treatment strategies. This study aimed to explore the association between Mets and OAB in the U.S. population and elucidate their causal relationships. Methods A cross-sectional study was conducted using data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES). OAB symptoms were assessed using the OAB symptom score (OABSS), and Mets was diagnosed based on the NCEP-ATP III criteria. Multivariate logistic regression was used to evaluate the relationship between Mets and OAB. Subgroup analyses and interaction tests were performed to assess the consistency of this association. Mendelian randomization (MR) analysis was conducted to investigate the causal effects of Mets components or risk factors on OAB symptoms, including bladder calcification /contracture/ overactivity (BCCO) and urinary frequency/incontinence (UFI). Results The cross-sectional study involved 7,596 participants. After adjusting for covariates, individuals with Mets had a significantly higher risk of OAB (OR: 2.27, 95% CI: 1.89–2.72, p = 0.035). Gender subgroup analysis revealed that females had 51% higher odds of developing OAB compared to the reference group (OR: 1.51, 95% CI: 1.13–2.02, p = 0.008), while this association was not observed in males (OR: 0.95, 95% CI: 0.63–1.43, p > 0.05). MR analysis found no significant causal relationship between Mets and OAB symptoms; however, certain Mets components or risk factors, including BMI, waist circumference (WC), fasting blood glucose (FBG), and hypertension, were associated with an increased risk of OAB. The sensitivity analysis excluded the influence of potential heterogeneity and horizontal pleiotropy. Conclusion This study highlighted a positive association between Mets and OAB in the U.S. population, with significant gender differences. Furthermore, it provided evidence suggesting a potential causal role of Mets components in the development of OAB and highlighted the importance of therapeutic strategies targeting Mets for managing OAB symptoms.https://doi.org/10.1186/s13098-025-01883-6Metabolic syndromeOveractive bladderObesityDiabetes mellitusHypertension
spellingShingle Zhihao Liu
Xiaotong Sun
Chunlei Liu
Che Wang
Rujie Zheng
Xiaoyu Du
Wenjuan Song
Chengzhi Lu
Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study
Diabetology & Metabolic Syndrome
Metabolic syndrome
Overactive bladder
Obesity
Diabetes mellitus
Hypertension
title Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study
title_full Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study
title_fullStr Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study
title_full_unstemmed Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study
title_short Relationship between metabolic syndrome and overactive bladder: insights from the NHANES and Mendelian randomization study
title_sort relationship between metabolic syndrome and overactive bladder insights from the nhanes and mendelian randomization study
topic Metabolic syndrome
Overactive bladder
Obesity
Diabetes mellitus
Hypertension
url https://doi.org/10.1186/s13098-025-01883-6
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