Elevated High-Density Lipoprotein Cholesterol May Reduce Risk of Stress Urinary Incontinence

Investigators have printed new knowledge within the Worldwide Journal of Medical Sciences demonstrating a causal hyperlink between elevated high-density lipoprotein ldl cholesterol (HDL-C) ranges and a decreased danger of stress urinary incontinence (SUI), with heightened safety noticed in sufferers with chubby and/or weight problems. The information highlights the distinctive position of HDL-C ranges in stopping SUI, particularly in people with a excessive physique mass index (BMI).¹

HDL-C, generally generally known as “good ldl cholesterol,” could play a protecting position in stress urinary incontinence. | Picture Credit score: © nobeastsofierce – inventory.adobe.com

Affiliation Between SUI and HDL-C Warrants Additional Analysis

SUI, a situation that significantly impacts ladies, includes the involuntary leakage of urine throughout bodily acts. Examples embody laughing, coughing, or sneezing. With as much as 10% to 40% of ladies globally affected by SUI—and prevalence rising with age and weight problems—there’s a vital want for analysis on prevention methods and danger issue amelioration. Elements akin to pelvic ground dysfunction and childbirth are established dangers for SUI, however newer proof factors to metabolic well being as a possible new avenue for SUI prevention.^1-3

HDL-C is called an indicator of cardiovascular safety in distinction to low-density lipoprotein ldl cholesterol (LDL-C). Newer analyses have begun to uncover the involvement of HDL-C in non-cardiovascular settings, together with infections, diabetes, and power kidney illness, providing potential for HDL-C to function a predictive measure of SUI growth. Sadly, accessible proof on the connection between HDL-C and SUI is conflicting, with quite a few investigative teams coming to various conclusions.^1,4

A dual-evidence examine, integrating cross-sectional analyses from the Nationwide Well being and Diet Examination Survey (NHANES) and a 2-sample Mendelian randomization, was imitated by the present authors to judge the affiliation between HDL-C ranges and SUI prevalence, with specific deal with sufferers with chubby or weight problems. Moreover, the authors sought to discover whether or not BMI ranges can modify the protecting impact of HDL-C. In complete, 18,415 ladies from the NHANES survey have been included within the evaluation, of which 7658 (41.59%) reported SUI.¹

Larger HDL-C Ranges Diminished Risk of SUI

Firstly, HDL-C and SUI associations have been examined. Restricted cubic splines (RCS) evaluation demonstrated a nonlinear affiliation between HDL-C and SUI in a crude mannequin (P for total < .001; P for nonlinear < .001). There was a steep danger lower noticed at decrease HDL-C ranges, with a plateau in danger discount at larger HDL-C. A stepwise weighted multivariate logistic regression indicated that, for every 1 mg/dL enhance in HDL-C, SUI danger decreased by 0.8% (95% CI, 0.989—0.994; P < .001), which remained vital within the partially adjusted and absolutely adjusted fashions.¹

Concerning particular HDL-C thresholds, people with HDL-C of 67 mg/dL or extra had a 17.3% (95% CI, 0.747—0.917) decreased danger of SUI. The authors additionally performed a stepwise evaluation investigating the danger of SUI with rising HDL-C ranges, with This fall indicating the very best LDL-C degree and Q1 indicating the bottom. Observations from a completely adjusted mannequin point out that the danger of SUI within the highest LDL-C degree was 25.1% (95% CI, 0.652—0.859) decrease in contrast with the bottom degree, whereas the second degree indicated no significant protecting impact (odds ratio [OR] = 0.950 [95% CI, 0.847—1.066]; P = .380).¹

A subgroup evaluation was performed throughout demographic and medical knowledge, which revealed that the protecting impact of HDL-C was particularly sturdy in people with chubby or weight problems (BMI of 25 kg/m² or extra: OR = 0.992, P = .006; BMI of 30 kg/m² or extra: OR = 0.991, P = .001). Notably, youthful ladies—aged 60 or much less—demonstrated a heightened danger discount of SUI. The authors additionally decided that, when SUI was stratified by various leakage frequencies, HDL-C ranges have been inversely associated with all frequency ranges of SUI, with rising HDL-C ranges inducing a parallel lower within the frequency of SUI.¹

A causal relationship between HDL-C and SUI was certainly noticed by the examine authors, suggesting a protecting impact with HDL-C in opposition to SUI. The investigators warning, nonetheless, that these protecting results will not be linear throughout the board; they famous an “HDL-C” paradox noticed of their unadjusted RCS evaluation, which underscores the necessity for precision and thorough additional investigation. Regardless of this limitation, the use of a big, nationally consultant pattern from a large-scale evaluation permits for these observations to be deemed dependable and a stable base for future analysis.¹

“These sturdy findings counsel that sustaining optimum HDL-C ranges could function an efficient preventive technique in opposition to SUI, particularly in high-BMI populations,” the examine authors concluded. “Whereas our outcomes spotlight the therapeutic potential of HDL-C, future research ought to additional elucidate the underlying mechanisms and validate these associations throughout numerous demographic teams.”¹

REFERENCES

1. Huang J, Wang Z, Liu Z, et al. Protecting Function of High-Density Lipoprotein Cholesterol in Stress Urinary Incontinence with Particular Emphasis on Chubby/Overweight People. Int J Med Sci. 2025;22(12):3304-3315. doi:10.7150/ijms.116324

2. Li J, Wang D, Tian H, et al. Affiliation between lipid accumulation merchandise and stress urinary incontinence: a cross-sectional examine from NHANES 2005 to 2018. Lipids in Well being and Illness. 2024;23(358). doi:10.1186/s12944-024-02350-3

3. Bo Okay, Frawley HC, Haylen BT. An Worldwide Urogynecological Affiliation (IUGA)/Worldwide Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological administration of feminine pelvic ground dysfunction. Neurourol Urodyn. 2017;36(2):221-244. doi:10.1002/nau.23107

4. Eckardstein AV, Nordestgaard BG, Remaley AT, Catapano AL. Excessive-density lipoprotein revisited: organic capabilities and medical relevance. Eur Coronary heart J. 2023;44(16):1394-1407. doi:10.1093/eurheartj/ehac605