Abstract
Introduction: Obese children are at increased risk to develop severe comorbidities, including: Type 2 Diabetes Mellitus, Obstructive Sleep Apnea (OSA), Attention Deficit/Hyperactivity Disorder (ADHD) and variable psychopathology.
Enuresis prevalence is increased in these specific medical conditions.
This study aims to assess the association between obesity and enuresis in children and adolescents.
Methods: A prospective study was performed among 344 subjects, aged 7-18 years. A questionnaire evaluated nocturnal enuresis, comorbidites and sociodemographic data. 281 subjects completed the questionnaires, 158 were normal weight, 37 overweight (85≤BMI≤95 percentiles, Body mass index(BMI), for age and gender) and 86 obese (BMI ≥95th percentile).
Outcome measures: height, weight, BMI and BMI-Z-score(BMIZ), prevalence of enuresis, association between enuresis and gender, family history, voiding dysfunction, ADHD, OSA and sociodemographic variables.
Results: Enuresis was present in 14(8.8%) of normal weight subjects, 6(16%) of overweight and 26(30%) of obese youth. A significant independent risk for enuresis was present in obese children (OR=6.5,95% CI(2.67-15.78)) compared to normal weight [P< 0.0001]. One unit increase in BMIZ, increases the risk for enuresis by OR of 2.14, P=0.00008,95% CI(1.46-3.12).
Male gender [OR-2.84,P=0.028,95% CI(1.10-5.58)],first degree relative with current/past enuresis [OR-4.24,P=0.003, 95% CI(1.62-11.08)],voiding dysfunction symptoms [OR-3.067,P=0.041,95% CI(1.05-9.00)] and ADHD [OR-2.31,P=0.051,95% CI(0.99-5.34)] increase the subjects risk to suffer from enuresis.
Conclusions: Enuresis in more prevalent among obese children. The joint risk factors support the hypothesis of a relation between the two entities. Due to this association, enuresis should be clarified during the primary workup of every obese child and adolescent.
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Weintraub, Y., Zinger, S., Chacham, S. et al. Enuresis- A New Comorbidity of Childhood Obesity?. Pediatr Res 70 (Suppl 5), 404 (2011). https://doi.org/10.1038/pr.2011.629
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DOI: https://doi.org/10.1038/pr.2011.629