Modeling the possibility of occurrence of overactive bladder in women of different ages, depending on anthropo-somatotypological indicators or hormonal background with the help of discriminant analysis
Abstract
One of the most important problems of modern urogynecology is the improvement of the treatment-diagnostic algorithm and prevention of overactive bladder syndrome (OAB). The purpose of the work is to construct and analyze discriminant models of the possibility of OAB occurrence in pregnant women of different age groups depending on the characteristics of anthropo-somatotypological indicators or hormonal background. 75 pregnant women with clinical signs of OAB syndrome and 60 healthy pregnant women had hormonal screening in the 1st and 3rd trimester of pregnancy and at 16 weeks postpartum using radioimmunoassay and immune enzyme methods (estradiol, progesterone, thyroid stimulating hormone and testosterone levels were determined). The anthropometry was carried out according to the method of V. V. Bunak, the components of the somatotype were determined according to the method of J. Carter and B. Heath, as well as the components of the body composition according to the method of J. Matiegka and the American Institute of Nutrition (AIN). By age, all pregnant women were divided into 3 subgroups: І - from 17 to 25 years, ІІ - from 26 to 35 years, ІІІ - from 36 to 41 years. A discriminant analysis of the possibility of OAB occurrence, depending on the anthropo-somatotypological or hormonal indices in women of different age groups, was conducted using the licensing program “Statistica 5.5”. When taken into account anthropo-somatotypological indices in women aged from 17 to 25 years, the model is correct in 86.7% of cases; in women aged from 26 to 35 years - in 90.9% of cases; in women between the ages of 36 and 41 years - in 89.3% of cases. Between healthy and OAB patients, women aged from 17 to 25 years discriminating variables are the width of the distal epiphysis of the shoulder (which has the greatest contribution to discrimination), conjugata externa, the muscle component of the body weight by AIN and the forearm's girth in the upper third; women from 26 to 35 years - dist. Іntеrtrochantericа, the width of the distal epiphyses of the forearm (the greatest contribution to discrimination), hip circumference, conjugata externa, mesomorphic component of the somatotype according to by Heath-Carter, fat mass component of the body by Matiegka, the forearm's girth in the upper third and the shoulder girth; women of age from 36 to 41 years - the width of the distal epiphysis of the leg (which has the greatest contribution to discrimination) and the length of the body. In general, the aggregate of all variables has a low level of discrimination between healthy and sick with OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.531; F = 5.521; p <0.01) and 36-41 years (Wilkes Lambda statistics = 0.445; F = 15.62; p <0.001), while among women between the ages of 26 and 35 - the average level of discrimination (Wilkes Lambda statistics = 0.386; F = 13.52; p <0.001). When taken into account characteristics of the hormonal background in women of all ages, the model is correct in 100% of cases. Between healthy and OAB patients, of 17-25 years age, discriminant variables are estradiol levels at 16 weeks of postpartum (with the largest contribution to discrimination) and prolactin levels in the first trimester of pregnancy; women aged from 26 to 35 years - estradiol levels at 16 weeks of postpartum (the most contributing to discrimination), testosterone in the third trimester of pregnancy, estradiol in the third trimester of pregnancy, prolactin in the third trimester of pregnancy, estradiol in the first trimester of pregnancy, and testosterone levels in the first trimester of pregnancy; women aged from 36 to 41 years - estradiol in the third trimester of pregnancy (has the largest contribution to discrimination) and estradiol in the 16 weeks of postpartum period. In general, the totality of all variables has a low level of discrimination between healthy and sick at OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.619; F = 131.4; p <0.001) and ages 26-35 (Wilks Lambda statistics = 0.493; F = 224.9; p <0.001), while among women between the ages of 36 and 41 - the average level of discrimination (Wilkes Lambda statistics = 0.371; F = 207.4; p <0.001). Thus, with the aid of discriminant analysis, reliable models of the possibility of OAB occurrence, based on anthropo-somatotypological or hormonal indices in women of different age groups, are constructed. In all age groups, the greatest contribution to discrimination between healthy and sick with OAB pregnant women, in most cases, make parameters of the width of distal epiphyses of long limb bones or the level of estradiol.
References
[2] Alyaev, Yu. G., Grogoryan, V. А., & Gadgieva, Z. C. (2006). Urinary Disorders. М.: Litterra.
[3] Bunak, V. V. (1941). Anthropometry: a practical course. М.: Uchpedgiz.
[4] Bursian, A. V. (2008). Pacemakers of the visceral system. Advances in physiological sciences, 39(4), 3-13.
[5] Buyanova, S. N., Petrova, V. D., Krasnopolskiy, I. V., & Muravieva, T. G. (2005). Diagnosis and treatment of complex and mixed forms of urinary incontinence. Obstetrics and gynecology, 1, 54-57.
[6] Carter, J. L., & Heath, B. H. (1990). Somatotyping – development and applications. Cambridge University Press.
[7] Choon, S. K., & Jun, H. L. (2014). Prevalence, risk factors, quality of life, and health-care seeking behaviors of female urinary incontinence: Results from the 4th Korean National Health and Nutrition Examination Survey VI (2007–2009). Int. Neurourol. J., 18(1), 31-36. doi: 10.5213/inj.2014.18.1.31
[8] Del Río-Gonzalez, S., Aragon, I. M., Castillo, E., Milla-España, F., Galacho, A., Machuca, J., … Herrera-Imbroda, B. (2017). Percutaneous Tibial Nerve Stimulation Therapy for Overactive Bladder Syndrome: Clinical Effectiveness, Urodynamic, and Durability Evaluation. Urology, 108, 52-58. doi: 10.1016/j.urology.2017.04.059
[9] Dumoulin, C., Bourbonnais, D., Morin, M., Gravel, D., & Lemieux, M. C. (2011). Predictors of success for physiotherapy treatment in women with persistent postpartum stress urinary incontinence. Arch. Phys. Med. Rehabil., 91(7), 1059-1063. doi: 10.1016/j.apmr.2010.03.006
[10] Horovyy, V. I., Mazorchuk, B. F., Shaprinskiy, V. О., Chayka, G. V., Baralo, І. V., Kapshuk, О. М., … Cerkovnyuk, R. G. (2015). Practical urogynecology: a course of lectures: a manual. Vinnitsa: Book-Vega.
[11] Losada, L., Amundsen, C. L., Ashton-Miller, J., Chai, T., Close, C., Damaser, M., … Mallampalli, M. P. (2016). Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span. Journal of Women's Health, 25(11), 1086-1096. doi: 10.1089/jwh.2016.5895
[12] Matiegka, J. (1921). The testing of physical effeciecy. Amer. J. Phys. Antropol., 2(3), 25-38.
[13] Nambiar, A. K., Bosch, R., Cruz, F., Lemack, G. E., Thiruchelvam, N., Tubaro, A., … Burkhard, F. C. (2018). EAU guidelines on assessment and nonsurgical management of urinary incontinence. Eur. Urol., 73(4), 596-609. doi: 10.1016/j.eururo.2017.12.031
[14] Nikityuk, B. A, Moroz, V. M., Nikityuk, D. B. (1998). Theory and Practice of Integrative Anthropology: Essays. К.: Publishing house “Zdorovia”.
[15] Nitti, V. W., Dmochowski, R., Herschorn, S., Sand, P., Thompson, C., Nardo, C., … Haag-Molkenteller, C. (2013). OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial. J. Urol., 89(6), 2186-2193. doi: 10.1016/j.juro.2012.12.022
[16] Noblett, K., Siegel, S., Mangel, J., Griebling, T. L., Sutherland, S. E., Bird, E. T., … Berg, K. C. (2016). Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder. Neurourol. Urodyn., 35(2), 246-251. doi: 10.1002/nau.22707
[17] Qaseem, A., Dallas, P., Forciea, M. A., Starkey, M., Denberg, T. D., & Shekelle, P. (2014). Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Ann. Intern. Med., 161(6), 429-440. doi: 10.7326/M13-2410
[18] Sako, T., Inoue, M., Watanabe, T., Ishii, A., Yokoyama, T., & Kumon, H. (2011). Impact of overactive bladder and lower urinary tract symptoms on sexual health in Japanese women. Int. Urogynecology J., 22(2), 165-169. doi: 10.1007/s00192-010-1250-x
[19] Salvesen, K. A., & Morkved, S. (2004). Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ, 329(7462), 378‐380. doi: 10.1136/bmj.38163.724306.3A
[20] Shephard, R. J. (1991). Body composition in biological anthropology. Cambridge.
[21] Siegel, S., Noblett, K., Mangel, J., Bennett, J., Griebling, T. L., Sutherland, S. E., … Berg, K. C. (2018). Five-Year Followup Results of a Prospective, Multicenter Study of Patients with Overactive Bladder Treated with Sacral Neuromodulation. J. Urol., 199(1), 229-236. doi: 10.1016/j.juro.2017.07.010
[22] Smith, F. J., Holman, C. D., Moorin, R. E., & Tsokos, N. (2010). Lifetime Risk of Undergoing Surgery for Pelvic Organ Prolapse. Obstetrics and Gynecology, 116(5), 1096‐1100. doi: 10.1097/AOG.0b013e3181f73729
[23] Stewart, W. F., Van Rooyen, J. B., Cundiff, G. W., Abrams, P., Herzog, A. R., Corey, R., … Wein, A. J. (2003). Prevalence and burden of overactive bladder in the United States. World Journal of Urology, 20(6), 327-336. doi: 10.1007/s00345-002-0301-4
[24] Tannenbaum, C., Brouillette, J., Michaud, J., Korner-Bitensky, N., Dumoulin, C., Corcos, J., … Valiquette, L. (2009). Responsiveness and clinical utility of the Geriatric self-efficacy index for urinary incontinence. Journal of the American Geriatrics Society, 57(3), 470-475. doi: 10.1111/j.1532-5415.2008.02146.x
[25] Viktrup, L. (2002). The risk of lower urinary tract symptoms five years after the first delivery. Neurourology and Urodynamics, 21(1), 2‐29. PMID: 11835420
[26] Villot, A., Deffieux, X., Billecocq, S., Auclair, L., Amarenco, G., & Thubert, T. (2016). Influence of cognitive rehabilitation on pelvic floor muscle contraction: A randomized controlled trial. Neurourology and Urodynamics, 36(6), 1636-1644. doi: 10.1002/nau.23169
[27] Voorham, J. C., De Wachter, S., Tine, W., Van den Bos, T. W. L., Putter, H., Lycklama À Nijeholt, G. A., & Voorham-van der Zalm, P. J. (2016). The effect of EMG biofeedback assisted pelvic floor muscle therapy on symptoms of the overactive bladder syndrome in women: A randomized controlled trial. Neurourology and Urodynamics, 36(7), 1796-1803. doi: 10.1002/nau.23180
[28] Wagg, A., Verdejo, C., & Molander, U. (2010). Review of cognitive impairment with antimuscarinic agents in elderly patients with overactive bladder. Int. J. Clin. Pract., 64(9), 1279‐1286. doi: 10.1111/j.1742-1241.2010.02449.x
[29] Zhou, F., Newman, D. K., & Palmer, M. H. (2018). Urinary Urgency in Working Women: What Factors Are Associated with Urinary Urgency Progression? Journal of Women's Health, 27(5), 575-583. doi: 10.1089/jwh.2017.6555
ISSN 
ISSN 
