Sarcopenia e obesidade e suas relações com a gravidade da incontinência urinária em mulheres na fase do climatério: um estudo transversal

Abstract

Introduction: The climacteric period is accompanied by hormonal and body composition changes, such as loss of lean mass and gain of fat mass, which contribute to functional deficits. Sarcopenia and obesity are related to several health conditions, however few studies have analyzed the presence of these conditions in incontinent women in the climacteric phase. Furthermore, it is not clear whether there is an association between these conditions and the severity of urinary incontinence. Objective: To verify the prevalence of sarcopenia and obesity, as well as its relations with the severity of urinary incontinence (UI) in climacteric women. Methods: Cross-sectional study, sample composed of women over 40 years old with a diagnosis of UI, referred to the Pelvic Physiotherapy service of Maternidade Escola Assis Chateaubriand (MEAC). Socioeconomic, demographic, urogynecological and obstetric history, UI severity (Incontinence Severity Index - ISI), grip strength and anthropometric measures (classification of sarcopenia and obesity) were evaluated. Means and standard deviations, absolute and relative frequencies, Student's t test and Fisher's exact test were used (significance level of 5%). Results: Sample of 177 women, mean of 56.3 (± 9.7) years old. Regarding UI, 69 (39.0%) women had mixed UI; and 53.1% moderate severity. Only 32 (18.1%) had a normal BMI, 83 (46.8%) were classified as general obesity and 139 (80.3%) as abdominal obesity. The prevalence of sarcopenia was 3.4% and 35 (20%) had a low grip strength (pre-sarcopenia). Women with severe or very severe UI had lower grip strength (p = 0.02) and higher BMI (p = 0.04). Sarcopenia was associated with greater UI severity (p = 0.005). Conclusion: The presence of sarcopenia and low muscle strength was observed in women during the climacteric phase, in addition to the high prevalence of general and abdominal obesity. There was an association between sarcopenia and greater UI severity. Thus, preventive measures are needed to promote increased muscle mass and strength, reduced weight and waist circumference, avoiding future complications.