Abstract
Childhood obesity increases the risk of obstructive sleep apnea syndrome, type 2 diabetes mellitus, cardiovascular abnormalities, and psychological and behavioral disorders. But it is unclear whether obesity is associated with childhood nocturnal enuresis (NE). This study aimed to assess the relationship between childhood obesity and NE in a nationally representative large sample in China. Subjects were enrolled from Urumqi, Chengdu, Xi’an, Hohhot, Wuhan, Canton, Shanghai, and Harbin cities in China in November and December 2005. The survey included 20,987 children aged 5–12 years and they and their caregivers completed questionnaires. Height and weight were measured by school teachers trained in healthcare. According to the WHO child growth standards, obesity was defined as a body mass index >95th percentile of peers with the same age and gender. NE was defined as bed wetting for more than twice a week for 3 consecutive months. Demographic variables were compared among different groups. The prevalence of obesity, asthma, attention-deficit/hyperactivity disorder (ADHD), depressive moods, and snoring were different between the NE and without-NE groups (P < 0.05). The raw odds ratio (OR) for NE and obesity was 1.36 (95%CI = 1.07–1.74; P = 0.013) and the adjusted OR was 1.42 (95%CI = 1.11–1.82; P = 0.005) in the multivariable analysis. When adjusting for co-occurring conditions, the results showed that asthma did not affect the risk of NE (OR = 1.42, 95%CI = 1.11–1.82; P = 0.005), but ADHD (OR = 1.41; 95%CI = 1.10–1.81; P = 0.006) and depressive moods (OR = 1.34; 95%CI = 1.07–1.76; P = 0.012) slightly weakens the association between NE in children and obesity, while snoring weakens the association between obesity and NE and the risk became non-significant (OR = 1.21; 95%CI = 0.94–1.56; P = 0.138). In conclusion, obese children were at a higher risk of incurring NE compared to non-obese children. This association was weaker in children who either snored, had ADHD, or had depressive mood.
Highlights
Childhood obesity is associated with consuming calories in excess to the body’s energy expenditure, leading to imbalance between energy input and output
The results showed there was a positive relationship between childhood obesity and nocturnal enuresis (NE), but the relationship was influenced by several factors including snoring, depressive moods, and attention-deficit/hyperactivity disorder (ADHD), among which snoring played the most important role
To the best of our knowledge, this might be the first study on the potential association between childhood obesity and NE based on a nationwide sample
Summary
Childhood obesity is associated with consuming calories in excess to the body’s energy expenditure, leading to imbalance between energy input and output. While other studies have shown the opposite[5,6], Erdem et al found that 62–86% of the children with voiding dysfunction (including NE) were diagnosed with obesity[5] In another cross-sectional study with 281 children and adolescents aged 7–18 from hospital-based samples, children with obesity were at high risk for www.nature.com/scientificreports/. Case-control studies and those with children enrolled from clinics have high selectivity and may draw conclusions that are not representative of the general population of obese children They did not take confounding factors (like OSAS, ADHD, and depressive moods) into consideration. We conducted this survey to investigate the underlying association between obesity and NE in a large, representative sample of Chinese children of 5–12 years of age. Potential factors that might influence the association between childhood obesity and NE were used to adjust the association in a multivariable logistic regression analysis
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