{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T18:03:38Z","timestamp":1769537018334,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to determine the association between appendicular muscle\u2010to\u2010fat ratio (aMFR) and the risk of urinary incontinence (UI) in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 4393 participants recruited from the National Health and Nutrition Examination Database (NHANES) from 2011 to 2018 were included in this study. We screened variables using least absolute shrinkage and selection regression, multivariate logistic regression, dose\u2013response curve and nomogram to estimate the relationship between aMFR and UI. The accuracy and discrimination of the nomogram were validated using calibration, receiver operating characteristic (ROC), and decision curve analysis (DCA) curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants with UI had a lower aMFR than those without (I [0.57, interquartile range [IQR]: 0.49, 0.69] vs 0.63, IQR: 0.54, 0.77,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Dose\u2013response curves and multivariate logistic regression showed a negative correlation between the aMFR and the risk of developing UI [adjusted odds ratio (aOR)\u2009=\u20090.35, 95% confidence interval (CI)\u2009=\u20090.226\u20130.537,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001]. Validation of the calibration curves, ROC curves and DCA curves revealed the good predictive ability of the UI nomogram, and the area under the ROC curve in the predictive model was 0.668 (95% CI\u2009=\u20090.641\u20130.695) in the training set and 0.660 (95% CI\u2009=\u20090.633\u20130.687) in the testing set, which demonstrated the good performance of the model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A low aMFR was significantly associated with an increased risk of UI in women in the US and could be included in risk prediction models for female UI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bco2.70132","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T07:27:37Z","timestamp":1767079657000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low muscle, high leak? The aMFR wake\u2010up call for women's bladders!"],"prefix":"10.1002","volume":"7","author":[{"given":"Jingyi","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruomeng","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zengyuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5444-636X","authenticated-orcid":false,"given":"Qian","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Research Center, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"},{"name":"Department of Reproductive Immunology, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal\u2010Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongsheng","family":"Yu","sequence":"additional","affiliation":[{"name":"Chongqing Institute of Green and Intelligent Technology Chinese Academy of Sciences  Chongqing China"},{"name":"Chongqing School University of Chinese Academy of Sciences  Chongqing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingmiao","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Nephropathy The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runtao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Normal\u2010Hong Kong Baptist University  Zhuhai Guangdong 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