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Nocturnal enuresis in obese children: a nation-wide epidemiological study from China

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 relatio...

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Published in:Scientific reports 2019-06, Vol.9 (1), p.8414, Article 8414
Main Authors: Zhang, Anyi, Li, Shenghui, Zhang, Yiwen, Jiang, Fan, Jin, Xingming, Ma, Jun
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description 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 >95 th 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 
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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 &gt;95 th 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 &lt; 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.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-019-44532-5</identifier><identifier>PMID: 31182742</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/699 ; 692/700 ; Apnea ; Asthma ; Attention deficit hyperactivity disorder ; Body mass index ; Child ; Children ; China - epidemiology ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Enuresis ; Epidemiology ; Female ; Humanities and Social Sciences ; Humans ; Hyperactivity ; Logistic Models ; Male ; Mental depression ; Mood ; multidisciplinary ; Multivariate Analysis ; Nocturnal ; Nocturnal Enuresis - complications ; Nocturnal Enuresis - epidemiology ; Nocturnal Enuresis - pathology ; Obesity ; Obesity - complications ; Risk Factors ; Science ; Science (multidisciplinary) ; Severity of Illness Index ; Sleep ; Sleep disorders</subject><ispartof>Scientific reports, 2019-06, Vol.9 (1), p.8414, Article 8414</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. 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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 &gt;95 th 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 &lt; 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.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>31182742</pmid><doi>10.1038/s41598-019-44532-5</doi><oa>free_for_read</oa></addata></record>
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subjects 692/699
692/700
Apnea
Asthma
Attention deficit hyperactivity disorder
Body mass index
Child
Children
China - epidemiology
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Enuresis
Epidemiology
Female
Humanities and Social Sciences
Humans
Hyperactivity
Logistic Models
Male
Mental depression
Mood
multidisciplinary
Multivariate Analysis
Nocturnal
Nocturnal Enuresis - complications
Nocturnal Enuresis - epidemiology
Nocturnal Enuresis - pathology
Obesity
Obesity - complications
Risk Factors
Science
Science (multidisciplinary)
Severity of Illness Index
Sleep
Sleep disorders
title Nocturnal enuresis in obese children: a nation-wide epidemiological study from China
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