March 3, 2026Open Access

Association Between Cardiovascular Health (Lifes Crucial 9) and Stress Urinary Incontinence in Women: The Mediating Role of Oxidative Stress Factors (NHANES 2005-2018)

YLYing LiSouthwest Petroleum University HHHaiyan Huang MLMeizhu Lin

Key Points

Higher cardiovascular health scores correlate with reduced odds of stress urinary incontinence, emphasizing the importance of cardiovascular health.
Women in higher tertiles of life's crucial 9 exhibited significant odds ratios of 0.817 and 0.765 for reduced urinary incontinence.
Analysis involved data from 5,292 U.S. women using the National Health and Nutrition Examination Survey to assess associations with oxidative stress.
Findings highlight oxidative stress biomarkers as mediators, playing a potential role in the relationship between cardiovascular health and urinary incontinence.

Abstract

Ying Li,1, Haiyan Huang,1, Meizhu Lin,2 Xuanmo Fang,1 Lanping Huang,1 Minhua Ye,1 Wanqing Wang,1 Yang Yang,2 Xiaoyan Li2 1Department of Obstetrics 2Department of Obstetrics These authors contributed equally to this workCorrespondence: Yang Yang, Department of Obstetrics 95% confidence intervals (CI), 0.673â 0.993 and 0.600â 0.975, respectively]. Furthermore, RCS results suggested an approximately linear dose-response relationship between LC9 and the prevalence of SUI. Additionally, mediation analysis indicated that oxidative stress biomarkers, specifically bilirubin and uric acid, mediated the relationship between LC9 and SUI, with mediation proportions of 2.22% and 2.64%, respectively (P < 0.05).Conclusion: The present study suggests that higher LC9 scores, which represent ideal CVH, are significantly associated with reduced odds of SUI. Additionally, oxidative stress biomarkers may play a mediating role in this relationship.Keywords: lifeâs crucial 9, stress urinary incontinence, cardiovascular health, oxidative stress, NHANES

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