Association Between Daily Sitting Time and Urinary Leakage and the Double Mediation Effects of Inflammation and Physical Activity: A Cross-Sectional Study

Background: Sedentary behavior (SB), recognized as a health risk, may contribute to urinary leakage (UL). This study examined the association between daily sitting time (DST) and UL risk, investigating inflammatory markers as potential mediators and leisure-time physical activity (LTPA) as a mediator. Methods: We conducted a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2020, involving 20,168 adult participants. Information on UL, DST, Dietary Inflammatory Index (DII), Body Mass Index (BMI), and Neutrophil-to-Lymphocyte Ratio (NLR) was collected through standardized questionnaires and 24-hour recall interviews. Logistic regression models assessed DST, LTPA, and UL relationships, adjusting for relevant covariates. Mediation analysis evaluated DII, BMI, and NLR's mediating roles in the DST-UL association. Results: The overall prevalence of UL among participants was 29.19%. Our findings revealed a significant positive association between longer DST and UL risk. Notably, individuals engaging in adequate LTPA demonstrated an attenuated association between DST and UL. Furthermore, mediation analysis identified significant parallel double mediating effects of DII-BMI and BMI-NLR on the relationship between DST and UL. However, no significant mediating effect was observed for DII-NLR, this suggests that DII, BMI, and NLR might jointly mediate the relationship of DST on UL risk. Conclusion: These findings suggest that prolonged sitting may be associated with higher UL risk through inflammatory mechanisms, and that LTPA may mitigate this risk. Further research is needed to validate these results and explore the underlying biological pathways.