Urinary incontinence (UI) is a prevalent and debilitating condition that significantly impacts quality of life worldwide. Metabolic disturbances have been implicated in various diseases, offering potential therapeutic targets. While previous studies suggest an association between metabolic disorders and UI, evidence supporting a causal relationship between blood metabolites and UI remains limited.

Using Mendelian randomization (MR), we evaluated the causal associations between 1,400 serum metabolites and urinary incontinence. The inverse variance weighted method (IVW), weighted median, MR-Egger regression, simple mode, and weighted mode methods were employed to assess causality. Pleiotropy and heterogeneity tests were conducted to ensure robustness of the findings.

After rigorous screening, we identified 83 metabolites or metabolite ratios associated with urinary incontinence. Among these, 41 metabolites exhibited negative associations, while 42 showed positive associations with UI risk. The top three metabolites associated with an increased risk of UI included Carnitine C14, Adenosine 5'-monophosphate (AMP) to palmitate (16:0) ratio, and Adenosine 5'-monophosphate (AMP).

Among the 1,400 blood metabolites analyzed, we identified 83 metabolites or metabolite ratios associated with urinary incontinence. This MR study provides novel insights into the role of metabolic pathways in UI pathogenesis and highlights potential biomarkers for screening, prevention, and therapeutic intervention.