Introduction: To offer valuable insights into potential dietary influences on bladder health, the study investigated the relationship between urinary caffeine metabolites and overactive bladder (OAB) syndrome. Methods: The data for this investigation consisted of individuals who were 20 years old or older, obtained from the National Health and Nutrition Examination Survey (NHANES) database. To assess the correlation between urinary caffeine metabolites and OAB, logistic regression analyses were utilized. In addition, quantile g-computation model (Qgcomp) and Bayesian kernel machine regression (BKMR) model were used to determine the combined effect of urine caffeine metabolites on OAB risk. Results: In the analyses of a dataset comprising 4,354 participants, 815 were diagnosed with OAB. After adjusting for various covariates, logistic regression analyses revealed the highest tertiles of caffeine metabolites and ln-transformed caffeine metabolites were negatively associated with OAB risk. Subsequent analyses using the Qgcomp demonstrated that an increase in the quartiles of caffeine metabolites mixture was associated with a decreased risk of developing OAB. The OR was 0.89 (95% confidence interval: 0.81, 0.99). Moreover, such negative correlation was primarily driven by 1,3-dimethylxanthine (1,3-DMX) and 1-methylxanthine (1-MX). The BKMR model confirmed a strong inverse link between urinary caffeine metabolites and OAB. Conclusion: Our work demonstrates a strong inverse relationship between urine caffeine metabolites and the occurrence of OAB. Among these metabolites, 1,3-DMX and 1-MX have the most pronounced impact on the combined effect. These findings suggest that the way caffeine is metabolized in the body could play a crucial role in the development of OAB.

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