From the *Research Institute at Nationwide Children's Hospital, †Departments of Pediatrics and Obstetrics and Gynecology, and ‡Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH.
Sex Transm Dis. 2014 May;41(5):295-9. doi: 10.1097/OLQ.0000000000000124.
Low serum vitamin D concentration has been associated with increased prevalence of bacterial vaginosis (BV) among pregnant women, but the few studies conducted in nonpregnant women have produced inconsistent results. Because serum vitamin D concentration is generally higher in the summer and fall than winter and spring, if vitamin D insufficiency causes BV, then BV would be expected to be more common during seasons with lower vitamin D concentrations.
The Longitudinal Study of Vaginal Flora followed up women in Birmingham, Alabama (33.5° latitude), quarterly for up to 1 year. We used a case-crossover design with conditional logistic regression among women who attended visits in each season, to assess the adjusted association between season and BV. We compared each woman's BV status in summer, fall, and spring to her own status in winter.
Among the 3620 women in the parent study, 2337 attended visits in each season; BV prevalence was 40% in winter, 38% in spring, and 41% in summer and fall. One thousand three hundred thirty-five women had BV at some but not all visits and were therefore included in the case-crossover analysis. Season was not associated with BV in women who were BV negative at study entry (odds ratio vs. winter were 1.0 for spring, 1.0 for summer, and 0.9 for fall; P = 0.81). Among women BV positive at study entry, the corresponding odds ratios were 0.9, 1.4, and 1.4 (P < 0.001).
These results do not support an association between vitamin D, measured through the proxy variable of season, and BV.
血清维生素 D 浓度低与孕妇细菌性阴道病（BV）的患病率增加有关，但在非孕妇中进行的少数研究得出的结果并不一致。由于血清维生素 D 浓度通常在夏季和秋季高于冬季和春季，如果维生素 D 不足导致 BV，那么在维生素 D 浓度较低的季节，BV 预计会更为常见。
阴道菌群纵向研究在阿拉巴马州伯明翰（北纬 33.5 度）对女性进行了长达 1 年的每季度随访。我们在每个季节就诊的女性中使用病例交叉设计和条件逻辑回归，评估季节与 BV 之间的调整关联。我们将每位女性在夏季、秋季和春季的 BV 状况与她在冬季的状况进行了比较。
在母研究的 3620 名女性中，有 2337 名女性在每个季节就诊；冬季 BV 患病率为 40%，春季为 38%，夏季和秋季为 41%。1335 名女性在某些但不是所有就诊时患有 BV，因此被纳入病例交叉分析。在研究开始时 BV 阴性的女性中，季节与 BV 无关（与冬季相比，春季的比值比为 1.0，夏季为 1.0，秋季为 0.9；P=0.81）。在研究开始时 BV 阳性的女性中，相应的比值比分别为 0.9、1.4 和 1.4（P<0.001）。
这些结果不支持通过季节这个代理变量测量的维生素 D 与 BV 之间存在关联。
