Aydogmus H, Demirdal U S
İzmir Katip Çelebi University Atatürk Research and Training Hospital, Department of Gynecology and Obstetrics, Turkey.
İzmir Katip Çelebi University School of Medicine, Department of Physical Medicine and Rehabilitation, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:48-52. doi: 10.1016/j.ejogrb.2018.06.009. Epub 2018 Jun 9.
The association of vitamin D deficiency and pelvic floor dysfunction has been examined by numerous studies. Lower urinary tract symptoms (LUTS) associated with bladder filling and voiding functions are common in both sexes. A recent study reports a higher incidence of LTUS in men over 50 years old with vitamin D deficiency. The aim of the study is to investigate whether there is a difference in the Lower Urinary Tract Symptoms frequency between women with vitamin D deficiency and the control group or not.
In this case control study, a total of 150 women who had a measured vitamin D level within a month were divided into two groups, one with a serum vitamin D deficiency and the other with a normal vitamin D level. Both groups were evaluated in terms of menopausal status, numbers of pregnancy and delivery, pelvic examination findings, pelvic floor muscle strength, level of pelvic organ prolapse, LUTS scores, and the findings were recorded. Both groups were compared for the presence of lower urinary system symptoms. The BFLUTS validated for Turkish-speaking populations was used to assess lower urinary system symptoms. Statistical analyses were performed via IBM SPSS Statistics 23.0. The results were considered significant at p < 0.05 and a confidence interval of 95%.
Vitamin D deficiency was detected in 67.3% of the participants. No significant differences were found between the groups regarding variables that could affect lower urinary system symptoms such as menopausal status, presence of pelvic organ prolapse and neonatal weight (fetal macrosomia) The Pelvic Floor Muscle Strength was significantly lower in the group with vitamin D deficiency than the control group. BFLUTS scores of premenopausal women with vitamin D deficiency were found to be similar to the control group, likewise no significant differences in the BFLUTS scores were detected in postmenopausal women.
Although vitamin D deficiency causes a significant reduction in pelvic floor muscle strength, no significant correlation was found between lower urinary tract symptoms and vitamin D deficiency. There is a necessity of prospective randomized controlled trials to investigate the relationship between vitamin D deficiency and pelvic floor functions.
众多研究已对维生素D缺乏与盆底功能障碍之间的关联进行了探讨。与膀胱充盈和排尿功能相关的下尿路症状（LUTS）在男女中都很常见。最近一项研究报告称，50岁以上维生素D缺乏的男性中LUTS的发病率较高。本研究的目的是调查维生素D缺乏的女性与对照组在下尿路症状频率上是否存在差异。
在这项病例对照研究中，共有150名在一个月内测量了维生素D水平的女性被分为两组，一组血清维生素D缺乏，另一组维生素D水平正常。两组均根据绝经状态、妊娠和分娩次数、盆腔检查结果、盆底肌肉力量、盆腔器官脱垂程度、LUTS评分进行评估，并记录结果。比较两组下尿路系统症状的存在情况。使用针对说土耳其语人群验证的BFLUTS来评估下尿路系统症状。通过IBM SPSS Statistics 23.0进行统计分析。结果在p<0.05和95%的置信区间时被认为具有显著性。
67.3%的参与者检测出维生素D缺乏。在可能影响下尿路系统症状的变量方面，如绝经状态、盆腔器官脱垂的存在和新生儿体重（巨大儿），两组之间未发现显著差异。维生素D缺乏组的盆底肌肉力量明显低于对照组。发现维生素D缺乏的绝经前女性的BFLUTS评分与对照组相似，同样，绝经后女性的BFLUTS评分也未检测到显著差异。
尽管维生素D缺乏会导致盆底肌肉力量显著下降，但未发现下尿路症状与维生素D缺乏之间存在显著相关性。有必要进行前瞻性随机对照试验来研究维生素D缺乏与盆底功能之间的关系。
