Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; Emory University, Department of Medicine, Atlanta, GA; Atlanta VA Medical Center, Decatur, GA.
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA; University of Alabama at Birmingham, Department of Medicine, Birmingham, AL.
Urology. 2021 Apr;150:213-218. doi: 10.1016/j.urology.2020.04.090. Epub 2020 May 7.
To determine if vitamin D intake is associated with reduced progression of urgency urinary incontinence (UI) in women.
We used the Nurses' Health Study (NHS) I and NHSII cohorts to evaluate the association of vitamin D intake with progression of urgency UI and mixed UI, from mild-moderate to severe symptoms, from 2004 to 2012 (NHS) and 2005-2013 (NHSII). Intake of vitamin D at study baseline was categorized and updated at the start of each 2-4 year follow-up period. Multivariable-adjusted relative risks (RRs) and 95% confidence intervals (95% CI) of progression to severe UI were estimated using Cox proportional hazard models.
At baseline, of the 20,560 older women (age range 58-73 years) in NHS I with mild/moderate urgency or mixed UI, 21% reported oral vitamin D intake of at least 800 IU per day. Among 12,573 middle-aged women (age range 42-59) in NHS II with mild/moderate urgency or mixed UI, 17% reported oral vitamin D intake of at least 800 IU daily. From 2004 to 2012, 4853 incident cases of urgency/mixed UI progression were identified among older women. From 2005 to 2013, 1378 incident cases of urgency/mixed UI progression were identified among middle-aged women. After multivariable adjustment, no significant associations between vitamin D intake and incidence of urgency/mixed UI progression were observed in either cohort (RR = 1.10, 95% CI 0.99-1.23 in older women, RR = 0.88, 95% CI 0.71, 1.10 in middle-aged women).
Despite interest in vitamin D as a low-cost strategy to prevent or reduce UI, our findings indicate oral vitamin D may not reduce urgency/mixed UI progression.
确定维生素 D 摄入量是否与女性急迫性尿失禁 (UI) 进展减少相关。
我们使用护士健康研究 (NHS) I 和 NHSII 队列来评估维生素 D 摄入量与急迫性 UI 和混合性 UI 从轻度至中度到严重症状的进展之间的关联，从 2004 年到 2012 年（NHS）和 2005-2013 年（NHSII）。研究基线时的维生素 D 摄入量进行分类，并在每个 2-4 年随访期开始时进行更新。使用 Cox 比例风险模型估计进展为严重 UI 的多变量调整相对风险 (RR) 和 95%置信区间 (95%CI)。
在 NHS I 中，20560 名年龄在 58-73 岁之间的老年女性（年龄范围）患有轻度/中度急迫性或混合性 UI，其中 21%报告每天至少口服 800IU 的维生素 D。在 NHS II 中，12573 名年龄在 42-59 岁之间的中年女性（年龄范围）患有轻度/中度急迫性或混合性 UI，其中 17%报告每天至少口服 800IU 的维生素 D。从 2004 年到 2012 年，在老年女性中发现了 4853 例急迫性/混合性 UI 进展的新发病例。从 2005 年到 2013 年，在中年女性中发现了 1378 例急迫性/混合性 UI 进展的新发病例。经过多变量调整后，在两个队列中均未观察到维生素 D 摄入量与急迫性/混合性 UI 进展之间存在显著关联（在老年女性中，RR=1.10，95%CI 0.99-1.23；在中年女性中，RR=0.88，95%CI 0.71，1.10）。
尽管人们对维生素 D 作为一种低成本策略来预防或减少 UI 很感兴趣，但我们的研究结果表明，口服维生素 D 可能不会减少急迫性/混合性 UI 的进展。
