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维生素 D 与妇科疾病。

Vitamin D in gynecological diseases.

机构信息

Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.

Taipei MJ Health Screening Center, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2021 Nov 1;84(11):1054-1059. doi: 10.1097/JCMA.0000000000000607.

Abstract

BACKGROUND

Most reproductive system studies suggest the protective effects of vitamin D, but vitamin D deficiency and insufficiency are growing global health issues. The present study investigates the association between vitamin D deficiency/insufficiency and gynecologic diseases to identify illness risks at different serum vitamin D levels in Taiwan.

METHODS

A total of 7699 female adults aged ≥20 years with results for both serum vitamin D and gynecologic-associated diseases were drawn from the Taiwan MJ cohort. We analyzed the correlation between serum vitamin D levels and results from reproductive system evaluations, including history of dysmenorrhea, results of Pap smear, high-risk human papillomavirus (HPV) infection of the cervix, mammography, and ultrasound of breast and pelvis.

RESULTS

Over 80% of participants showed vitamin D deficiency/insufficiency. Participants with abnormal Pap smear results, high-risk HPV infection, and history of dysmenorrhea showed significantly lower levels of serum vitamin D (p < 0.001-0.05). Serum vitamin D deficiency was significantly associated with positive high-risk HPV infection of the cervix (p < 0.05) and dysmenorrhea (p < 0.001). After controlling for age as a confounding variable for each gynecologic disease, level of serum vitamin D was significantly associated with abnormal breast ultrasound (odds ratio = 0.724) and uterus ultrasound (odds ratio = 0.673 - 0.8), and dysmenorrhea (odds ratio = 0.829).

CONCLUSION

Associations were found between vitamin D deficiency and endometriosis, uterine myoma, dysmenorrhea, abnormal Pap smear results, and high-risk HPV infection of the cervix. Therefore, vitamin D supplements may present a cost-effective benefit for the prevention and treatment of gynecologic diseases, and thus reduction of healthcare expenditures.

摘要

背景

大多数生殖系统研究表明维生素 D 具有保护作用,但维生素 D 缺乏和不足是全球日益严重的健康问题。本研究旨在调查维生素 D 缺乏/不足与妇科疾病之间的关系,以确定台湾不同血清维生素 D 水平下的疾病风险。

方法

从台湾 MJ 队列中抽取了 7699 名年龄≥20 岁且血清维生素 D 和妇科相关疾病结果均为阳性的女性成年人。我们分析了血清维生素 D 水平与生殖系统评估结果之间的相关性,包括痛经史、巴氏涂片结果、宫颈高危型人乳头瘤病毒(HPV)感染、乳房 X 线摄影和乳房及骨盆超声。

结果

超过 80%的参与者存在维生素 D 缺乏/不足。巴氏涂片结果异常、高危 HPV 感染和痛经史的参与者血清维生素 D 水平明显较低(p < 0.001-0.05)。血清维生素 D 缺乏与宫颈高危型 HPV 感染(p < 0.05)和痛经(p < 0.001)显著相关。在控制了每个妇科疾病的年龄混杂变量后,血清维生素 D 水平与异常乳房超声(优势比=0.724)和子宫超声(优势比=0.673-0.8)以及痛经(优势比=0.829)显著相关。

结论

维生素 D 缺乏与子宫内膜异位症、子宫肌瘤、痛经、巴氏涂片结果异常和宫颈高危型 HPV 感染之间存在相关性。因此,维生素 D 补充剂可能为预防和治疗妇科疾病提供具有成本效益的益处,并降低医疗保健支出。

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