妇女参与护士健康研究 I 和 II 中总 25-羟维生素 D 浓度和尿失禁风险。
Total and free 25-hydroxyvitamin D concentrations and risk of urinary incontinence in women participating in Nurses Health Studies I & II.
机构信息
Emory University Department of Medicine, Emory School of Medicine, Atlanta, GA and the Atlanta VA Medical Center, Atlanta, GA.
Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL and Atlanta, GA.
出版信息
Am J Med Sci. 2023 Nov;366(5):330-336. doi: 10.1016/j.amjms.2023.08.007. Epub 2023 Aug 20.
BACKGROUND
Urgency urinary incontinence (UUI) occurs in >40% of older women. Our objective was to examine the relationship of total and free plasma 25-hydroxyvitamin D (25(OH)D) and UUI to evaluate vitamin D status as a novel target for prevention of UUI.
METHODS
We conducted a nested case control study using the Nurses' Health Study (NHS) and NHS II. Using stored plasma samples from 2000, we measured total 25(OH)D, free 25(OH)D, and intact parathyroid hormone (PTH) levels and examined their relationship to incident UUI from 2000 to 2013. Plasma biomarker levels were categorized as quartiles. Multivariable-adjusted odds ratios of UUI were estimated by conditional logistic regression models (with matching by age) across categories of each biomarker and covariates.
RESULTS
The analytic sample included 398 cases of incident UUI and 398 matched controls with a mean age of 50 years. We found a strong correlation of plasma levels of total 25(OH)D with free 25(OH)D (r=0.5). Plasma total 25(OH)D and free 25(OH)D concentrations were negatively correlated with PTH (r=-0.08 AND -0.09, respectively). Overall, we found no evidence that levels of total plasma 25(OH)D, free 25(OH)D, or PTH were related to incident UUI after adjustment for obesity, physical activity, cigarette smoking, menopausal status, hypertension, and type 2 diabetes.
CONCLUSIONS
Free plasma 25(OH)D by quartile, as well as total plasma 25(OH)D, was not associated with incident UUI in women. We found that plasma total and free 25(OH)D were highly correlated with each other and inversely correlated with PTH. Plasma free 25(OH)D did not provide additional predictive value in determining risk of UUI.
背景
急迫性尿失禁（UUI）发生在> 40％的老年女性中。我们的目的是研究总血浆和游离 25-羟维生素 D（25（OH）D）与 UUI 的关系，以评估维生素 D 状态作为预防 UUI 的新目标。
方法
我们使用护士健康研究（NHS）和 NHS II 进行了嵌套病例对照研究。使用 2000 年存储的血浆样本，我们测量了总 25（OH）D、游离 25（OH）D 和完整甲状旁腺激素（PTH）水平，并研究了它们与 2000 年至 2013 年期间新发 UUI 的关系。将血浆生物标志物水平分为四分位。通过条件逻辑回归模型（按年龄匹配），在每个生物标志物和协变量的类别中，估计 UUI 的多变量调整比值比。
结果
分析样本包括 398 例新发 UUI 病例和 398 例匹配对照，平均年龄为 50 岁。我们发现总 25（OH）D 与游离 25（OH）D 之间存在很强的相关性（r=0.5）。血浆总 25（OH）D 和游离 25（OH）D 浓度与 PTH 呈负相关（r=-0.08 和-0.09）。总体而言，我们发现调整肥胖、体力活动、吸烟、绝经状态、高血压和 2 型糖尿病后，总血浆 25（OH）D、游离 25（OH）D 或 PTH 水平与新发 UUI 无关。
结论
按四分位距划分的游离血浆 25（OH）D 以及总血浆 25（OH）D 与女性新发 UUI 无关。我们发现，血浆总 25（OH）D 和游离 25（OH）D 彼此高度相关，与 PTH 呈负相关。血浆游离 25（OH）D 并不能提供额外的预测价值来确定 UUI 的风险。
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