Dr Zhuma Rani Paul, Phase-B Resident, MS, Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Med J. 2023 Oct;32(4):1109-1117.
Pelvic organ prolapse refers to protrusion of the pelvic organ into or out of the vaginal canal. One in four women in the USA suffer from some type of pelvic floor disorder including pelvic organ prolapse and frequency of pelvic organ prolapse is more with increasing age. In Bangladesh, 15.6% women suffered from pelvic organ prolapse and more than 11.0% of women require surgical correction of prolapse in their life times. According to few researches, there is an observed association between low vitamin D levels with pelvic organ prolapse but this finding is not unequivocal. This case control study has been conducted in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from October 2018 to August 2020 to investigate the level of vitamin D in patients with and without pelvic organ prolapse to explore the association of low vitamin D with pelvic organ prolapse. A total 148 participants of 52 years or older attending the out or inpatient department were enrolled in the study. The study population was divided into two groups, a case group (n=74) consisting of patients with pelvic organ prolapse and a control group (n=74) comprising of women without pelvic organ prolapse. After taking informed written consent the serum vitamin D level of all participants was measured by CMIA technology with flexible assay protocols at Biochemistry and Molecular Biology department of the same institute. All necessary Data were collected on variables of interest by using the structured questionnaire pre-designed for interview, observation, clinical examination, and biochemical Data collection. Distributions were expressed by mean and standard deviation for continuous variables and by frequency and percentage for qualitative variables. Student's t-test and Chi square test were done to see the significance of differences between Group I and Group II. Odds ratio, correlation coefficient, and multivariate logistic regression analysis was done to assess the association of low vitamin D level with pelvic organ prolapse. Mean±SD level of Vitamin D in the case group was 13.96±5.18ng/ml and in the control group was 21.08±5.77ng/ml respectively. The difference was statistically significant (p<0.05). Moreover, the vitamin D levels were inversely proportionate with the severity of pelvic organ prolapse. OR (95% CI), of two groups showed risk of developing pelvic organ prolapse 5.63 times higher in women with decreased vitamin D level. Thus it can be concluded that women having low level of vitamin D have more chance of developing pelvic organ prolapse.
盆腔器官脱垂是指盆腔器官向阴道内或阴道外突出。美国每四名妇女中就有一人患有某种类型的盆底功能障碍，包括盆腔器官脱垂，且随着年龄的增长，盆腔器官脱垂的发病率也越来越高。在孟加拉国，15.6%的妇女患有盆腔器官脱垂，超过 11.0%的妇女在其一生中需要手术矫正脱垂。根据一些研究，维生素 D 水平低与盆腔器官脱垂之间存在观察到的关联，但这一发现并不明确。这项病例对照研究在孟加拉国的 Bangabandhu Sheikh Mujib 医科大学（BSMMU）妇产科进行，研究时间为 2018 年 10 月至 2020 年 8 月，目的是调查患有和不患有盆腔器官脱垂的患者的维生素 D 水平，以探讨低维生素 D 与盆腔器官脱垂的关系。共有 148 名年龄在 52 岁或以上的患者参加了这项研究，他们来自门诊或住院部。研究人群分为两组，病例组（n=74）由患有盆腔器官脱垂的患者组成，对照组（n=74）由没有盆腔器官脱垂的妇女组成。在获得知情书面同意后，采用 CMIA 技术，在同一研究所的生化和分子生物学系使用灵活的分析方案测量所有参与者的血清维生素 D 水平。所有必要的数据均通过为访谈、观察、临床检查和生化数据收集预先设计的结构化问卷收集。使用学生 t 检验和卡方检验比较组 I 和组 II 之间的差异。计算比值比、相关系数和多变量逻辑回归分析以评估低维生素 D 水平与盆腔器官脱垂的关系。病例组的平均±标准差维生素 D 水平为 13.96±5.18ng/ml，对照组为 21.08±5.77ng/ml。差异具有统计学意义（p<0.05）。此外，维生素 D 水平与盆腔器官脱垂的严重程度呈反比。两组的 OR（95%CI）显示，维生素 D 水平降低的妇女发生盆腔器官脱垂的风险增加 5.63 倍。因此，可以得出结论，维生素 D 水平低的妇女患盆腔器官脱垂的几率更高。
