Wang Chao, Sun Shuangquan, Wang Yong, Wang Hui, Li Hui, Wen Hui
Department of Urology, Song Jiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Medicine (Baltimore). 2025 Feb 28;104(9):e41621. doi: 10.1097/MD.0000000000041621.
Observational studies have found an association between vitamin D and stress urinary incontinence (SUI); however, this conclusion remains controversial, and the causal relationship is unclear. This study aimed to investigate the causal relationship between vitamin D and SUI using a Mendelian randomization (MR) approach. We conducted an MR analysis utilizing publicly available summary data from genome-wide association studies on European ancestry for SUI, vitamin D levels, vitamin D supplementation, and vitamin D deficiency. Regression models such as the inverse variance-weighted (IVW) method, MR-Egger, weighted median, and weighted mode were used for analysis, along with heterogeneity tests, sensitivity analyses, and pleiotropy assessments.MR analysis indicated that vitamin D levels, vitamin D deficiency, and vitamin D supplementation were not causally associated with SUI (IVW OR: 0.999, 95% CI: 0.992-1.006, P = .786); (IVW OR: 1.000, 95% CI: 1.000-1.000, P = .646); (IVW OR: 1.000, 95% CI: 1.000-1.001, P = .064). No evidence of horizontal pleiotropy or heterogeneity was found (P > .05). Our findings do not support a causal relationship between vitamin D and SUI. The incidental effect of SUI and vitamin D may be mediated by other factors, warranting further observational studies and clinical trials.
观察性研究发现维生素D与压力性尿失禁(SUI)之间存在关联;然而,这一结论仍存在争议,因果关系尚不清楚。本研究旨在采用孟德尔随机化(MR)方法探讨维生素D与SUI之间的因果关系。我们利用公开可得的全基因组关联研究的汇总数据,对欧洲血统人群的SUI、维生素D水平、维生素D补充剂使用情况和维生素D缺乏情况进行了MR分析。采用逆方差加权(IVW)法、MR-Egger法、加权中位数法和加权众数法等回归模型进行分析,并进行了异质性检验、敏感性分析和多效性评估。MR分析表明,维生素D水平、维生素D缺乏和维生素D补充剂使用与SUI无因果关联(IVW比值比:0.999,95%置信区间:0.992-1.006,P = 0.786);(IVW比值比:1.000,95%置信区间:1.000-1.000,P = 0.646);(IVW比值比:1.000,95%置信区间:1.000-1.001,P = 0.064)。未发现水平多效性或异质性的证据(P>0.05)。我们的研究结果不支持维生素D与SUI之间存在因果关系。SUI与维生素D的偶然效应可能由其他因素介导,需要进一步的观察性研究和临床试验。