PROVIDENCE, R.I. – Vitamin D levels were significantly lower in women diagnosed with a pelvic floor disorder than in a comparison group of gynecology patients without pelvic floor disorders, based on a retrospective chart review of patients seen at a urogynecology care clinic between 2008 and 2010.
In the study, 550 patients had both a clinic visit and an assessment of vitamin D levels, but 156 were excluded from consideration because of missing clinical data (n = 137), stage III or greater kidney disease (n = 17), or other medical conditions (n = 2).
Of the 394 remaining patients, 268 had at least one pelvic floor disorder (PFD).
The most common diagnoses were pelvic organ prolapse (49%) and mixed urinary incontinence (30%).
In the “benign gynecologic” group used for comparison, 126 women were seen for routine gynecologic exams but were not diagnosed with any PFD.
The women with PFDs were older (64.3 years vs. 60.2 years), and included a greater percentage of blacks (40% vs. 20%), reported Dr. Candace Y. Parker-Autry, who presented the findings as a poster at the meeting.
Total mean 25(OH)D levels were 29.3 ng/mL in women with PFDs and 35.0 ng/mL in women without PFDs, a significant difference.
Among women with PFDs, 51.5% had insufficient or deficient vitamin D levels with mean 25(OH)D levels of 18.6 ng/mL and 48.5% were found to be vitamin D sufficient with mean 25(OH)D levels of 38.4 ng/mL (P = .001).
Women who had PFDs and were vitamin D sufficient were significantly more likely to have taken vitamin D and calcium supplements. Vitamin D insufficiency was defined as levels between 15 ng/mL and 29 ng/mL; levels below 15 ng/mL were deemed deficient.
Some racial disparity was noted. Vitamin D insufficiency/deficiency was noted in 50% of non-Hispanic whites and in 68% of black women with PFDs.
Approximately 73% of U.S. adults and 80% of reproductive aged women have insufficient vitamin D levels, according to Dr. Parker-Autry, who is affiliated with the division of urogynecology and pelvic reconstructive surgery at the University of Alabama at Birmingham.
The question remains whether vitamin D insufficiency contributes to pelvic muscle weakness and PFDs.
At baseline, women in the PFD gro up were asked to complete three validated questionnaires, assessing the impact of their symptoms on quality of life, including the Pelvic Floor Distress Inventory and its three subscales: Pelvic Organ Prolapse Distress Severity (POPDI-6), the Colorectal-Anal Distress Inventory (CRDAI-8), and the Urogenital Distress Inventory for Incontinence (UDI-6); the Medical, Epidemiologic, and Social Aspects of Aging (MESA) questionnaire, and the Incontinence Impact Questionnaire (IIQ-7).
After controlling for confounding variables, vitamin D insufficiency was associated with a greater negative impact from urinary incontinence symptoms (P = .001 on the IIQ-7) but there were no other significant differences regarding other pelvic or colorectal symptoms.