Vitamin D ve diğer faktörlerin yaşlı bireylerde üriner inkontinans ve aşırı aktif mesane varlığı ve şiddetine etkisi

Öz

Amaç: Bu çalışmada, yaşlı bireylerde serum vitamin D düzeyinin üriner inkontinans (UI) ve aşırı aktif mesane (OAB) üzerindeki etkisi araştırılmıştır. Yöntem: Çalışmaya, son bir yıl içinde serum vitamin D düzeyi ölçülmüş 106 yaşlı birey dahil edilmiş-tir. Katılımcıların sosyodemografik özellikleri, alışkanlıkları, tıbbi geçmişleri, kullandıkları ilaçlar, boy ve vücut ağırlığı verileri toplanmış, ICIQ-UI kısa formu ve Aşırı Aktif Mesane - V8 formu uygulanmış-tır. Katılımcılar vitamin D düzeylerine göre gruplandırılmıştır. Bulgular: Katılımcıların %17,9'u ciddi D vitamini eksikliği, %28,3'ü D vitamini eksikliği, %18,9'u D vitamini yetersizliği gösterirken, %34,9'unun vitamin D düzeyi normaldi. Vitamin D düzeyi ile üriner inkontinans ve aşırı aktif mesane varlığı arasında anlamlı bir ilişki bulunmamıştır. Katılımcılar vitamin D düzeylerine göre gruplandırıldığında, gruplar üriner inkontinans ve aşırı aktif mesane varlığı açısından anlamlı bir farklılık göstermedi. Ancak, aşırı aktif mesane şiddeti açısından anlamlı bir farklılık tespit edildi. Vitamin D düzeyi normal olan bireylerde üriner inkontinans ve aşırı aktif mesane görülme oranı, düşük düzeyde olanlara göre anlamlı şekilde yüksekti. Sonuç: Üriner inkontinans yaşla birlikte artmaktadır ve yaşlanma ile artan komorbid hastalıklarla ilişki-lendirilebilir. Vitamin D eksikliği ile üriner inkontinans ve aşırı aktif mesane arasında ilişkiye dair literatürde raporlar bulunmasına rağmen, bu ilişki çalışmamızda doğrulanmamıştır. Bu fark, literatürdeki çalışmalarda incelenen popülasyonların farklı özelliklere sahip olmasından kaynaklanabilir.

Anahtar Kelimeler

• Vitamin D
• üriner inkontinans
• aşırı aktif mesane

Effect of vitamin-D and other factors on the presence and severity of urinary incontinence and overactive bladder in elderly individuals

Öz

Objective: This study aimed to investigate the effect of serum vitamin D levels on urinary incontinence and overactive bladder in elderly individuals. Methods: The study included 106 elderly individuals who had their serum vitamin D levels measured in the past year. Sociodemographic characteristics, habits, medical histories, medications used, height, and weight data were collected. The ICIQ-UI short form and Overactive Bladder-V8 form were adminis-tered. Participants were grouped based on their vitamin D levels. Results: Among participants, 17.9% had severe vitamin D deficiency, 28.3% had vitamin D deficiency, 18.9% had vitamin D insufficiency, and 34.9% had normal vitamin D levels. No significant association was found between vitamin D levels and the presence of urinary incontinence and overactive bladder. When participants were grouped by vitamin D levels, there was no significant difference in the presence of urinary incontinence and overactive bladder among the groups. However, a significant difference was found in the severity of overactive bladder. Individuals with normal vitamin D levels had significantly higher rates of urinary incontinence and overactive bladder compared to those with lower levels. Conclusion: Urinary incontinence increases with age and may be associated with aging-related comor-bidities. Although reports in the literature suggest a relationship between vitamin D deficiency and urinary incontinence and overactive bladder, this relationship was not confirmed in our study. This discrepancy may be due to differences in the characteristics of the populations studied in the literature.

Anahtar Kelimeler

• Vitamin D
• urinary incontinence
• overactive bladder

Kaynakça

1. 1. Park WH. Urinary incontinence and physician's attitu-de. J Korean Med Sci 2013;28(11):1559-60. doi: 10.3346/jkms.2013.28.11.1559.
2. 2. Riss P, Kargl J. Quality of life and urinary incontinen-ce in women. Maturitas 2011;68(2):137-42. doi: 10.1016/j.maturitas.2010.11.006.
3. 3. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the Internati-onal Continence Society. Urology 2003;61(1): 37-49. doi: 10.1016/s0090-4295(02)02243-4.
4. 4. Irwin DE, Milsom I, Hunskaar S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006;50(6):1306-15. doi: 10.1016/j.eururo.2006.09.019.
5. 5. Terzi H, Terzi R, Kale A. 18 yaş üstü kadınlarda üriner inkontinans sıklığı ve etkileyen faktörler. Ege Tıp Dergi-si 2013;52(1):15-9
6. 6. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266-81. doi:10.1056/NEJMra070553.
7. 7. Atli T, Gullu S, Uysal A, Erdogan G. The prevalence of vitamin D deficiency and effects of ultraviolet light on vitamin D levels in elderly Turkish population. Arch Gerontol Geriatr 2005;40(1):53-60. doi:10.1016/j.archger.2004.05.006.
8. 8. Ward K, Das G, Roberts S, et al. A randomized, cont-rolled trial of vitamin D supplementation upon muscu-loskeletal health in postmenarchal females. J Clin Endoc-rinol Metab 2010;95(10):4643-51. doi: 10.1210/jc.2009-2725.

9. 9. Navaneethan PR, Kekre A, Jacob KS, Varghese L. Vi-tamin D deficiency in postmenopausal women with pelvic floor disorders. J Midlife Health 2015;6(2):66-9. doi: 10.4103/0976-7800.158948.
10. 10. Badalian SS, Rosenbaum PF. Vitamin D and pelvic floor disorders in women: results from the National Health and Nutrition Examination Survey. Obstet Gyne-col 2010;115(4):795-803
11. 11. Adorini L, Penna G, Amuchastegui S, et al. Inhibition of prostate growth and inflammation by the vitamin D receptor agonist BXL-628 (elocalcitol). J Steroid Bioc-hem Mol Biol 2007;103(3-5): 689-93. doi: 10.1016/j.jsbmb.2006.12.065.
12. 12. Hanna‐Mitchell AT, Robinson D, Cardozo L, Everaert K, Petkov GV. Do we need to know more about the ef-fects of hormones on lower urinary tract dysfunction? ICI‐RS 2014. Neurourol Urodyn 2016;35(2):299-303. doi: 10.1002/nau.22809.
13. 13. Gau JT. Urinary incontinence resolved after adequate vitamin D supplementation: a report of two cases. J Am Geriatr Soc 2010;58(12):2438-9. doi: 10.1111/j.1532-5415.2010.03179.x.
14. 14. Çetinel B, Özkan B, Can G. ICIQ-SF Türkçe versiyonu validasyon (geçerlilik) çalışması. Türk Üroloji Dergisi 2004;30(3):332-8.
15. 15. Coyne K, Revicki D, Hunt T, et al. Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual Life Res 2002;11(6):563-74. doi: 10.1023/a:1016370925601.
16. 16. Acquadro C, Kopp Z, Coyne KS, et al. Translating overactive bladder questionnaires in 14 languages. Uro-logy 2006;67(3):536-40. doi: 10.1016/j.urology.2005.09.035.
17. 17. Tarcan T, Mangır N, Özgür MÖ, Akbal C. OAB-V8 Aşırı aktif mesane sorgulama formu validasyon çalışma-sı. Üroloji Bülteni. 2012;21:113-6.
18. 18. TEMD Osteoporoz ve Diğer Metobolik Kemik Hastalıkları Çalışma Grubu. Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu. TEMD, 2017.
19. 19. Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjälmås K, Lapitan MC. Epidemiology and natural his-tory of urinary incontinence in women. Urology 2003;62(4):16-23. doi:10.1016/s0090-4295(03)00755-6.
20. 20. Kilic MK, Kizilarslanoglu MC, Kara O, et al. Hypovi-taminosis D is an independent associated factor of ove-ractive bladder in older adults. Arch Gerontol Geriatr 2016;65:128-32. doi: 10.1016/j.archger.2016.03.019.
21. 21. Cetinel B, Demirkesen O, Tarcan T, et al. Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: what are the determinants of bothersome urinary incontinence and help-seeking behavior? Int Urogynecol J Pelvic Floor Dysfunc. 2007;18(6):659-64. doi: 10.1007/s00192-006-0223-6.
22. 22. Kocak I, Okyay P, Dundar M, Erol H, Beser E. Female urinary incontinence in the west of Turkey: prevalence, risk factors and impact on quality of life. Eur Urol 2005;48(4):634-41. doi: 10.1016/j.eururo.2005.04.017.
23. 23. Ekin M, Karayalçin R, Özcan U, Erdemlioglu E. The prevalence of urinary incontinence and its influence on the quality of life in women of reproductive and post-menopausal age groups. Journal of Ankara Medical School 2004;26(1):21-5.
24. 24. Zhu J, Hu X, Dong X, Li L. Associations between risk factors and overactive bladder: a meta-analysis. Female Pelvic Med Reconstr Surg 2018;25(3):238-46. doi:10.1097/SPV.0000000000000531.
25. 25. Tampakoudis P, Tantanassis T, Grimbizis G, Papalet-sos M, Mantalenakis S. Cigarette smoking and urinary incontinence in women—a new calculative method of estimating the exposure to smoke. Eur J Obstet Gynecol Reprod Biol 1995;63(1):27-30. doi: 10.1016/0301-2115(95)02212-p.
26. 26. Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 2003;110(3):247-54.
27. 27. Tamanini JTN, Pallone LV, Sartori MGF, et al. A populational—based survey on the prevalence, inciden-ce, and risk factors of urinary incontinence in older adults—results from the “SABE STUDY”. Neurourol Urodyn 2018;37(1):466-77. doi: 10.1002/nau.23331.
28. 28. Öztürk GZ, Toprak D, Basa E. 35 yaş üzeri kadınlarda üriner inkontinans sıklığı ve etkileyen faktörlerin değer-lendirilmesi. Şişli Etfal Hastanesi Tıp Bülteni 2012;46(4): 170-6.
29. 29. Kaur H, Bala R, Nagpal M. Role of vitamin D in urogenital health of geriatric participants. J Midlife Health 2017;8(1):28-35. doi: 10.4103/jmh.JMH_84_16.
30. 30. Vaughan CP, Tangpricha V, Motahar-Ford, N, et al. Vitamin D and incident urinary incontinence in older adults. Eur J Clin Nutr 2016;70(9):987-9. doi: 10.1038/ejcn.2016.20
31. 31. Parker-Autry CY, Markland AD, Ballard AC, Downs-Gunn D, Richter HE. Vitamin D status in women with pelvic floor disorder symptoms. Int Urogynecol J 2012;23(12):1699-705. doi: 10.1007/s00192-012-1700-8.
32. 32. Dallosso HM, McGrother CW, Matthews RJ, Donald-son MM. Nutrient composition of the diet and the deve-lopment of overactive bladder: a longitudinal study in women. Neurourol Urodyn 2004;23(3):204-10. doi: 10.1002/nau.20028
33. 33. Grant WB, Boucher BJ, Al Anouti F, Pilz S. Compa-ring the evidence from observational studies and rando-mized controlled trials for nonskeletal health effects of vitamin D. Nutrients 2022;14(18):3811. doi: 10.3390/nu14183811
34. 34. Premer C, Schulman IH. Have we been measuring the wrong form of vitamin D? Circ Res 2018;123(8):934-5. doi: 10.1161/CIRCRESAHA.118.313814.
35. 35. Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella re-view of systematic reviews and meta-analyses of obser-vational studies and randomised trials. BMJ 2014;348:g2035. doi: 10.1136/bmj.g2035.