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 Table of Contents 
EDITORIAL
Year : 2017  |  Volume : 8  |  Issue : 3  |  Page : 101-102  

Vitamin D and pelvic floor disorders


1 Department of Obstetrics and Gynaecology, GMC, Jammu, Jammu and Kashmir, India
2 Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India

Date of Web Publication15-Sep-2017

Correspondence Address:
Sudhaa Sharma
Department of Obstetrics and Gynaecology, GMC, Jammu, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmh.JMH_88_17

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How to cite this article:
Sharma S, Aggarwal N. Vitamin D and pelvic floor disorders. J Mid-life Health 2017;8:101-2

How to cite this URL:
Sharma S, Aggarwal N. Vitamin D and pelvic floor disorders. J Mid-life Health [serial online] 2017 [cited 2017 Dec 17];8:101-2. Available from: http://www.jmidlifehealth.org/text.asp?2017/8/3/101/214949



Vitamin D is a fat-soluble vitamin whose active metabolite (1,25-hydroxyvitamin D [1,25{OH}D]) plays a vital role in calcium homeostasis and thus is important for overall health of all individuals. Vitamin D insufficiency affects up to 80% of reproductive age women.[1] Factors that affect Vitamin D status include ethnicity (African-Americans individuals and with darker skin),[2],[3] intake of Vitamin D supplementation, obesity, seasonality (lower levels are found after winter months), and regional location (lower levels found in areas of higher latitudes and lesser sunlight).[2] Insufficient Vitamin D status has received increased attention and has been shown to be associated with various extraskeletal medical conditions including cardiovascular disease, diabetes, asthma, and preeclampsia.[4],[5],[6] However, the most notable effect of insufficient Vitamin D has been on musculoskeletal health. Observational and randomized studies have confirmed that lower levels of serum 25-(OH)D are associated with decreased postural stability and increased risk of falls.[7],[8] In addition, human and animal in vitro studies consistently demonstrate a relationship between Vitamin D and muscle growth and function,[2],[3] though the exact mechanism is yet to be clearly elucidated. Level I studies exploring the role of Vitamin D in skeletal muscle strength and functional efficiency are inconclusive. Despite discrepant conclusions, there is significant plausibility behind the hypothesis that Vitamin D has an important role in skeletal muscle function and efficiency.

The female pelvic floor is a complex component of the body whose global function is reliant on delicate relationships between musculoskeletal connections to pelvic bones that support the abdominal cavity and pelvic viscera. Disorders of the pelvic floor include urinary incontinence (UI), fecal incontinence (FI), pelvic organ prolapse, and other storage and emptying problems of the lower urinary and gastrointestinal tracts. Pelvic floor muscle weakness is clinically observed in women with pelvic floor disorder (PFD) symptoms and thus may be impacted by insufficient serum Vitamin D. The Vitamin D receptor has also been identified in the detrusor wall, thus its insufficient level may impact bladder function also.

In vitro skeletal muscle cell, culture studies have demonstrated that Vitamin D may affect muscle strength by influencing cell proliferation and differentiation and muscle fiber size. It also protects against muscle degradation by preventing fatty degeneration, insulin resistance, and arachidonic acid mobilization. Hence, Vitamin D may play a role in the efficiency of muscle function that is distinct from the role of calcium in muscle contractility.

Prospective cohort or randomized studies investigating the relationship between Vitamin D nutritional status and PFD symptoms are lacking. However, Jen-Tzer Gau reported few case studies of resolution of UI with Vitamin D supplementation. Thus, more follow-up studies and randomised control trials are needed for confirmation and documentation.



 
   References Top

1.
Badalian SS, Rosenbaum PF. Vitamin D and pelvic floor disorders in women: Results from the national health and nutrition examination survey. Obstet Gynecol 2010;115:795-803.  Back to cited text no. 1
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2.
Holick MF, Chen TC, Lu Z, Sauter E. Vitamin D and skin physiology: A D-lightful story. J Bone Miner Res 2007;22 Suppl 2:V28-33.  Back to cited text no. 2
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Wang S. Epidemiology of Vitamin D in health and disease. Nutr Res Rev 2009;22:188-203.  Back to cited text no. 3
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4.
Pittas AG, Chung M, Trikalinos T, Mitri J, Brendel M, Patel K, et al. Systematic review: Vitamin D and cardiometabolic outcomes. Ann Intern Med 2010;152:307-14.  Back to cited text no. 4
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Allan K, Devereux G. Diet and asthma: Nutrition implications from prevention to treatment. J Am Diet Assoc 2011;111:258-68.  Back to cited text no. 5
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Shand AW, Nassar N, Von Dadelszen P, Innis SM, Green TJ. Maternal Vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre-eclampsia. BJOG 2010;117:1593-8.  Back to cited text no. 6
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7.
Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C, et al. Effects of a short-term Vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 2000;15:1113-8.  Back to cited text no. 7
    
8.
Bischoff HA, Stähelin HB, Dick W, Akos R, Knecht M, Salis C, et al. Effects of Vitamin D and calcium supplementation on falls: A randomized controlled trial. J Bone Miner Res 2003;18:343-51.  Back to cited text no. 8
    




 

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