Association of Circulating 25(OH)D and Lower Urinary Tract Symptoms: A Four-Year Prospective Study among Elderly Chinese Men.

Zhao-Min Liu,Carmen Wong,Dicken Chan,Bailing Chen,Yu-Ming Chen,Lap-Ah Tse,Jean Woo,Samuel Wong

doi:10.3390/nu8050273

Abstract

The role of vitamin D in relation to lower urinary tract symptoms (LUTS) remains inconclusive. This four-year longitudinal study aims to explore the association of circulating 25(OH)D and LUTS in elderly Chinese men. Two thousand Chinese men aged 65 and older were recruited from a local community, of which 1998 (99.9%) at baseline and 1564 (78.2%) at four-year follow-up reported data on LUTS, and 988 of the randomly chosen subpopulation were assayed for serum 25(OH)D by radioimmunoassay at baseline. LUTS were evaluated by a validated International Prostate Symptoms Scale (IPSS). Data on demographic characteristics, lifestyle factors, health, and medications were collected. Serum parathyroid and sex steroid hormones and genotypes of vitamin D receptors were assayed. The association of serum 25(OH)D and LUTS was examined by using multivariable regression models. Serum 25(OH)D was not significantly associated with the changes of IPSS or the risk of LUTS in overall participants. However, among men with 25(OH)D ≤ 60 nmol/L, each 10 nmol/L increase of 25(OH)D over 0 nmol/L was significantly associated with 1.3 lower points of IPSS or a 51.6% decreased risk for moderate/severe LUTS four years later. Adjustment for serum androstenedione (p = 0.019) and dehydropiandrosterone (p = 0.037) attenuated the associations. Our study suggested that among individuals with low vitamin D status, the increase of the 25(OH)D level may be associated with a lowered risk of LUTS.

Highlights

Lower urinary tract symptoms (LUTS), a cluster of chronic urinary symptoms in the bladder, prostate or urethra, represent one of the most common clinical complaints in elderly men [1]
Our analysis used data from a prospective study in elderly Chinese men to examine the association of serum 25(OH)D and LUTS, and we explored the potential mechanisms on vitamin D receptor (VDR) gene polymorphisms and sex hormones
Our findings among elderly men with low vitamin D status are consistent with previous cross-sectional studies in men [9,10] and women [24], which show that low serum vitamin D was associated with an increased odds of LUTS

Summary

Introduction

Lower urinary tract symptoms (LUTS), a cluster of chronic urinary symptoms in the bladder, prostate or urethra, represent one of the most common clinical complaints in elderly men [1]. LUTS result from a complex interplay of pathophysiologic features, comprising a progressive, age-related combination of storage, voiding, and post-micturition symptoms [2]. Men with overactive bladder symptoms (bladder-storage dysfunction) were found to have a high prevalence of LUTS and greater. Both urological and non-urological conditions may contribute to LUTS with benign prostatic hyperplasia (BPH) being one of the principal underlying causes of LUTS [3]. A recent survey in China reported a high prevalence with 78.8% of men above 40 years of age having at least one LUTS [4]. The pervasiveness of LUTS, along with its associated medical costs, requires further understanding of the causes of LUTS and the identification of modifiable risk factors in order to prevent or delay the symptom progression

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Conclusion