Systematic Review and Meta-Analysis of the Association between Vitamin D Status and Lower Urinary Tract Symptoms

Abstract

Purpose: Cumulative studies have shown that vitamin D may be associated with lower urinary tract symptoms but the findings have been inconsistent. The aim of this study was to systematically evaluate the relationship between vitamin D and lower urinary tract symptoms. Materials and Methods: The PubMedÒ, ScopusÒ and EmbaseÔ databases were searched for articles up to June 2020. A meta-analysis was conducted to evaluate the effects of vitamin D insufficiency or intake on lower urinary tract symptoms. A qualitative description summarized vitamin D intervention for treating lower urinary tract symptoms. Sensitivity analysis was conducted to examine heterogeneity and the robustness of the results. Results: A total of 23 studies including 86,332 participants were analyzed in our study. Vitamin D insufficiency was associated with a 1.37-fold to 2.06-fold increased likelihood of having lower urinary tract symptoms, and patients with lower urinary tract symptoms had significantly lower levels of vitamin D. Furthermore, vitamin D intake was significantly associated with an 11% reduction in the risk of lower urinary tract symptoms. In the subgroup analysis, the effects of vitamin D insufficiency on the risk of lower urinary tract symptoms were notably observed in nonAsians, females and patients with urinary incontinence. Conclusions: Consistent results indicated that vitamin D insufficiency was a crucial risk factor for lower urinary tract symptoms and that vitamin D supplementation showed promising effects on these symptoms. It would be of great guiding significance to consider vitamin D status when treating lower urinary tract symptoms.

Effect of Vitamin D Supplementation on Overactive Bladder and Urinary Incontinence Symptoms in Older Men: Ancillary Findings From a Randomized Trial

“…[10][11][12] A recent systematic review and meta-analysis of observational studies and clinical trials reported that vitamin D supplementation showed "promising effects" on LUTS and UI. 13 The evidence supports a higher strength of the association of vitamin D with improved UI symptoms in women. Specifically in men aged 50 and older with enlarged prostates, one randomized clinical trial (n[119) of a vitamin D analog compared to placebo reduced urinary flow rates after 12 weeks.…”

Impact of sarcopenia and vitamin D levels on the severity of lower urinary tract symptoms in older males

“… 22 It was demonstrated that VDR agonists exhibit antiproliferative and proapoptotic effects in BPH cells. 25 These protective effects are achieved by inhibiting the inflammatory response through the COX2/PGE2 and NF-KB pathways. 26 Furthermore, a specific variant of the vitamin D receptor has been found to have a protective effect against LUTS in men.…”

Benign Prostatic Hyperplasia in African American Men Merits Greater Consideration in Academic Medicine

“…Vitamin D insufficiency, which is often seen in African Americans, has been extensively studied as an exacerbating factor for LUTS [17]. A 2021 meta-analysis of 23 studies showed that Vitamin D insufficiency was associated with a 1.37-2.06-fold increased likelihood of having LUTS [17]. African Americans are at greater risk of Vitamin D deficiency due to decreased UV absorption secondary to higher skin melanin content.…”

“…It contains seven questions related to BPH symptoms and one question related to the patient's perceived quality of life. BPH symptom severity is proportionate to the IPSS score, which ranges from 0 to 35 and categorizes symptoms as mild (1-7), moderate (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), or severe (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). The IPSS survey is widely used in Urology and the AUA also encourages its use in primary care settings.…”