Abstract
Introduction: Our aim was to investigate the relationship between menopausal symptoms and serum vitamin D levels.
Methods: We analyzed 110 postmenopausal women aged between 42-65 years among menopause symptoms by using Menopause Rating Scale (MRS) questionnaire. Patients were divided into three groups according to their serum 25-OH vitamin D levels; sufficient (>20 ng/mL), insufficient (12-20 ng/mL), deficient (<12 ng/mL), then compared. Serum vitamin D cut-off level was determined for menopausal symptoms. The correlations between symptoms and vitamin D status were calculated.
Results: Vitamin D deficiency was detected in 38,1% (42/110) of the participants. The total MRS score was 22,97±2,71 in Vitamin D deficiency group and significantly higher than others (p<0,001). In deficiency group, somatic, psyhcological and urogenital subscale scores were higher than other groups (p<0,001, p=0,007 and p=0,036, respectively). Evaluation of the correlations among independent variables revealed a negative relationship between vitamin D level and MRS scores. The threshold value at which serum vitamin D causes severe MRS scores in those with sufficient levels was calculated as 25.31 ng/ml. The area under the ROC curve was 0,876 (95% CI, 0,702-1,00, p=0.003).
Conclusion: In the present study, a relationship between serum vitamin D levels and menopause-related symptoms in postmenopausal population was demonstrated. Low levels of vitamin D in menopausal period might aggravate menopause-related symptoms.
References
- 1. Roberts H, Hickey M. Managing the menopause: An update. Maturitas 2016, 86: 53-58.
- 2. Proceedings from the NIH State-of-the-Science Conference on Management of Menopause-Related Symptoms, March 21-23, 2005, Bethesda, Maryland, USA. In: The American journal of medicine 2005. 142.12_Part_1: 1003-1013
- 3. Conde DM, Pinto-Neto AM, Santos-Sá D, Costa-Paiva L, Martinez EZ. Factors associated with quality of life in a cohort of postmenopausal women. Gynecol Endocrinol 2006; 22.8: 441-446.
- 4. Bouillon R, Carmeliet G, Verlinden L,et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008 Oct;29(6):726-76.
- 5. Cass WA, Smith MP, Peters LE. Calcitriol protects against the dopamine- and serotonin-depleting effects of neurotoxic doses of methamphetamine. In: Annals of the New York Academy of Sciences 2006, 1074.1: 261-271.
- 6. Rossmanith WG, Ruebberdt W. What causes hot flushes? The neuroendocrine origin of vasomotor symptoms in the menopause. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol 2009 May;25(5):303–14.
- 7. Foti D, Greco M, Cantiello F, et al. Hypovitaminosis D and Low Urinary Tract Symptoms in a Female Population. Eur J Inflamm [Internet] 2014 May 1;12(2):365–72.
- 8. Arvold DS, Odean MJ, Dornfeld MP, et al. Corelation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: A randomized controlled trial. Endocr Pract 2009; 15(3), 203-212.
- 9. Metintas S, Arikan I, Kalyoncu C, Ozalp S. Menopause Rating Scale as a screening tool in rural Turkey. Rural Remote Health 2010 10(1), 27-37.
- 10. Potthoff P, Heinemann LAJ, Schneider HPG, Rosemeier HP, Hauser GA. Menopause-Rating-Skala (MRS II): Methodische standardisierung in der deutschen bevolkerung. Zentralbl Gynakol 2000; 122: 280-6.
- 11. Giustina A, Adler RA, Binkley N, et al. Controversies in Vitamin D: Summary Statement from an International Conference. J Clin Endocrinol Metab 2019, 104.2: 234-240.
- 12. LeBlanc ES, Desai M, Perrin N, et al. Vitamin D levels and menopause-related symptoms. Menopause 2014; 21(11), 1197.
- 13. Buchanan JR, Santen R, Cauffman S, Cavaliere A, Greer RB. The effect of endogenous estrogen fluctuation on metabolism of 25-hydroxyvitamin D. Calcif Tissue Int 1986; 39.3: 139-144.
- 14. Siebert C, Pierozan P, Kolling J, et al. Vitamin D(3) Reverses the Hippocampal Cytoskeleton Imbalance But Not Memory Deficits Caused by Ovariectomy in Adult Wistar Rats. Neuromolecular Med 2017 Sep;19(2–3):345–56.
- 15. Siebert C, Bertó CG, Ferreira FS,et al. Vitamin D partially reverses the increase in p-NF-κB/p65 immunocontent and interleukin-6 levels, but not in acetylcholinesterase activity in hippocampus of adult female ovariectomized rats. Int J Dev Neurosci 2018; 71: 122-129.
- 16. Fedotova JO. Vitamin D (3) treatment differentially affects anxiety-like behavior in the old ovariectomized female rats and old ovariectomized female rats treated with low dose of 17β-estradiol. BMC Med Genet 2019 Apr;20(Suppl 1):49.
- 17. Bener A, Saleh N. Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and postmenopausal women. J Midlife Health 2015; 6.3: 108.
- 18. Tan MN, Kartal M, Guldal D. The effect of physical activity and body mass index on menopausal symptoms in Turkish women: A cross-sectional study in primary care. BMC Womens Health 2014; 14.1: 1-9.
- 19. Aydogmus H, Demirdal US. Vitamin D Deficiency and Lower Urinary Tract Symptoms in Women. Eur J Obstet Gynecol Reprod Biol 2018; 228: 48-52.
- 20. Oberg J, Verelst M, Jorde R, Cashman K, Grimnes G. High dose vitamin D may improve lower urinary tract symptoms in postmenopausal women. J Steroid Biochem Mol Biol 2017; 173: 28-32.
- 21. Simon JA, Reape KZ. Understanding the menopausal experiences of professional women. Menopause 2009; 16.1: 73-76.
Abstract
Amaç: Amacımız menopoz semptomları ile serum D vitamini düzeyleri arasındaki ilişkiyi araştırmaktı.
Gereç-Yöntem: Menopoz semptomları, 42-65 yaş arası 110 postmenopozal kadında Menopoz Derecelendirme Ölçeği (MDÖ) anketi kullanılarak analiz edildi. Hastalar serum 25-OH D vitamini düzeylerine göre üç gruba ayrıldı; yeterli (>20 ng/mL), azalmış (12-20 ng/mL), eksik (<12 ng/mL), sonra karşılaştırıldı. Şiddetli menopoz semptomlarına yol açan serum D vitamini düzeyi için ROC eğirisi ile eşik değer belirlendi. Semptomlar ve vitamin D seviyesi arasındaki korelasyon hesaplandı.
Bulgular: Katılımcıların %38,1'inde (42/110) D vitamini eksikliği saptandı. D vitamini eksikliği grubunda toplam MDÖ puanı 22,97±2,71 olup diğerlerinden anlamlı olarak yüksekti (p<0,001). Eksiklik grubunda somatik, psikolojik ve ürogenital alt ölçek puanları diğer gruplara göre daha yüksekti (sırasıyla p<0,001, p=0,007 ve p=0,036). Bağımsız değişkenler arasındaki korelasyonlar değerlendirildiğinde, D vitamini düzeyi ile MDÖ puanları arasında negatif bir ilişki ortaya çıktı. Yeterli düzeyde olanlarda serum D vitamininin ciddi MDÖ skorlarına neden olduğu eşik değer 25.31 ng/ml olarak hesaplandı. ROC eğrisi altında kalan alan 0,876 (%95 CI, 0,702-1,00, p=0,003) idi.
Sonuç: Bu çalışmada postmenopozal popülasyonda serum D vitamini düzeyleri ile menopoza bağlı semptomlar arasında ilişki olduğu gösterilmiştir. Menopoz dönemindeki düşük D vitamini seviyeleri menopoza bağlı semptomları şiddetlendirebilir.
Keywords
References
- 1. Roberts H, Hickey M. Managing the menopause: An update. Maturitas 2016, 86: 53-58.
- 2. Proceedings from the NIH State-of-the-Science Conference on Management of Menopause-Related Symptoms, March 21-23, 2005, Bethesda, Maryland, USA. In: The American journal of medicine 2005. 142.12_Part_1: 1003-1013
- 3. Conde DM, Pinto-Neto AM, Santos-Sá D, Costa-Paiva L, Martinez EZ. Factors associated with quality of life in a cohort of postmenopausal women. Gynecol Endocrinol 2006; 22.8: 441-446.
- 4. Bouillon R, Carmeliet G, Verlinden L,et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008 Oct;29(6):726-76.
- 5. Cass WA, Smith MP, Peters LE. Calcitriol protects against the dopamine- and serotonin-depleting effects of neurotoxic doses of methamphetamine. In: Annals of the New York Academy of Sciences 2006, 1074.1: 261-271.
- 6. Rossmanith WG, Ruebberdt W. What causes hot flushes? The neuroendocrine origin of vasomotor symptoms in the menopause. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol 2009 May;25(5):303–14.
- 7. Foti D, Greco M, Cantiello F, et al. Hypovitaminosis D and Low Urinary Tract Symptoms in a Female Population. Eur J Inflamm [Internet] 2014 May 1;12(2):365–72.
- 8. Arvold DS, Odean MJ, Dornfeld MP, et al. Corelation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: A randomized controlled trial. Endocr Pract 2009; 15(3), 203-212.
- 9. Metintas S, Arikan I, Kalyoncu C, Ozalp S. Menopause Rating Scale as a screening tool in rural Turkey. Rural Remote Health 2010 10(1), 27-37.
- 10. Potthoff P, Heinemann LAJ, Schneider HPG, Rosemeier HP, Hauser GA. Menopause-Rating-Skala (MRS II): Methodische standardisierung in der deutschen bevolkerung. Zentralbl Gynakol 2000; 122: 280-6.
- 11. Giustina A, Adler RA, Binkley N, et al. Controversies in Vitamin D: Summary Statement from an International Conference. J Clin Endocrinol Metab 2019, 104.2: 234-240.
- 12. LeBlanc ES, Desai M, Perrin N, et al. Vitamin D levels and menopause-related symptoms. Menopause 2014; 21(11), 1197.
- 13. Buchanan JR, Santen R, Cauffman S, Cavaliere A, Greer RB. The effect of endogenous estrogen fluctuation on metabolism of 25-hydroxyvitamin D. Calcif Tissue Int 1986; 39.3: 139-144.
- 14. Siebert C, Pierozan P, Kolling J, et al. Vitamin D(3) Reverses the Hippocampal Cytoskeleton Imbalance But Not Memory Deficits Caused by Ovariectomy in Adult Wistar Rats. Neuromolecular Med 2017 Sep;19(2–3):345–56.
- 15. Siebert C, Bertó CG, Ferreira FS,et al. Vitamin D partially reverses the increase in p-NF-κB/p65 immunocontent and interleukin-6 levels, but not in acetylcholinesterase activity in hippocampus of adult female ovariectomized rats. Int J Dev Neurosci 2018; 71: 122-129.
- 16. Fedotova JO. Vitamin D (3) treatment differentially affects anxiety-like behavior in the old ovariectomized female rats and old ovariectomized female rats treated with low dose of 17β-estradiol. BMC Med Genet 2019 Apr;20(Suppl 1):49.
- 17. Bener A, Saleh N. Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and postmenopausal women. J Midlife Health 2015; 6.3: 108.
- 18. Tan MN, Kartal M, Guldal D. The effect of physical activity and body mass index on menopausal symptoms in Turkish women: A cross-sectional study in primary care. BMC Womens Health 2014; 14.1: 1-9.
- 19. Aydogmus H, Demirdal US. Vitamin D Deficiency and Lower Urinary Tract Symptoms in Women. Eur J Obstet Gynecol Reprod Biol 2018; 228: 48-52.
- 20. Oberg J, Verelst M, Jorde R, Cashman K, Grimnes G. High dose vitamin D may improve lower urinary tract symptoms in postmenopausal women. J Steroid Biochem Mol Biol 2017; 173: 28-32.
- 21. Simon JA, Reape KZ. Understanding the menopausal experiences of professional women. Menopause 2009; 16.1: 73-76.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Article |
| Authors | |
| Early Pub Date | October 24, 2022 |
| Publication Date | October 29, 2022 |
| Submission Date | July 26, 2022 |
| Published in Issue | Year 2022 Volume: 32 Issue: 5 |
Journal of General Medicine is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).