Prostate and Urinary systems much better with higher vitamin D – many studies

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• UTI associated with low Vitamin D as well as treated - many studies
• Urgent need to pee (Overactive Bladder) in elderly men was decreased by 200,000 IU Vitamin D injection – May 2018
• Vitamin D and urinary incontinence - many studies
• Elderly urinary urgency incontinence associated with low vitamin D – July 2016
• Urinary tract infection in children strongly associated with low vitamin D – Feb 2015
• Urinary Tract Infection in infants 5.6 X MORE likely if low Vitamin D, 3.3 X LESS likely if supplement – July 2016
• Possible reduction in nocturia, nighttime urination, or BPH after taking vitamin D
• Fecal incontinence 2.8 X more likely with low vitamin D – May 2014
• Erectile Dysfunction and vitamin D - many studies

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Prostate volume and urinary system much better with even 28 ng of vitamin D – April 2017

Vitamin D deficiency and lower urinary tract symptoms in males above 50 years of age.
Urol Ann. 2017 Apr-Jun;9(2):170-173. doi: 10.4103/0974-7796.204192.
Elshazly MA1, Sultan MF1, Aboutaleb HA1, Salem SM1, Aziz MS1, Abd Elbaky TM1, Elsherif EA1, Gawish MM2, Alajrawi FT3, Elgadi FAA3, Thaher AH3, Shebl MA4, Allam AM1, Kehinde E5.

CONTEXT:
Lower urinary tract symptoms (LUTSs) in elderly males are usually related to benign prostatic hyperplasia (BPH) in the majority of cases. It is estimated that BPH affects half of men above the age of 50 years. Recently, a relationship between Vitamin D deficiency and LUTS in elderly males has been reported.

AIMS: The aim of this study was to analyze Vitamin D levels in males aged above 50 years presenting with LUTS.

SETTINGS AND DESIGN: This is a prospective case-control study.

PATIENTS AND METHODS:
This was a case-control study in which males above 50 years of age who presented with LUTS (Group A) were compared with a control group (Group B ) without LUTS. Both groups were investigated regarding Vitamin D level, prostate-specific antigen (PSA), International Prostatic Symptoms Score (IPSS), prostate size, flow rate, serum calcium levels, and abdominal ultrasonography.

STATISTICAL ANALYSIS USED:
Statistical software package (SPSS Inc., Chicago, IL, USA) was used for the statistical analyses, performing t-test for quantitative data to compare between the two groups. Pearson's correlation coefficient "r" test was calculated between two quantitative, continuous variables in Group A. P <0.05 was considered statistically significant.

RESULTS:
A total of 150 patients were studied. There were 70 and 80 patients in Groups A and B, respectively. The mean age of Group A patients was 60.32 ± 11.93 years versus 58.12 ± 10.55 years for Group B patients (P > 0.05). The mean value of Vitamin D level was 40.82 ± 29.46 nmol/L in Group A and 70.25 ± 22.42 nmol/L in Group B (P < 0.001). The mean value of prostate size was 50.12 ± 23.24 g in Group A and 30.68 ± 4.90 g in Group B (P < 0.001). The mean serum calcium level was 2.4 ± 0.14 mmol/L and 2.50 ± 0.15 mmol/L in Groups A and B, respectively (P < 0.001). The mean value of PSA in Group A was 2.24 ± 1.95 ng/ml versus 2.11 ± 0.45 ng/ml in Group B (P < 0.001). The mean value of IPSS in Group A was 13.38 ± 5.32 ml/s versus 3.41 ± 2.42 ml/s in Group B. The mean value of Q max in uroflowmetry in Group A was 11.5 ± 2 ml/s versus 15.4 ± 1 ml/s in Group B.

CONCLUSIONS: Men older than 50 years of age with LUTS have lower levels of Vitamin D compared to men without LUTS.

PMID: 28479770 PMCID: PMC5405662 DOI: 10.4103/0974-7796.204192
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BPH 5.2 X more likely if low vitamin D – Nov 2016

Vitamin D Deficiency as a Potential Marker of Benign Prostatic Hyperplasia.
Urology. 2016 Nov;97:212-218. doi: 10.1016/j.urology.2016.03.070. Epub 2016 Jun 17.
Zhang W1, Zheng X2, Wang Y1, Xiao H1.
1 Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, China.
2 Department of Urology, Zhongnan Hospital, Wuhan University, Wuhan, China. zhangweibin1969 at 163.com.

OBJECTIVE:
To determine whether prostatic volumes and urinary flow changes were higher in old Chinese men with vitamin D deficiency than in those without vitamin D deficiency.

METHODS:
This was an observational case-control study of 224 old Chinese men. End point variables were prostatic volume, measured by transrectal ultrasound, and urinary flow, measured by urinary flowmetry. The International Prostate Symptom Score and International Index of Erectile
Function score were determined.

RESULTS:
Two hundred and thirty-one (71.7%) out of the 322 were defined as vitamin D deficiency.
The vitamin D deficiency group had a significantly higher

• prostate volume (42 mL vs 28 mL, P <.001),
• aldosterone (293 pg/mL vs 220 pg/mL, P < .001),
• prostate-specific antigen value (3.28 ng/mL vs 2.55 ng/mL, P < .001), and
• IPSS (4.47 vs 1.98, P < .001), and a
• significantly lower maximum urinary flow (13.44 mL/s vs 29.98 mL/s, P < .001) vs free of vitamin D deficiency group.

Binary logistic regression analysis showed a strong association between the presence of vitamin D deficiency and benign prostatic hyperplasia (BPH) after adjusting for age, International Prostate Symptom Score, urination time, urinary volume, abdominal obesity, aldosterone, glucose, insulin, parathyroid hormone, and C-reactive protein (odds ratio 5.22, 95% confidence interval 1.96-12.76, P = .001).

CONCLUSION:
There is a relationship between the presence of vitamin D deficiency and prostate growth-associated urinary symptoms, likely attributable to their pathophysiological similarity. This study suggests that vitamin D deficiency may be a marker of BPH. Thus, it may be used as a future therapeutic target in patients with BPH. Further studies were necessary to confirm this association.

PMID: 27327576 DOI: 10.1016/j.urology.2016.03.070

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Urinary tract infection 40% less likely if man has a good Vitamin D receptor – Meta-analysis Oct 2014

Systematic review and meta-analysis of candidate gene association studies of lower urinary tract symptoms in men.
Eur Urol. 2014 Oct;66(4):752-68. doi: 10.1016/j.eururo.2014.01.007. Epub 2014 Jan 22.
Cartwright R1, Mangera A2, Tikkinen KA3, Rajan P4, Pesonen J5, Kirby AC6, Thiagamoorthy G7, Ambrose C8, Gonzalez-Maffe J9, Bennett PR10, Palmer T11, Walley A12, Järvelin MR13, Khullar V14, Chapple C15.

CONTEXT:
Although family studies have shown that male lower urinary tract symptoms (LUTS) are highly heritable, no systematic review exists of genetic polymorphisms tested for association with LUTS.

OBJECTIVE:
To systematically review and meta-analyze studies assessing candidate polymorphisms/genes tested for an association with LUTS, and to assess the strength, consistency, and potential for bias among pooled associations.

EVIDENCE ACQUISITION:
A systematic search of the PubMed and HuGE databases as well as abstracts of major urologic meetings was performed through to January 2013. Case-control studies reporting genetic associations in men with LUTS were included. Reviewers independently and in duplicate screened titles, abstracts, and full texts to determine eligibility, abstracted data, and assessed the credibility of pooled associations according to the interim Venice criteria. Authors were contacted for clarifications if needed. Meta-analyses were performed for variants assessed in more than two studies.

EVIDENCE SYNTHESIS:
We identified 74 eligible studies containing data on 70 different genes. A total of 35 meta-analyses were performed with statistical significance in five (ACE, ELAC2, GSTM1, TERT, and VDR). The heterogeneity was high in three of these meta-analyses. The rs731236 variant of the vitamin D receptor had a protective effect for LUTS (odds ratio: 0.64; 95% confidence interval, 0.49-0.83) with moderate heterogeneity (I(2)=27.2%). No evidence for publication bias was identified. Limitations include wide-ranging phenotype definitions for LUTS and limited power in most meta-analyses to detect smaller effect sizes.

CONCLUSIONS:
Few putative genetic risk variants have been reliably replicated across populations. We found consistent evidence of a reduced risk of LUTS associated with the common rs731236 variant of the vitamin D receptor gene in our meta-analyses.

PATIENT SUMMARY:
Combining the results from all previous studies of genetic variants that may cause urinary symptoms in men, we found significant variants in five genes. Only one, a variant of the vitamin D receptor, was consistently protective across different populations.

PMID: 24491308 PMCID: PMC4410299 DOI: 10.1016/j.eururo.2014.01.007
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BPH decreased (by 3%) with 6,000 IU Vitamin D analogs for 10 months– Dec 2013

Vitamin D and benign prostatic hyperplasia — a review.
Can J Urol. 2013 Aug;20(4):6820-5.
Espinosa G1, Esposito R, Kazzazi A, Djavan B. New York University School of Medicine, New York, NY, USA.
INTRODUCTION:
Benign prostatic hyperplasia (BPH) is a more common form of lower urinary tract symptoms (LUTS). BPH is due to the excessive growth of both stromal and epithelial cells of the prostate. Fifty percent of men over the age of 50 will have this disease, along with the probability that 90% of men at the age of 80 will have an enlarged prostate. The prevalence of vitamin D deficiency in the male urological population may represent a connection between BPH and vitamin D.

MATERIAL AND METHODS:
This review is geared to provide the most relevant data on the correlation between vitamin D and BPH. A comprehensive review was conducted on all studies on the specific topic and compiled into a complete article.

RESULTS:
Data suggests that vitamin D has an inhibitory effect on the RhoA/ROCK pathway, along with cyclooxygenase-2 expression and prostaglandin E2 production in BPH stromal cells. Increasing intake of vitamin D from diet and supplements has shown a correlation with decreased BPH prevalence.
Vitamin D analogues of up to 6000 IU/day have shown to decrease prostate volume in BPH patients. Pre-clinical trials have shown vitamin D to not only decrease BPH cell and prostate cell proliferation alone, but also when induced by known growth promoting molecules such as IL-8, Des (1-3) IGF-1, testosterone and dihydrotestosterone. Among all the studies there has not been any side effects or negative implications with increased vitamin D intake.

CONCLUSION:
The impact of vitamin D on prostate volume and BPH has shown promising results, thus proposing further studies on vitamin D and BPH be conducted.

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Urinary incontinence 3.2X less likely in elderly if OK level of vitamin D – Sept 2016

Vitamin D and incident urinary incontinence in older adults.
Eur J Clin Nutr. 2016 Sep;70(9):987-9. doi: 10.1038/ejcn.2016.20. Epub 2016 Mar 16.
Vaughan CP1,2,3, Tangpricha V2,3, Motahar-Ford N2,3, Goode PS4,5,6, Burgio KL4,5,6, Allman RM7, Daigle SG4, Redden DT4,8, Markland AD4,5,6.

BACKGROUND/OBJECTIVES:
The aim of this study is to determine whether vitamin D status is associated with incident urinary incontinence (UI) among community-dwelling older adults.

SUBJECTS/METHODS:
The University of Alabama at Birmingham Study of Aging is a prospective cohort study of community-dwelling Medicare enrollees. Standardized assessment of UI was conducted using the validated Incontinence Severity Index. The analysis of 25-hydroxyvitamin D [25(OH)D] levels was performed on stored baseline sera. UI was assessed every 6-12 months for up to 42 months. The analyses included multivariable logistic regression and Cox proportional hazard models.

RESULTS:
Of 350 participants (175 male, 147 black, mean age 73.6±5.8), 54% (189/350) were vitamin D deficient (25(OH)D <20 ng/ml) and 25% (87/350) were vitamin D insufficient (25(OH)D: 20 ng/ml to <30 ng/ml). Among the 187 subjects with no UI at baseline, 57% (107/187) were vitamin D deficient and 24% (45/187) were vitamin D insufficient. A total of 175 of the 187 subjects had follow-up evaluation for incident UI over 42 months, and incident UI occurred in 37% (65/175). After adjustment, cumulative incident UI at 42 months was associated with baseline vitamin D insufficiency (P=0.03) and demonstrated a trend association with deficiency (P=0.07). There was no association between baseline vitamin D status and the time to incident UI.

CONCLUSIONS:
These preliminary results support an association between vitamin D and incident UI in community-dwelling older adults. Future studies may target specific at-risk groups, such as men with BPH or women with pelvic floor disorders for evaluation of the impact of vitamin D supplementation on urinary symptoms.

PMID: 26979990 PMCID: PMC5014687 DOI: 10.1038/ejcn.2016.20

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