are vitamin d levels linked to primary monosymptomatic nocturnal enuresis in children? six years of experience about a controversy in medicine: a case-control study

Background: the relationship between vitamin d and primary monosymptomatic nocturnal enuresis (pmne) is still controversial. objectives: this study aimed to investigate the relationship between different vitamin d levels with the development and severity of pmne. methods: a case-control study of 534 children (267 children with pmne as the case group and 267 healthy children without enuresis as the control group), aged 6 - 15 years old, was conducted in two tertiary primary care hospitals, tehran, iran, from 2015 to 2021. the participants' demographic characteristics and vitamin d status were evaluated in both groups. the relationship between vitamin d levels with enuresis and its severity was studied as the main outcome measures. multiple logistic regression models were utilized for statistical analyses to assay the odds ratio at a confidence interval of 95%. in this study, p < 0.05 were set as the significance level. results: vitamin d levels significantly differed between the two groups (18.58 ± 9.83 ng/ml and 30.23 ± 10.62 ng/ml, respectively; p < 0.001). after adjusting for confounders, vitamin d was significantly associated with enuresis (< 20 ng/ml, or 3.07, 95% ci 1.9 - 4.95, p = 0.0001; 20 - 30 ng/ml, or 2.72, 95% ci 1.47 - 3.67, p = 0.0001). adjusted or with 95% ci concerning the history of parental enuresis was 15.03 (95% ci 1.88 - 19.6, p = 0.01). the prevalence of vitamin d deficiency and insufficiency in the pmne subjects were 107 cases (40.1%) and 109 cases (40.8%), respectively, and the prevalence values in the control group were 57 cases (21.3%) and 71 cases (26.6%), respectively (p < 0.05). furthermore, the participants with higher frequencies of bedwetting represented lower vitamin d levels (severe, 10.6 ± 1.23 ng/ ml; moderate, 19.46 ± 1.21 ng/ml; mild, 26.8 ± 2.61 ng/ml, p = 0.0001). conclusions: according to the finding of this study, parental history, and the participants’ vitamin d status were significant risk factors for the pmne development. vitamin d levels were significantly lower in the pmne children. the prevalence of vitamin d deficiency and insufficiency was significantly higher in the enuretic subjects. children with higher frequencies of bedwetting represented lower vitamin d levels.