Abstract:
Objective To investigate the correlations between serum elafin, osteopontin (OPN), pelvic floor electrophysiology and pelvic floor functional disorders (PFD).
Methods Totally 39 patients with simple pelvic organ prolapse (POP), 58 patients with POP and stress urinary incontinence (SUI) and 63 women without PFD were selected as simple POP group, POP plus SUI group and control group respectively, and serum levels of elafin, OPN, pelvic floor muscle strength and fatigue were detected. Pearson correlation or Spearman rank correlation was used to analyze the correlations between elafin, OPN and pelvic floor muscle strength as well as fatigue, and Logistic regression analysis was used to explore the factors affecting the incidence of PFD.
Results The level of serum elafin, the muscle voltage of type Ⅰ muscle fiber and the muscle voltage of type Ⅱ muscle fiber gradually decreased in the control group, the simple POP group and the POP plus SUI group, while the level of serum OPN, absolute value of fatigue degree of type Ⅰ muscle fiber and absolute value of fatigue degree of type Ⅱ muscle fiber gradually increased in the above three groups (P < 0.05). The level of serum elafin, muscle voltage of type Ⅰ muscle fiber and muscle voltage of type Ⅱ muscle fiber gradually decreased in cases with degree Ⅰ, Ⅱ and Ⅲ of POP and SUI, while the level of serum OPN, absolute value of fatigue degree of type Ⅰ muscle fiber and absolute value of fatigue degree of type Ⅱ muscle fiber gradually increased in the above cases (P < 0.05). Spearman rank correlation analysis showed that serum elafin level, muscle voltage of type Ⅰ muscle fiber and muscle voltage of type Ⅱ muscle fiber were negatively correlated with grading of POP and SUI (P < 0.05), while serum OPN level, fatigue degree of type Ⅰ muscle fiber and fatigue degree of type Ⅱ muscle fiber were positively correlated with grading of POP and SUI (P < 0.05). Pearson correlation analysis showed that muscle voltages of type Ⅰ and Ⅱ muscle fibers were positively correlated with elafin level, and negatively correlated with OPN (P < 0.05). Fatigue degrees of type Ⅰ and Ⅱ muscle fibers were negatively correlated with elafin level, and positively correlated with OPN (P < 0.05). Logistic regression analysis showed that age, number of deliveries, menopause, OPN and elafin were correlated with incidence of PFD (P < 0.01).
Conclusion In the patients with PFD, the level of serum elafin and muscle voltage of pelvic floor muscle fiber decrease, while the level of OPN and fatigue degree of pelvic floor muscle increase, and elafin, OPN, voltage and fatigue of pelvic floor muscle fibers are related to the occurrence and degree of PFD.