title: Systemic markers of collagen metabolism and vitamin C in smokers and non-smokers with pelvic organ prolapse.
abstract: OBJECTIVE
  To evaluate systemic markers of collagen metabolism and vitamin C in female smokers with pelvic organ prolapse (POP). Secondary aims were to compare these levels in women based on prolapse or smoking history alone.
  
  
  METHODS
  This was a cross-sectional study with four groups: smokers with POP, non-smokers with POP, smokers without POP and non-smokers without POP. Subjects were age-matched based on smoking history and presence of POP. All underwent a fasting blood panel, including plasma procollagen 1-N propeptide (P1NP), matrix metalloproteinase 9 (MMP-9), and vitamin C.
  
  
  RESULTS
  Ninety-six subjects were enrolled. There were no differences for any demographics other than stage of prolapse, which was highest in non-smokers with POP. Significant variations in the levels of vitamin C and MMP-9 were noted among the four groups. Smokers with POP had lower levels of vitamin C and higher levels of MMP-9, compared to non-smokers with POP, but this relationship was not statistically significant. However, when contrasting smokers without POP to non-smokers without POP, significant differences in both vitamin C and MMP-9 were documented, confirming an impact of smoking on these markers. Notwithstanding, when evaluated independent of smoking status, vitamin C and MMP-9 levels in women with POP were similar to those of women without POP.
  
  
  CONCLUSIONS
  Lower vitamin C and higher MMP-9 among smokers confirms the usefulness of such markers in documenting the smoking's impact on collagen. However, the lack of a difference based on POP suggests these are poor measures for understanding the pathophysiology of this disorder.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, United States.
authors.forename: M Victoria
authors.initials: MV
authors.lastname: Estanol
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, United States.
authors.forename: Catrina C
authors.initials: CC
authors.lastname: Crisp
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, United States.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Oakley
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, United States.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Kleeman
authors.affiliation: Hatton Institute for Research and Education, Good Samaritan Hospital, Cincinnati, OH, United States.
authors.forename: Angela N
authors.initials: AN
authors.lastname: Fellner
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, United States.
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Pauls
mesh_terms: D000368:Aged; D001205:Ascorbic Acid / Q000097:blood*; D003094:Collagen / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011347:Procollagen / Q000097:blood*; D012907:Smoking / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D011347:Procollagen; C047202:procollagen Type I N-terminal peptide; D003094:Collagen; D020780:Matrix Metalloproteinase 9; D001205:Ascorbic Acid
keywords: Collagen metabolism; Pelvic organ prolapse; Smoking