DOI QR코드

DOI QR Code

Vitamin D deficiency in women with polycystic ovary syndrome

  • Kim, Jin Ju (Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital) ;
  • Choi, Young Min (The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine) ;
  • Chae, Soo Jin (Department of Obstetrics and Gynecology, Maria Fertility Hospital) ;
  • Hwang, Kyu Ri (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Yoon, Sang Ho (Department of Obstetrics and Gynecology, Graduate School of Medicine, Dongguk University) ;
  • Kim, Min Jeong (Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital) ;
  • Kim, Sun Mie (Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital) ;
  • Ku, Seung Yup (The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine) ;
  • Kim, Seok Hyun (The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine) ;
  • Kim, Jung Gu (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • Received : 2014.05.15
  • Accepted : 2014.06.06
  • Published : 2014.06.30

Abstract

Objective: To investigate: the prevalence of vitamin D deficiency in Korean women with polycystic ovary syndrome (PCOS), and the relationship between vitamin D status and clinical or metabolic features in this group. Methods: We recruited 38 women with PCOS using the Rotterdam criteria. A total of 109 premenopausal control women were matched with patients based on age and body mass index. Serum 25-hydroxy vitamin D concentrations less than 20 ng/mL were classified as frank vitamin D deficiency. Since vitamin D may play a significant role in metabolic disturbances in women with PCOS, correlations between clinical or metabolic parameters and vitamin D status were analyzed separately in patients and controls. Results: Women with PCOS showed no differences in the level of 25-hydroxy vitamin D ($19.6{\pm}6.6ng/mL$ in patients vs. $20.1{\pm}7.4ng/mL$ in controls, respectively, p=0.696) or prevalence of vitamin D deficiency (57.9% in patients vs. 56.5% in controls, respectively, p=0.880). In addition, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles in either PCOS patients or controls. Conclusion: Our study found no differences in the absolute level of serum vitamin D between PCOS patients and matched controls. Prevalence of vitamin D deficiency was equally common among both patients and controls. Additionally, we did not find any correlations between serum vitamin D level and clinical or metabolic profiles, suggesting that the role of vitamin D in the pathogenesis of PCOS is not yet clear.

Keywords

References

  1. Scragg R, Holdaway I, Singh V, Metcalf P, Baker J, Dryson E. Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Res Clin Pract 1995;27:181-8. https://doi.org/10.1016/0168-8227(95)01040-K
  2. Scragg R, Sowers M, Bell C; Third National Health and Nutrition Examination Survey. Serum 25-hydroxyvitamin D, diabetes, and ethnicity in the Third National Health and Nutrition Examination Survey. Diabetes Care 2004;27:2813-8. https://doi.org/10.2337/diacare.27.12.2813
  3. Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care 2006;29:650-6. https://doi.org/10.2337/diacare.29.03.06.dc05-1961
  4. Mattila C, Knekt P, Mannisto S, Rissanen H, Laaksonen MA, Montonen J, et al. Serum 25-hydroxyvitamin D concentration and subsequent risk of type 2 diabetes. Diabetes Care 2007;30:2569-70. https://doi.org/10.2337/dc07-0292
  5. Liu E, Meigs JB, Pittas AG, McKeown NM, Economos CD, Booth SL, et al. Plasma 25-hydroxyvitamin d is associated with markers of the insulin resistant phenotype in nondiabetic adults. J Nutr 2009;139:329-34. https://doi.org/10.3945/jn.108.093831
  6. Chiu KC, Chuang LM, Lee NP, Ryu JM, McGullam JL, Tsai GP, et al. Insulin sensitivity is inversely correlated with plasma intact parathyroid hormone level. Metabolism 2000;49:1501-5. https://doi.org/10.1053/meta.2000.17708
  7. McCarty MF, Thomas CA. PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses 2003;61:535-42. https://doi.org/10.1016/S0306-9877(03)00227-5
  8. Reis JP, von Muhlen D, Kritz-Silverstein D, Wingard DL, Barrett- Connor E. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care 2007;30:1549-55. https://doi.org/10.2337/dc06-2438
  9. Maestro B, Campion J, Davila N, Calle C. Stimulation by 1,25-dihydroxyvitamin D3 of insulin receptor expression and insulin responsiveness for glucose transport in U-937 human promonocytic cells. Endocr J 2000;47:383-91. https://doi.org/10.1507/endocrj.47.383
  10. Maestro B, Davila N, Carranza MC, Calle C. Identification of a Vitamin D response element in the human insulin receptor gene promoter. J Steroid Biochem Mol Biol 2003;84:223-30. https://doi.org/10.1016/S0960-0760(03)00032-3
  11. Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 2008;29:726-76. https://doi.org/10.1210/er.2008-0004
  12. Panidis D, Balaris C, Farmakiotis D, Rousso D, Kourtis A, Balaris V, et al. Serum parathyroid hormone concentrations are increased in women with polycystic ovary syndrome. Clin Chem 2005;51:1691-7. https://doi.org/10.1373/clinchem.2005.052761
  13. Hahn S, Haselhorst U, Tan S, Quadbeck B, Schmidt M, Roesler S, et al. Low serum 25-hydroxyvitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 2006;114:577-83. https://doi.org/10.1055/s-2006-948308
  14. Wehr E, Pilz S, Schweighofer N, Giuliani A, Kopera D, Pieber TR, et al. Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome. Eur J Endocrinol 2009;161:575-82. https://doi.org/10.1530/EJE-09-0432
  15. Mahmoudi T, Gourabi H, Ashrafi M, Yazdi RS, Ezabadi Z. Calciotropic hormones, insulin resistance, and the polycystic ovary syndrome. Fertil Steril 2010;93:1208-14. https://doi.org/10.1016/j.fertnstert.2008.11.031
  16. Selimoglu H, Duran C, Kiyici S, Ersoy C, Guclu M, Ozkaya G, et al. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010;33:234-8. https://doi.org/10.1007/BF03345785
  17. Li HW, Brereton RE, Anderson RA, Wallace AM, Ho CK. Vitamin D deficiency is common and associated with metabolic risk factors in patients with polycystic ovary syndrome. Metabolism 2011;60:1475-81. https://doi.org/10.1016/j.metabol.2011.03.002
  18. Ngo DT, Chan WP, Rajendran S, Heresztyn T, Amarasekera A, Sverdlov AL, et al. Determinants of insulin responsiveness in young women: impact of polycystic ovarian syndrome, nitric oxide, and vitamin D. Nitric Oxide 2011;25:326-30. https://doi.org/10.1016/j.niox.2011.06.005
  19. Ranjzad F, Mahban A, Shemirani AI, Mahmoudi T, Vahedi M, Nikzamir A, et al. Influence of gene variants related to calcium homeostasis on biochemical parameters of women with polycystic ovary syndrome. J Assist Reprod Genet 2011;28:225-32. https://doi.org/10.1007/s10815-010-9506-4
  20. Wehr E, Trummer O, Giuliani A, Gruber HJ, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol 2011;164:741-9. https://doi.org/10.1530/EJE-11-0134
  21. Mazloomi S, Sharifi F, Hajihosseini R, Kalantari S, Mazloomzadeh S. Association between Hypoadiponectinemia and Low Serum Concentrations of Calcium and Vitamin D in Women with Polycystic Ovary Syndrome. ISRN Endocrinol 2012;2012:949427.
  22. Muscogiuri G, Policola C, Prioletta A, Sorice G, Mezza T, Lassandro A, et al. Low levels of 25(OH)D and insulin-resistance: 2 unrelated features or a cause-effect in PCOS? Clin Nutr 2012;31:476-80. https://doi.org/10.1016/j.clnu.2011.12.010
  23. El-Shal AS, Shalaby SM, Aly NM, Rashad NM, Abdelaziz AM. Genetic variation in the vitamin D receptor gene and vitamin D serum levels in Egyptian women with polycystic ovary syndrome. Mol Biol Rep 2013;40:6063-73. https://doi.org/10.1007/s11033-013-2716-y
  24. Krul-Poel YH, Snackey C, Louwers Y, Lips P, Lambalk CB, Laven JS, et al. The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review. Eur J Endocrinol 2013; 169:853-65. https://doi.org/10.1530/EJE-13-0617
  25. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41-7. https://doi.org/10.1093/humrep/deh098
  26. Kim JJ, Chae SJ, Choi YM, Hwang SS, Hwang KR, Kim SM, et al. Assessment of hirsutism among Korean women: results of a randomly selected sample of women seeking pre-employment physical check-up. Hum Reprod 2011;26:214-20. https://doi.org/10.1093/humrep/deq303
  27. Chae SJ, Kim JJ, Choi YM, Hwang KR, Jee BC, Ku SY, et al. Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women. Hum Reprod 2008;23:1924-31. https://doi.org/10.1093/humrep/den239
  28. Adams JS, Hewison M. Update in vitamin D. J Clin Endocrinol Metab 2010;95:471-8. https://doi.org/10.1210/jc.2009-1773
  29. Yildizhan R, Kurdoglu M, Adali E, Kolusari A, Yildizhan B, Sahin HG, et al. Serum 25-hydroxyvitamin D concentrations in obese and non-obese women with polycystic ovary syndrome. Arch Gynecol Obstet 2009;280:559-63. https://doi.org/10.1007/s00404-009-0958-7
  30. Thomson RL, Spedding S, Buckley JD. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2012;77:343-50. https://doi.org/10.1111/j.1365-2265.2012.04434.x
  31. Thys-Jacobs S, Donovan D, Papadopoulos A, Sarrel P, Bilezikian JP. Vitamin D and calcium dysregulation in the polycystic ovarian syndrome. Steroids 1999;64:430-5. https://doi.org/10.1016/S0039-128X(99)00012-4
  32. Kotsa K, Yavropoulou MP, Anastasiou O, Yovos JG. Role of vitamin D treatment in glucose metabolism in polycystic ovary syndrome. Fertil Steril 2009;92:1053-8. https://doi.org/10.1016/j.fertnstert.2008.07.1757
  33. Wehr E, Pieber TR, Obermayer-Pietsch B. Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in polycystic ovary syndrome women: a pilot study. J Endocrinol Invest 2011;34:757-63.
  34. Prentice A. Vitamin D deficiency: a global perspective. Nutr Rev 2008;66:S153-64. https://doi.org/10.1111/j.1753-4887.2008.00100.x
  35. Lips P. Worldwide status of vitamin D nutrition. J Steroid Biochem Mol Biol 2010;121:297-300. https://doi.org/10.1016/j.jsbmb.2010.02.021
  36. De Felici M, Dolci S, Siracusa G. An increase of intracellular free Ca2+ is essential for spontaneous meiotic resumption by mouse oocytes. J Exp Zool 1991;260:401-5. https://doi.org/10.1002/jez.1402600314

Cited by

  1. Effect of vitamin D on clinical and biochemical parameters in polycystic ovary syndrome women: A meta‐analysis vol.41, pp.11, 2014, https://doi.org/10.1111/jog.12793
  2. Classic PCOS phenotype is not associated with deficiency of endogenous vitamin D and VDR gene polymorphisms rs731236 (TaqI), rs7975232 (ApaI), rs1544410 (BsmI), rs10735810 (FokI): a case-control study vol.31, pp.12, 2014, https://doi.org/10.3109/09513590.2015.1062865
  3. The relationship of serum 25-dihydroxy vitamin D3 concentrations with metabolic parameters in non-obese women with polycystic ovarian syndrome vol.21, pp.4, 2014, https://doi.org/10.1016/j.mefs.2016.06.003
  4. Evaluation of vitamin D status and its correlation with oxidative stress markers in women with polycystic ovary syndrome vol.15, pp.6, 2017, https://doi.org/10.29252/ijrm.15.6.345
  5. Evaluation of Relationship between Body Mass Index with Vitamin D Receptor Gene Expression and Vitamin D Levels of Follicular Fluid in Overweight Patients with Polycystic Ovary Syndrome vol.11, pp.2, 2017, https://doi.org/10.22074/ijfs.2017.4704
  6. Correlation of clinical, radiological and serum analysis of hypovitaminosis D with polycystic ovary syndrome: A systematic review and meta-analysis vol.12, pp.4, 2017, https://doi.org/10.1016/j.jtumed.2017.02.005
  7. Vitamin D, PCOS and androgens in men: a systematic review vol.7, pp.3, 2014, https://doi.org/10.1530/ec-18-0009
  8. Independent association of serum vitamin D with anti‐Mullerian hormone levels in women with polycystic ovary syndrome vol.89, pp.5, 2014, https://doi.org/10.1111/cen.13816
  9. Comparison of clinical, metabolic, hormonal, and ultrasound parameters among the clomiphene citrate-resistant and clomiphene citrate-sensitive polycystic ovary syndrome women vol.12, pp.3, 2014, https://doi.org/10.4103/jhrs.jhrs_89_18
  10. Efficient Production of Murine Uterine Damage Model vol.16, pp.2, 2019, https://doi.org/10.1007/s13770-018-0149-3
  11. Proliferation Profile of Uterine Endometrial Stromal Cells during In Vitro Culture with Gonadotropins: Recombinant versus Urinary Follicle Stimulating Hormone vol.16, pp.2, 2019, https://doi.org/10.1007/s13770-018-0156-4
  12. Modulatory Effects of Single and Complex Vitamins on the In Vitro Growth of Murine Ovarian Follicles vol.16, pp.3, 2014, https://doi.org/10.1007/s13770-019-00188-w
  13. A new possibility in fertility preservation: The artificial ovary vol.13, pp.8, 2014, https://doi.org/10.1002/term.2870
  14. Type 2 Diabetes Mellitus, Insulin Resistance, and Vitamin D vol.19, pp.10, 2014, https://doi.org/10.1007/s11892-019-1201-y
  15. The correlation between vitamin D, glucose homeostasis and androgen level among polycystic ovary syndrome patients: a cross-sectional study vol.37, pp.3, 2014, https://doi.org/10.1080/09513590.2020.1810228