Wehr E, Pilz S, Schweighofer N, Giuliani A, Kopera D, Pieber T R, Obermayer-Pietsch B
Divison of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University Graz, Auenbruggerplatz 15, A-8036 Graz, Austria.
Eur J Endocrinol. 2009 Oct;161(4):575-82. doi: 10.1530/EJE-09-0432. Epub 2009 Jul 23.
Women with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances, in particular from insulin resistance. Accumulating evidence suggests that vitamin D deficiency may contribute to the development of the metabolic syndrome (MS). Hence, the aim of our study was to investigate the association of 25(OH)D levels and the components of the MS in PCOS women.
25(OH)D levels were measured by means of ELISA in 206 women affected by PCOS. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.
The prevalence of insufficient 25(OH)D levels (<30 ng/ml) was 72.8% in women with PCOS. PCOS women with the MS had lower 25(OH)D levels than PCOS women without these features (17.3 vs 25.8 ng/ml respectively; P<0.05). In multivariate regression analysis including 25(OH)D, season, body mass index (BMI), and age, 25(OH)D and BMI were independent predictors of homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI; P<0.05 for all). In binary logistic regression analyses, 25(OH)D (OR 0.86, P=0.019) and BMI (OR 1.28, P<0.001) were independent predictors of the MS in PCOS women. We found significantly negative correlations of 25(OH)D levels with BMI, waist circumference, waist-to-hip ratio, systolic and diastolic blood pressure, fasting and stimulated glucose, area under the glucose response curve, fasting insulin, HOMA-IR, HOMA-beta, triglycerides, and quotient total cholesterol/high-density lipoprotein (HDL) and positive correlations of 25(OH)D levels with QUICKI and HDL (P<0.05 for all).
We demonstrate that low 25(OH)D levels are associated with features of the MS in PCOS women. Large intervention trials are warranted to evaluate the effect of vitamin D supplementation on metabolic disturbances in PCOS women.
多囊卵巢综合征（PCOS）女性常伴有代谢紊乱，尤其是胰岛素抵抗。越来越多的证据表明，维生素D缺乏可能促使代谢综合征（MS）的发生。因此，我们研究的目的是调查PCOS女性中25（OH）D水平与MS各组分之间的关联。
采用酶联免疫吸附测定法（ELISA）检测206例PCOS女性的25（OH）D水平。进行代谢、内分泌、人体测量及口服葡萄糖耐量试验。
PCOS女性中25（OH）D水平不足（<30 ng/ml）的患病率为72.8%。患有MS的PCOS女性的25（OH）D水平低于无这些特征的PCOS女性（分别为17.3 ng/ml和25.8 ng/ml；P<0.05）。在包含25（OH）D、季节、体重指数（BMI）和年龄的多因素回归分析中，25（OH）D和BMI是稳态模型评估-胰岛素抵抗（HOMA-IR）和定量胰岛素敏感性检查指数（QUICKI）的独立预测因素（所有P<0.05）。在二元逻辑回归分析中，25（OH）D（比值比0.86，P=0.019）和BMI（比值比1.28，P<0.001）是PCOS女性发生MS的独立预测因素。我们发现25（OH）D水平与BMI、腰围、腰臀比、收缩压和舒张压、空腹及刺激后血糖、葡萄糖反应曲线下面积、空腹胰岛素、HOMA-IR、HOMA-β、甘油三酯以及总胆固醇/高密度脂蛋白（HDL）比值呈显著负相关，与QUICKI和HDL呈正相关（所有P<0.05）。
我们证明，PCOS女性中低25（OH）D水平与MS特征相关。有必要进行大型干预试验以评估补充维生素D对PCOS女性代谢紊乱的影响。
