Departments of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria.
Eur J Endocrinol. 2012 May;166(5):897-902. doi: 10.1530/EJE-11-1070. Epub 2012 Feb 13.
To evaluate whether parameters for calcium metabolism were associated with characteristics of polycystic ovary syndrome (PCOS).
A prospective cohort study.
Ninety-one anovulatory, infertile women with PCOS patients underwent clomiphene citrate (CC) stimulation. Main outcome measures were parathyroid hormone (PTH); 25-hydroxyvitamin D3 (25OHD3); serum levels of calcium, phosphorus, magnesium, albumin, and total protein; the serum calcium-phosphorus product; LH; FSH; sexual hormone binding globulin; testosterone; and androstenedione.
PTH correlated inversely with serum calcium (r=-0.235; P=0.004) and 25OHD3 (r=-0.664; P<0.001), whereas positive correlations were found between PTH and body mass index (BMI; r=0.270; P=0.010) and between PTH and testosterone (r=0.347; P=0.001). After stimulation with 50 mg CC, 57.1% (52/91) developed a follicle, whereas 26.4% (24/91) became pregnant. In a multivariate model to predict both follicle development and pregnancy, BMI and 25OHD3 deficiency were significant predictive parameters.
25OHD3 deficiency was an independent predictive parameter of CC stimulation outcome, in terms of follicle development and pregnancy. Our results suggest a substantial role of vitamin D in PCOS and infertility treatment in these patients.
评估钙代谢参数是否与多囊卵巢综合征(PCOS)的特征相关。
前瞻性队列研究。
91 名排卵障碍、不孕的 PCOS 患者接受枸橼酸氯米酚(CC)刺激。主要观察指标为甲状旁腺激素(PTH);25-羟维生素 D3(25OHD3);血清钙、磷、镁、白蛋白和总蛋白水平;血清钙磷乘积;黄体生成素(LH);促卵泡生成素(FSH);性激素结合球蛋白;睾酮;雄烯二酮。
PTH 与血清钙(r=-0.235;P=0.004)和 25OHD3(r=-0.664;P<0.001)呈负相关,而 PTH 与体重指数(BMI;r=0.270;P=0.010)和 PTH 与睾酮(r=0.347;P=0.001)呈正相关。50mgCC 刺激后,57.1%(52/91)形成卵泡,26.4%(24/91)妊娠。在预测卵泡发育和妊娠的多变量模型中,BMI 和 25OHD3 缺乏是显著的预测参数。
25OHD3 缺乏是 CC 刺激反应(卵泡发育和妊娠)的独立预测参数。我们的结果表明维生素 D 在 PCOS 及其在这些患者中的不孕治疗中具有重要作用。