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多囊卵巢综合征中的维生素 D:与肥胖和胰岛素抵抗的关系。

Vitamin D in polycystic ovary syndrome: Relationship to obesity and insulin resistance.

机构信息

Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.

Diabetes and Vascular Medicine Unit, Monash Health, Victoria, Australia.

出版信息

Mol Nutr Food Res. 2016 Jan;60(1):110-8. doi: 10.1002/mnfr.201500259. Epub 2015 Sep 7.

Abstract

SCOPE

Polycystic ovary syndrome (PCOS) is underpinned by insulin resistance (IR). In PCOS, the relationships between vitamin D, adiposity, and IR are unclear. We aim to explore these relationships in lean and overweight women with PCOS.

METHODS AND RESULTS

This is a cross-sectional study conducted in a tertiary medical center. Participants included 42 women with PCOS and 34 controls without PCOS. Vitamin D and metabolic markers were measured. Detailed body composition and gold standard hyperinsulinemic euglycemic clamps were performed. The main outcome measures were plasma levels of vitamin D, adiposity measures, and glucose infusion rate. Vitamin D levels were lower in overweight women with PCOS compared with overweight controls (31.6 and 46.1 nmol/L, respectively, p = 0.01). Vitamin D was not associated with IR after adjustment for confounders; however, there was a significant interaction between PCOS and percentage body fat. Further analysis by PCOS status revealed that vitamin D was associated with IR in the PCOS group (β coefficient 2.1, 95% CI 0.2-4.0, p = 0.03), but not in the non-PCOS group.

CONCLUSION

Vitamin D is associated with IR in women with PCOS, but not in controls. Large intervention studies are needed to determine if vitamin D supplementation can improve IR in PCOS.

摘要

研究范围

多囊卵巢综合征(PCOS)的发病基础是胰岛素抵抗(IR)。在 PCOS 中,维生素 D、肥胖与 IR 之间的关系尚不清楚。我们旨在探索 PCOS 患者中瘦体重和超重人群的这些关系。

方法和结果

这是在一家三级医疗中心进行的横断面研究。参与者包括 42 名患有 PCOS 的女性和 34 名无 PCOS 的对照组女性。测量了维生素 D 和代谢标志物。进行了详细的身体成分和金标准高胰岛素正葡萄糖钳夹试验。主要观察指标为血浆维生素 D 水平、肥胖指标和葡萄糖输注率。超重的 PCOS 女性的维生素 D 水平低于超重对照组(分别为 31.6 和 46.1 nmol/L,p = 0.01)。在调整混杂因素后,维生素 D 与 IR 无关;然而,PCOS 和体脂百分比之间存在显著的交互作用。按 PCOS 状态进一步分析显示,维生素 D 与 PCOS 组的 IR 相关(β系数 2.1,95%CI 0.2-4.0,p = 0.03),但与非 PCOS 组无关。

结论

维生素 D 与 PCOS 患者的 IR 相关,但与对照组无关。需要进行大型干预研究来确定维生素 D 补充是否可以改善 PCOS 患者的 IR。

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