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补充维生素D对多囊卵巢综合征患者激素和血糖状况的影响:一项随机试验的荟萃分析。

The effect of Vitamin D supplementation on hormonal and glycaemic profile of patients with PCOS: A meta-analysis of randomised trials.

作者信息

Pergialiotis Vasilios, Karampetsou Nikoleta, Panagopoulos Periklis, Trakakis Eftihios, Papantoniou Nikolaos

机构信息

Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Int J Clin Pract. 2017 Jun;71(6). doi: 10.1111/ijcp.12957. Epub 2017 May 19.

Abstract

BACKGROUND

Vitamin D deficiency is frequently manifested in women with polycystic ovarian syndrome (PCOS). To date, supplementation of deficient patients has not been correlated with the hormonal and metabolic status of these patients.

PURPOSE

We aimed to investigate the impact of vitamin D supplementation on the hormonal and metabolic profile of PCOS women.

MATERIALS AND METHODS

We searched Medline, Scopus, ClinicalTrials.gov and Cochrane Central Register databases for published randomised controlled trials. The meta-analysis was performed with the RevMan 5.3.5 software.

RESULTS

Nine studies were included in the present meta-analysis which investigated the impact of vitamin D supplementation in 647 patients. According to our meta-analysis neither serum testosterone (MD 0.04 ng/mL, 95% CI -0.09 to 0.17) nor serum LH (MD -0.48 IU/mL, 95% CI -1.97 to 1.00) were significantly affected by vitamin D supplementation in any of the subgroup comparisons. On the contrary, serum DHEAS was significantly affected by vitamin D (MD -32.24 μg/dL, 95% CI -32.24 to -14.01) an effect which was mainly affected by the vitamin D vs placebo comparison. Vitamin D supplementation did not have an impact on fasting glucose (MD 0.42 mg/dL, 95% CI -2.75 to 3.60) or fasting insulin (MD 1.27 μU/mL, 95% CI -1.42 to 3.97) levels. HOMA-IR was, however, increased among patients that received placebo compared to vitamin D (MD 0.52, 95% CI 0.39-0.65).

CONCLUSION

There is no evidence to support that vitamin D supplementation significantly benefits PCOS patients. However, given the relatively small number of enrolled patients further studies are needed to elucidate this field.

摘要

背景

维生素D缺乏在多囊卵巢综合征(PCOS)女性中经常出现。迄今为止,对缺乏维生素D的患者进行补充与这些患者的激素和代谢状况并无关联。

目的

我们旨在研究补充维生素D对PCOS女性激素和代谢状况的影响。

材料与方法

我们检索了Medline、Scopus、ClinicalTrials.gov和Cochrane Central Register数据库,以查找已发表的随机对照试验。使用RevMan 5.3.5软件进行荟萃分析。

结果

本荟萃分析纳入了9项研究,这些研究调查了647例患者补充维生素D的影响。根据我们的荟萃分析,在任何亚组比较中,补充维生素D均未显著影响血清睾酮(MD 0.04 ng/mL,95% CI -0.09至0.17)或血清促黄体生成素(MD -0.48 IU/mL,95% CI -1.97至1.00)。相反,血清硫酸脱氢表雄酮受到维生素D的显著影响(MD -32.24 μg/dL,95% CI -32.24至-14.01),这一效应主要受维生素D与安慰剂比较的影响。补充维生素D对空腹血糖(MD 0.42 mg/dL,95% CI -2.75至3.60)或空腹胰岛素(MD 1.27 μU/mL,95% CI -1.42至3.97)水平没有影响。然而,与补充维生素D的患者相比,接受安慰剂的患者胰岛素抵抗指数(HOMA-IR)有所升高(MD 0.52,95% CI 0.39 - 0.65)。

结论

没有证据支持补充维生素D能使PCOS患者显著获益。然而,鉴于纳入患者数量相对较少,需要进一步研究以阐明该领域。

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