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男性体内的维生素D、多囊卵巢综合征与雄激素:一项系统评价

Vitamin D, PCOS and androgens in men: a systematic review.

作者信息

Trummer Christian, Pilz Stefan, Schwetz Verena, Obermayer-Pietsch Barbara, Lerchbaum Elisabeth

机构信息

Department of Internal MedicineDivision of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.

Department of Internal MedicineDivision of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

出版信息

Endocr Connect. 2018 Mar;7(3):R95-R113. doi: 10.1530/EC-18-0009. Epub 2018 Feb 15.

Abstract

BACKGROUND

Accumulating evidence from animal and human studies suggests that vitamin D is involved in many functions of the reproductive system in both genders.

AIM

The aim of this review was to provide an overview on the effects of vitamin D on polycystic ovary syndrome (PCOS) in women and androgen metabolism in men.

METHODS

We performed a systematic literature search in PubMed for relevant English language publications published from January 2012 until September 2017.

RESULTS AND DISCUSSION

The vitamin D receptor and vitamin D-metabolizing enzymes are found in reproductive tissues of women and men. In women, vitamin D status has been associated with several features of PCOS. In detail, cross-sectional data suggest a regulatory role of vitamin D in PCOS-related aspects such as ovulatory dysfunction, insulin resistance as well as hyperandrogenism. Moreover, results from randomized controlled trials (RCTs) suggest that vitamin D supplementation may be beneficial for metabolic, endocrine and fertility aspects in PCOS. In men, vitamin D status has been associated with androgen levels and hypogonadism. Further, there is some evidence for a favorable effect of vitamin D supplementation on testosterone concentrations, although others failed to show a significant effect on testosterone levels.

CONCLUSION

In summary, vitamin D deficiency is associated with adverse fertility outcomes including PCOS and hypogonadism, but the evidence is insufficient to establish causality. High-quality RCTs are needed to further evaluate the effects of vitamin D supplementation in PCOS women as well as on androgen levels in men.

摘要

背景

动物和人体研究积累的证据表明,维生素D参与了两性生殖系统的多种功能。

目的

本综述旨在概述维生素D对女性多囊卵巢综合征(PCOS)和男性雄激素代谢的影响。

方法

我们在PubMed中对2012年1月至2017年9月发表的相关英文出版物进行了系统的文献检索。

结果与讨论

在男性和女性的生殖组织中均发现了维生素D受体和维生素D代谢酶。在女性中,维生素D状态与PCOS的几个特征有关。具体而言,横断面数据表明维生素D在PCOS相关方面如排卵功能障碍、胰岛素抵抗以及高雄激素血症中起调节作用。此外,随机对照试验(RCT)的结果表明,补充维生素D可能对PCOS的代谢、内分泌和生育方面有益。在男性中,维生素D状态与雄激素水平和性腺功能减退有关。此外,有一些证据表明补充维生素D对睾酮浓度有有利影响,尽管其他研究未能显示对睾酮水平有显著影响。

结论

总之,维生素D缺乏与包括PCOS和性腺功能减退在内的不良生育结局有关,但证据不足以确定因果关系。需要高质量的RCT来进一步评估补充维生素D对PCOS女性的影响以及对男性雄激素水平的影响。

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本文引用的文献

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Correlation of Vitamin D with metabolic parameters in polycystic ovarian syndrome.
J Family Med Prim Care. 2017 Jan-Mar;6(1):115-119. doi: 10.4103/2249-4863.214985.
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Vitamin D and Testosterone in Healthy Men: A Randomized Controlled Trial.
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The role of vitamin D in male fertility: A focus on the testis.
Rev Endocr Metab Disord. 2017 Sep;18(3):285-305. doi: 10.1007/s11154-017-9425-0.
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