Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, UT.
Am J Obstet Gynecol. 2018 Jun;218(6):608.e1-608.e6. doi: 10.1016/j.ajog.2018.03.012. Epub 2018 Mar 13.
Prior studies have reported mixed results regarding relationships between vitamin D, androgens, and sex hormone-binding globulin in patients with polycystic ovary syndrome. However, less is known regarding these associations in eumenorrheic, premenopausal women.
Our objective was to study the relationships between serum vitamin D and androgen biomarkers in eumenorrheic women with a history of pregnancy loss who were attempting pregnancy.
This was an analysis of a cohort of 1191 participants from the Effects of Aspirin in Gestation and Reproduction trial (2006-2012). Participants were attempting to conceive, aged 18-40 years, with 1-2 documented prior pregnancy losses and no history of infertility, and recruited from 4 academic medical centers in the United States. Serum vitamin D (25-hydroxyvitamin D) and hormone concentrations were measured at baseline.
Vitamin D concentration was negatively associated with free androgen index (percentage change [95% confidence interval, -5% (-8% to -2%)] per 10 ng/mL increase) and positively associated with sex hormone-binding globulin (95% confidence interval, 4% [2-7%]), although not with total testosterone, free testosterone, or dehydroepiandrosterone sulfate after adjusting for age, body mass index, smoking status, race, income, education, physical activity, and season of blood draw.
Overall, vitamin D was associated with sex hormone-binding globulin and free androgen index in eumenorrheic women with prior pregnancy loss, suggesting that vitamin D may play a role in the bioavailability of androgens in eumenorrheic women. We are limited in making assessments regarding directionality, given the cross-sectional nature of our study.
先前的研究报告称，多囊卵巢综合征患者的维生素 D、雄激素和性激素结合球蛋白之间的关系存在差异。然而，对于月经正常、绝经前的女性，这些关联的了解较少。
我们的目的是研究既往妊娠丢失且正在备孕的月经正常女性的血清维生素 D 与雄激素生物标志物之间的关系。
这是一项来自妊娠和生殖中阿司匹林作用的队列研究（2006-2012 年）的 1191 名参与者的分析。参与者年龄在 18-40 岁之间，正在备孕，有 1-2 次已知的既往妊娠丢失史，且无不孕史，她们是从美国 4 家学术医疗中心招募的。在基线时测量血清维生素 D（25-羟维生素 D）和激素浓度。
维生素 D 浓度与游离雄激素指数呈负相关（每增加 10ng/mL，百分比变化[-5%（-8%至-2%）]），与性激素结合球蛋白呈正相关（95%置信区间，4%[2-7%]），但与总睾酮、游离睾酮或脱氢表雄酮硫酸酯无关，调整年龄、体重指数、吸烟状况、种族、收入、教育、身体活动和采血季节后。
总体而言，维生素 D 与既往妊娠丢失的月经正常女性的性激素结合球蛋白和游离雄激素指数相关，这表明维生素 D 可能在月经正常女性的雄激素生物利用度中发挥作用。鉴于我们研究的横断面性质，我们只能对方向进行有限的评估。
