Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R, Iran.
School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
Reprod Biol Endocrinol. 2018 Oct 4;16(1):94. doi: 10.1186/s12958-018-0413-3.
Vitamin D deficiency in women diagnosed with polycystic ovary syndrome (PCOS) remarkably decreases the chance of pregnancy, which might be related to its impact on metabolic abnormalities in these patients. It is hypothesized that vitamin D supplementation influences metabolic profile of these patients and indirectly might affect fertility and the outcomes. Therefore, this study was conducted to determine the effects of vitamin D supplementation on the levels of anti-Müllerian hormone (AMH), metabolic profiles, and gene expression of insulin and lipid metabolism in infertile women with PCOS who were candidate for in vitro fertilization (IVF).
This study was a randomized, double-blinded, placebo-controlled trial conducted among 40 infertile women, aged 18-40 years, diagnosed with PCOS and was candidate for IVF. Participants were randomly assigned into two intervention groups for receiving either 50,000 IU vitamin D or placebo (n = 20 each group) every other week for 8 weeks. Gene expression for insulin and lipid metabolism was conducted using peripheral blood mononuclear cells (PBMCs) of women with PCOS, via RT-PCR method.
Vitamin D supplementation led to a significant reduction in serum AMH (- 0.7 ± 1.2 vs. - 0.1 ± 0.5 ng/mL, P = 0.02), insulin levels (- 1.4 ± 1.6 vs. -0.3 ± 0.9 μIU/mL, P = 0.007), homeostatic model of assessment for insulin resistance (- 0.3 ± 0.3 vs. -0.1 ± 0.2, P = 0.008), and a significant increase in quantitative insulin sensitivity check index (+ 0.009 ± 0.01 vs. + 0.001 ± 0.004, P = 0.04), compared with the placebo. Moreover, following vitamin D supplementation there was a significant decrease in serum total- (- 5.1 ± 12.6 vs. + 2.9 ± 10.9 mg/dL, P = 0.03) and LDL-cholesterol levels (- 4.5 ± 10.3 vs. + 2.5 ± 10.6 mg/dL, P = 0.04) compared with the placebo.
Overall, the findings of this trial supported that 50,000 IU vitamin D supplementation every other week for 8 weeks had beneficial effects on insulin metabolism, and lipid profile of infertile women with PCOS who are candidate for IVF. These benefits might not be evident upon having sufficient vitamin D levels.
This study was retrospectively registered in the Iranian website ( www.irct.ir ) for clinical trials registration ( http://www.irct.ir : IRCT20170513033941N27).
患有多囊卵巢综合征（PCOS）的女性维生素 D 缺乏显著降低了怀孕的几率，这可能与其对这些患者代谢异常的影响有关。据推测，维生素 D 补充剂会影响这些患者的代谢状况，从而间接影响生育能力和结局。因此，本研究旨在确定维生素 D 补充对接受体外受精（IVF）的 PCOS 不孕妇女的抗苗勒管激素（AMH）水平、代谢谱以及胰岛素和脂质代谢基因表达的影响。
这是一项随机、双盲、安慰剂对照试验，纳入了 40 名年龄在 18-40 岁之间、被诊断为 PCOS 且符合 IVF 条件的不孕妇女。参与者被随机分为两组，分别接受 50000IU 维生素 D 或安慰剂（每组 20 人），每两周接受一次，共 8 周。通过 RT-PCR 法检测 PCOS 妇女外周血单核细胞（PBMCs）中胰岛素和脂质代谢的基因表达。
与安慰剂组相比，维生素 D 补充组血清 AMH（-0.7±1.2 与-0.1±0.5ng/mL，P=0.02）、胰岛素水平（-1.4±1.6 与-0.3±0.9μIU/mL，P=0.007）、稳态模型评估胰岛素抵抗（-0.3±0.3 与-0.1±0.2，P=0.008）显著降低，而定量胰岛素敏感性检查指数（+0.009±0.01 与+0.001±0.004，P=0.04）显著增加。此外，与安慰剂组相比，维生素 D 补充组血清总胆固醇（-5.1±12.6 与+2.9±10.9mg/dL，P=0.03）和 LDL 胆固醇水平（-4.5±10.3 与+2.5±10.6mg/dL，P=0.04）显著降低。
总之，本试验结果支持每两周接受 50000IU 维生素 D 补充剂 8 周对接受 IVF 的 PCOS 不孕妇女的胰岛素代谢和血脂谱有有益影响。这些益处可能不会在维生素 D 水平充足时显现出来。
本研究在伊朗网站（www.irct.ir）上进行了回顾性注册（http://www.irct.ir：IRCT20170513033941N27）。
