Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica - Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Buenos Aires, Argentina.
Universidad de Buenos Aires, Hospital de Clínicas "José de San Martín", División Endocrinología, Buenos Aires, Argentina.
Sci Rep. 2019 Mar 8;9(1):3968. doi: 10.1038/s41598-019-40653-z.
Vitamin D deficiency has been related with metabolic alterations in polycystic ovary syndrome (PCOS). As well, hyperactivation of adrenal axis can be programmed early in life and could be related later with PCOS development. Our aim was to establish the relationship between vitamin D and adrenal parameters with metabolic alterations and inflammation markers in PCOS. In 73 patients and 33 controls, 25-hydroxyvitamin D (25-OH-D), total and bioavailable testosterone (TT and bioT), androstenedione (A4), SHBG, cortisol, insulin, and C-reactive protein (hs-CRP) were determined; HOMA and lipid accumulation product (LAP) index were calculated. All parameters were higher in patients than in controls, except for SHBG and 25-OH-D which were lower. Binary regression analysis showed that differences in TT, bioT, A4, insulin and HOMA were independent of body mass index and waist circumference but SHBG, hs-CRP, LAP and 25-OH-D were related to body weight and fat distribution. Binary logistic regression analysis showed that cortisol and 25-OH-D could be associated to PCOS development. Correlations found between LAP and insulin, HOMA and hs-CRP confirm it is a good indicator of metabolic complications. Vitamin D and cortisol association to PCOS development justifies future research to understand the role of vitamin D in PCOS and analyze patient's perinatal history and its possible relationship with hyperactivation of adrenal axis in adult life.
维生素 D 缺乏与多囊卵巢综合征 (PCOS) 的代谢改变有关。此外,肾上腺轴的过度活跃可能在生命早期就被编程,并且可能与 PCOS 的发展有关。我们的目的是确定维生素 D 与肾上腺参数与 PCOS 代谢改变和炎症标志物之间的关系。在 73 名患者和 33 名对照中,测定了 25-羟维生素 D (25-OH-D)、总睾酮和生物可利用睾酮 (TT 和 bioT)、雄烯二酮 (A4)、性激素结合球蛋白 (SHBG)、皮质醇、胰岛素和 C 反应蛋白 (hs-CRP);计算了 HOMA 和脂积聚产物 (LAP) 指数。所有参数在患者中均高于对照组,除了 SHBG 和 25-OH-D 较低。二元回归分析显示,TT、bioT、A4、胰岛素和 HOMA 的差异独立于体重指数和腰围,但 SHBG、hs-CRP、LAP 和 25-OH-D 与体重和脂肪分布有关。二元逻辑回归分析显示,皮质醇和 25-OH-D 可能与 PCOS 的发展有关。LAP 与胰岛素、HOMA 和 hs-CRP 之间的相关性证实它是代谢并发症的一个很好的指标。维生素 D 和皮质醇与 PCOS 发展的相关性证明了未来研究了解维生素 D 在 PCOS 中的作用以及分析患者围产期病史及其与成年期肾上腺轴过度活跃的可能关系的合理性。