Wang Li, Lv Shulan, Li Fen, Yu Xuewen, Bai E, Yang Xiaofeng
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Endocrinol (Lausanne). 2020 Mar 31;11:171. doi: 10.3389/fendo.2020.00171. eCollection 2020.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women at reproductive age, which is characterized by obesity, hyperandrogenemia, and insulin resistance (IR). This study aimed to investigate the vitamin D status, and analyze the relationship between vitamin D deficiency and metabolic risk factors in PCOS women in Shaanxi China. A cross-sectional study included 169 women diagnosed with PCOS and 114 control women without PCOS. The serum 25(OH)D and metabolic markers were measured. Vitamin D deficiency was defined as serum 25(OH)D concentration less than 20 ng/mL. The primary outcome was the difference in vitamin D status between the PCOS and control groups, the secondary outcomes were correlations between serum 25(OH)D concentration and metabolic risk factors in women with PCOS. The serum 25(OH)D concentration was significantly lower in women with PCOS than in controls ( < 0.05), and the prevalence rates of 25(OH)D deficiency and insufficiency were significantly higher in women with PCOS than in controls ( < 0.05). The serum 25(OH)D concentration was significantly lower in PCOS women with obesity or IR than in women without obesity or IR ( < 0.05), and the prevalence of 25(OH)D deficiency in PCOS women with obesity or IR was significantly higher than in women without obesity or IR ( < 0.05). Serum 25(OH)D concentration was significantly negatively correlated with body mass index (BMI), waist-to-hip ratio (WHR), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-sensitivity C-reactive protein (hs-CRP) ( < 0.05). In comparison, serum 25(OH)D concentration was significantly positively correlated with high-density lipoprotein cholesterol (HDL-C) ( < 0.05). Increased BMI and WHR, high levels of fasting insulin, HOMA-IR, total cholesterol, LDL-C and hs-CRP were regarded as risk factors, but high level of HDL-C was considered to be protective factor of vitamin D deficiency in PCOS women. Vitamin D deficiency is prevalent in PCOS women in Shaanxi China, especially in those with obesity and IR. The serum 25(OH)D level was correlated with metabolic risk factors in PCOS women. Multi-center randomized controlled trials with large sample sizes are needed to probe the metabolic effect of vitamin D supplementation in PCOS women.
多囊卵巢综合征（PCOS）是育龄期女性常见的内分泌紊乱疾病，其特征为肥胖、高雄激素血症和胰岛素抵抗（IR）。本研究旨在调查中国陕西PCOS女性的维生素D状况，并分析维生素D缺乏与代谢风险因素之间的关系。一项横断面研究纳入了169例诊断为PCOS的女性和114例无PCOS的对照女性。检测了血清25（OH）D和代谢标志物。维生素D缺乏定义为血清25（OH）D浓度低于20 ng/mL。主要结局是PCOS组和对照组之间维生素D状况的差异，次要结局是PCOS女性血清25（OH）D浓度与代谢风险因素之间的相关性。PCOS女性的血清25（OH）D浓度显著低于对照组（<0.05），PCOS女性25（OH）D缺乏和不足的患病率显著高于对照组（<0.05）。肥胖或IR的PCOS女性血清25（OH）D浓度显著低于无肥胖或IR的女性（<0.05），肥胖或IR的PCOS女性25（OH）D缺乏的患病率显著高于无肥胖或IR的女性（<0.05）。血清25（OH）D浓度与体重指数（BMI）、腰臀比（WHR）、空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、总胆固醇、低密度脂蛋白胆固醇（LDL-C）和高敏C反应蛋白（hs-CRP）显著负相关（<0.05）。相比之下，血清25（OH）D浓度与高密度脂蛋白胆固醇（HDL-C）显著正相关（<0.05）。BMI和WHR增加、空腹胰岛素、HOMA-IR、总胆固醇、LDL-C和hs-CRP水平升高被视为风险因素，但HDL-C水平升高被认为是PCOS女性维生素D缺乏的保护因素。中国陕西的PCOS女性中维生素D缺乏普遍存在，尤其是在肥胖和IR的女性中。PCOS女性的血清25（OH）D水平与代谢风险因素相关。需要开展大样本量的多中心随机对照试验来探究补充维生素D对PCOS女性的代谢影响。
