Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton 3168, Australia.
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton 3168, Australia.
Nutrients. 2020 Apr 26;12(5):1219. doi: 10.3390/nu12051219.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, with hyperandrogenism present in up to 90% of affected women. Some evidence suggests a link between vitamin D deficiency and PCOS features via insulin resistance and inflammation. Our aim was to explore the relationship between biochemical markers of vitamin D status and androgens in women with PCOS. This cross-sectional study used bio-banked samples from 46 pre-menopausal women with PCOS (mean ± SD: age 30 ± 6 years; BMI 29 ± 6 kg/m). We measured 25-hydroxyvitamin D (25[OH]D), vitamin D-binding protein (DBP), total testosterone, sex hormone-binding globulin (SHBG), and calculated the free androgen index (FAI) and bioavailable and free 25(OH)D. Fasting glucose and insulin were used to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) and body fat percentage was determined via dual energy x-ray absorptiometry. High-sensitivity C-reactive protein (hs-CRP) was measured as a marker of inflammation. DBP was positively associated with total 25(OH)D and expectedly, negatively associated with free 25(OH)D. There were no associations between vitamin D metabolites and total testosterone, SHBG or FAI, even after adjusting for age, body fat percentage, HOMA-IR and hs-CRP. We found no associations between vitamin D metabolites and androgens in women with PCOS. Studies that have identified a vitamin D-androgen link have largely relied on methodology with numerous pitfalls; future studies should exclusively use gold-standard measures to confirm these findings in this population.
多囊卵巢综合征（PCOS）是育龄妇女中最常见的内分泌疾病，高达 90%的受影响妇女存在高雄激素血症。一些证据表明，维生素 D 缺乏与 PCOS 特征之间存在联系，这种联系通过胰岛素抵抗和炎症起作用。我们的目的是探讨维生素 D 状态的生化标志物与 PCOS 妇女雄激素之间的关系。这项横断面研究使用了来自 46 名绝经前 PCOS 妇女的生物样本（平均 ± 标准差：年龄 30 ± 6 岁；BMI 29 ± 6kg/m²）。我们测量了 25-羟维生素 D（25[OH]D）、维生素 D 结合蛋白（DBP）、总睾酮、性激素结合球蛋白（SHBG），并计算了游离雄激素指数（FAI）和生物可利用的游离 25(OH)D。空腹血糖和胰岛素用于计算胰岛素抵抗的稳态模型评估（HOMA-IR），并通过双能 X 射线吸收法测定体脂百分比。高敏 C 反应蛋白（hs-CRP）被用作炎症标志物。DBP 与总 25(OH)D 呈正相关，与游离 25(OH)D 呈负相关，这是意料之中的。维生素 D 代谢物与总睾酮、SHBG 或 FAI 之间没有关联，即使在调整年龄、体脂百分比、HOMA-IR 和 hs-CRP 后也是如此。我们在 PCOS 妇女中没有发现维生素 D 代谢物与雄激素之间的关联。已经确定维生素 D-雄激素联系的研究在很大程度上依赖于存在众多缺陷的方法学；未来的研究应专门使用金标准措施来证实这一人群中的这些发现。
