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维生素D与多囊卵巢综合征:一篇叙述性综述

Vitamin D and Polycystic Ovary Syndrome: a Narrative Review.

作者信息

Mu Yang, Cheng Dan, Yin Tai-Lang, Yang Jing

机构信息

Reproductive Medicine Center, Renmin Hospital of Wuhan University, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan University, Jiefang Road 238, Wuhan, 430060, China.

出版信息

Reprod Sci. 2021 Aug;28(8):2110-2117. doi: 10.1007/s43032-020-00369-2. Epub 2020 Oct 28.

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of reproductive age women and contributes to metabolic dysfunctions including insulin resistance (IR) and dyslipidemia. Vitamin D is a steroid hormone, which is involved in calcium metabolism and bone structure and has a potential role in the prevention of many illnesses, including cancers, autoimmune disorders, hypertension, diabetes, and obesity. Recently, it has been reported that vitamin D deficiency was a common complication of PCOS and vitamin D status was associated with reproductive ability, metabolic alterations, and mental health of PCOS patients. This review summarizes the advances between vitamin D status and the pathophysiological process of PCOS. Vitamin D level was negatively associated with serum androgen level. Vitamin D treatment could reduce serum androgen and anti-MüllerianHormone (AMH) levels, and decrease endometrial thickness, which resulted in improvement of menstrual cycle and folliculogenesis of PCOS patients. Moreover, vitamin D concentrations were negatively correlated with parameters of IR and body fat mass. Vitamin D supplementation has beneficial effects on IR and lipid metabolism. In addition, a positive of vitamin D on mental health of PCOS patients was proposed. Understanding the relationship between vitamin D status and the symptoms of PCOS patients is of great clinical significance to treat and prevent the progression of PCOS.

摘要

多囊卵巢综合征(PCOS)是育龄女性最常见的内分泌疾病之一,会导致包括胰岛素抵抗(IR)和血脂异常在内的代谢功能障碍。维生素D是一种类固醇激素,参与钙代谢和骨骼结构,在预防多种疾病(包括癌症、自身免疫性疾病、高血压、糖尿病和肥胖症)方面具有潜在作用。最近,有报道称维生素D缺乏是PCOS的常见并发症,维生素D状态与PCOS患者的生殖能力、代谢改变和心理健康有关。本综述总结了维生素D状态与PCOS病理生理过程之间的进展。维生素D水平与血清雄激素水平呈负相关。维生素D治疗可降低血清雄激素和抗苗勒管激素(AMH)水平,并减少子宫内膜厚度,从而改善PCOS患者的月经周期和卵泡生成。此外,维生素D浓度与IR参数和体脂量呈负相关。补充维生素D对IR和脂质代谢有有益作用。此外,还提出了维生素D对PCOS患者心理健康有积极作用。了解维生素D状态与PCOS患者症状之间的关系对治疗和预防PCOS的进展具有重要的临床意义。

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