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补充维生素D可改善多囊卵巢综合征患者的代谢功能障碍:随机对照试验的系统评价及潜在机制探讨

Vitamin D Supplementation Ameliorates Metabolic Dysfunction in Patients with PCOS: A SystematicReview of RCTs and Insight into the Underlying Mechanism.

作者信息

Guo Shan, Tal Reshef, Jiang Haoyu, Yuan Tao, Liu Ying

机构信息

Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06510, USA.

出版信息

Int J Endocrinol. 2020 Dec 19;2020:7850816. doi: 10.1155/2020/7850816. eCollection 2020.

Abstract

OBJECTIVE

Evidence suggests that vitamin D deficiency correlated with metabolic disorders in women with polycystic ovary syndrome (PCOS). We conducted this systematic review and meta-analysis to evaluate the impact of vitamin D supplementation alone on glucose, lipid, and androgen parameters and inflammation biomarkers in women with PCOS.

METHODS

Literature research was conducted in Pubmed, Embase, Web of Science, Clinical Trials, and Cochrane Library to identify relevant randomized controlled trials (RCTs) up to March 2020. The effect of vitamin D supplementation alone on women with PCOS was compared with administration of placebo. The systematic review and meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (Prospero) as number CRD42020157444.

RESULTS

Thirteen randomized controlled trials with 824 patients in total were included. Serum FPG, fasting insulin, HOMA-IR, and VLDL-C were significantly decreased in the vitamin D group versus placebo. Vitamin D supplementation group also showed a significantly elevated level of QUICKI. No significant impact was seen on serum triglyceride, total-C, LDL-C, HDL-C, total testosterone, DHEAS, SHBG, or hs-CRP. Subgroup analysis demonstrated that oral vitamin D intake had significantly decreased serum triglyceride and total-C level in women with PCOS who have vitamin D deficiency (serum vitamin  < 20 ng/ml).

CONCLUSION

The findings of the present meta-analysis indicate that vitamin D supplementation exerted favorable effects among women with PCOS on glucose metabolism and lipid metabolism, especially in vitamin D deficient women, but had no significant effect on the androgenic profile or inflammation status.

摘要

目的

有证据表明,维生素D缺乏与多囊卵巢综合征(PCOS)女性的代谢紊乱相关。我们进行了这项系统评价和荟萃分析,以评估单独补充维生素D对PCOS女性的血糖、血脂、雄激素参数和炎症生物标志物的影响。

方法

在PubMed、Embase、Web of Science、Clinical Trials和Cochrane图书馆进行文献研究,以识别截至2020年3月的相关随机对照试验(RCT)。将单独补充维生素D对PCOS女性的效果与给予安慰剂进行比较。该系统评价和荟萃分析方案已在国际前瞻性系统评价注册库(Prospero)中注册,编号为CRD42020157444。

结果

共纳入13项随机对照试验,总计824例患者。与安慰剂组相比,维生素D组的血清空腹血糖(FPG)、空腹胰岛素、稳态模型评估胰岛素抵抗(HOMA-IR)和极低密度脂蛋白胆固醇(VLDL-C)显著降低。补充维生素D组的定量胰岛素敏感性检查指数(QUICKI)水平也显著升高。对血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总睾酮、硫酸脱氢表雄酮(DHEAS)、性激素结合球蛋白(SHBG)或超敏C反应蛋白(hs-CRP)未观察到显著影响。亚组分析表明,口服维生素D摄入可使维生素D缺乏(血清维生素D<20 ng/ml)的PCOS女性的血清甘油三酯和总胆固醇水平显著降低。

结论

本荟萃分析的结果表明,补充维生素D对PCOS女性的糖代谢和脂代谢具有有益作用,尤其是在维生素D缺乏的女性中,但对雄激素水平或炎症状态无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4197/7773476/ffbda9052cfe/IJE2020-7850816.001.jpg

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