Clinicogenomics Lab, Sir Surendranath Banerjea Advanced Research Centre, Department of Physiology, Surendranath College, University of Calcutta, Kolkata, West Bengal, India.
Department of Gynaecology and Obstetrics, Medical College, Kolkata, West Bengal, India.
F S Sci. 2024 Aug;5(3):252-264. doi: 10.1016/j.xfss.2024.06.002. Epub 2024 Jun 12.
To study the association between altered vitamin D profiles and different indices as well as clinical features of polycystic ovary syndrome (PCOS), including antimüllerian hormone (AMH) levels, phenotypes (A [hyperandrogenism {HA} + ovulatory dysfunction {OD} + polycystic ovarian morphology {PCOM}], B [HA + OD], C [HA + PCOM], and D [OD + PCOM]), insulin resistance, oligomenorrhea, hyperandrogenism, obesity indices, and stress biomarkers in the ethnic population of West Bengal.
Case-control observational study.
Outpatient department of gynecology and obstetrics and environing.
PARTICIPANTS (PATIENTS AND CONTROL): Sample size: case group (PCOS, n = 160), age: 16-38 years, and their gender, age, as well as ethnicity-matched healthy control (n = 160).
INTERVENTION(S): In this observational study, a structured questionnaire for menstrual status and to determine the scores of cutaneous manifestations, a bioelectrical impedance analyzer for measurement of anthropometric indices, relevant biochemical assessments (vitamin D, AMH, insulin, glucose, and other associated hormonal profiles), statistical software for the social sciences, and Microsoft Office Excel were used to evaluate as well as analyze different indices.
MAIN OUTCOME MEASURE(S): Study of the association of vitamin D deficiency with differential manifestations of PCOS such as phenotypes of the syndrome, altered AMH levels, and risk of insulin resistance. An attempt has been made to determine the cutoff value of AMH of the patients with PCOS belonging to the ethnic population of West Bengal using receiver operating characteristic (ROC).
RESULT(S): Vitamin D deficiency was found to be directly correlated with AMH level in PCOS phenotype A (67%), oligomenorrhea, and PCOM, along with a substantial agonistic relationship with insulin resistance in the PCOS population under study. In the PCOS phenotype B, the AMH level was highest, with a cutoff value of 5.27 ng/mL (asymptotic sig. = 0.000, 95% confidence interval: 8.37-9.95, derived by ROC analysis, with area under the ROC curve- area under the curve value = 0.949, sensitivity=0.882, and specificity = 0.880). Oligomenorrhic women with PCOS possess significantly higher values of AMH levels (8.70 ± 3.66 > 3.09 ± 1.86 ng/mL) level than the regular menstrual rhythm within the same group. Patients with PCOS had significantly less skeletal muscle mass and greater subcutaneous fat content than the control group.
CONCLUSION(S): 25-hydroxy-vitamin D might be intermeshed with the underlying pathophysiology and severity of PCOS, as well as associated metabolic disorders like insulin resistance. The AMH level is finely tuned by most of the plausible effectors of PCOS and contends to be a promising biomarker for the diagnosis as well as prognosis of PCOS.
研究维生素 D 谱的改变与多囊卵巢综合征（PCOS）的不同指标和临床特征之间的关联，包括抗缪勒管激素（AMH）水平、表型（A[高雄激素血症{HA}+排卵功能障碍{OD}+多囊卵巢形态{PCOM}]、B[HA+OD]、C[HA+PCOM]和 D[OD+PCOM]）、胰岛素抵抗、稀发排卵、高雄激素血症、肥胖指数和应激生物标志物之间的关系，研究对象为西孟加拉邦的族群。
病例对照观察性研究。
妇产科门诊及周边地区。
参与者（患者和对照组）：样本量：病例组（PCOS，n=160），年龄 16-38 岁，以及他们的性别、年龄和种族匹配的健康对照组（n=160）。
在这项观察性研究中，使用了一个用于月经状况和确定皮肤表现评分的结构化问卷、一个用于测量人体测量指数的生物电阻抗分析仪、相关的生化评估（维生素 D、AMH、胰岛素、葡萄糖和其他相关激素谱）、用于社会科学的统计软件和 Microsoft Office Excel 来评估和分析不同的指标。
研究维生素 D 缺乏与 PCOS 不同表现（如综合征表型、AMH 水平改变和胰岛素抵抗风险）之间的关联。尝试使用受试者工作特征（ROC）分析确定来自西孟加拉邦族群的 PCOS 患者的 AMH 截断值。
在 PCOS 表型 A（67%）、稀发排卵和 PCOM 中，维生素 D 缺乏与 AMH 水平直接相关，并与研究人群中的胰岛素抵抗呈显著的协同关系。在 PCOS 表型 B 中，AMH 水平最高，截断值为 5.27ng/mL（渐近显著=0.000，95%置信区间：8.37-9.95，由 ROC 分析得出，ROC 曲线下面积-曲线下面积值=0.949，敏感性=0.882，特异性=0.880）。患有 PCOS 的稀发排卵妇女的 AMH 水平显著高于同组的正常月经节律（8.70±3.66>3.09±1.86ng/mL）。与对照组相比，PCOS 患者的骨骼肌质量明显减少，皮下脂肪含量明显增加。
25-羟维生素 D 可能与 PCOS 的潜在病理生理学和严重程度以及胰岛素抵抗等相关代谢紊乱有关。AMH 水平受 PCOS 的大多数可能效应因子的精细调节，并被认为是 PCOS 诊断和预后的有前途的生物标志物。
