Abstract

Objective: To compare vitamin D status in, women with PCOS & fertile women without PCOS and its subsequent evaluation.
 Introduction: PCOS is an endocrine disorder of women in reproductive age, characterised by obesity, hyperandrogenaemia and insulin resistance. Women with PCOS tend to be overweight and have increased risk of development of Type II Diabetes and cardiovascular disease. Exact Etiology of PCOS still remain an enigmatic dilemma however various studies conducted till date include diet and lifestyle modification as the key factor to promote health, BMI, reduced hyperinsulinemia and reduce the risk of development of PCOS.
 Main aim of our study was to compare vitamin D status in women having PCOS, with fertile women in a tertiary care hospital in Uttarakhand.
 Methodology: The conducted study was cross sectional, involving the enrolment of 100 women comprising of 50 women with PCOS and 50 fertile women without PCOS. Participants were selected from gynaecological OPD at Shri Mahant Indiresh Hospital, associated with Shri Guru Ram Rai Institute of Medical Sciences, Dehradun from July 2019 to January 2020. The diagnostic criteria of PCOS used was the Rotterdam criteria. The serum 25-hydroxy vitamin D and other metabolic markers were measured. Vitamin D deficiency was defined as serum 25 (OH) D concentrations less than 20 ng/ml measured on an instrument named as miniVidas (BioMerieux, Germany) based on ELFA (enzyme linked fluorescent assay).
 Results: Serum 25-hydroxyvitamin D was significantly lower in women with PCOS compared to fertile controls (p< 0.0001), and the prevalence rates of 25(OH) D deficiency and insufficiency were higher in women with PCOS than in fertile women (p < 0.0001). The study results showed that the prevalence of 25 (OH) D deficiencies in PCOS women was significantly high. Serum 25 (OH) D concentrations were significantly negatively correlated with body mass index (BMI), waist-to-hip ratio (WHR), fasting insulin, total cholesterol and low-density lipoprotein cholesterol (LDL-C), (P < 0.05). In comparison, serum 25 (OH) D concentrations were significantly positively correlated with high-density lipoprotein cholesterol (HDL-C) (P < 0.05). Increased BMI and WHR, high levels of fasting insulin, total cholesterol and LDL-C were regarded as risk factors, but high level of HDL-C was considered to be protective factor of vitamin D deficiency in PCOS women.
 Conclusion: The study demonstrated that women with PCOS have a significantly lower 25(OH) D compared to fertile controls. A compromised vitamin D status in PCOS women is associated with a higher prevalence and metabolic risk of PCOS in women.

Highlights

  • PCOS is an endocrine disorder of women in reproductive age and is the main cause of anovulatory infertility [1]

  • Serum 25-hydroxyvitamin D was significantly lower in women with PCOS compared to fertile controls (p< 0.0001), and the prevalence rates of 25(OH) D deficiency and insufficiency were higher in women with PCOS than in fertile women (p < 0.0001)

  • Serum 25 (OH) D concentrations were significantly negatively correlated with body mass index (BMI), waist-to-hip ratio (WHR), fasting insulin, total cholesterol and low-density lipoprotein cholesterol (LDL-C), (P < 0.05)

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Summary

Introduction

PCOS is an endocrine disorder of women in reproductive age and is the main cause of anovulatory infertility [1]. Various studies have reported low levels of vitamin D in women with PCOS, with average 25-hydroxy vitamin D (25OHD) levels between 11 and 31 ng/ml [7,9,10,8,11,12,13,14,15,16,17]. Vitamin D3 undergoes two successive hydroxylation, the first of which takes place in the liver and is catalysed by vitamin D-25 hydroxylase to form 25OHD. The second hydroxylation step is regulated by parathyroid hormone (PTH) and mediated by 25hydroxyvitamin D3 1a-hydroxylase and occurs predominately in the kidney. This second hydroxylation produces the final active metabolite of vitamin D3, which is 1,25-dihydroxyvitamin D3. This second hydroxylation produces the final active metabolite of vitamin D3, which is 1,25-dihydroxyvitamin D3. 1, 25-dihydroxyvitaminD3 circulates bound to vitamin D-binding protein until it reaches its target tissue where it binds to vitamin D receptors to initiate its effect

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