Abstract
Vitamin D deficiency (VDD) is common in women with and without polycystic ovary syndrome (PCOS) and may be associated with metabolic and endocrine disorders in PCOS. The aim of this meta-analysis is to assess the associations of serum vitamin D levels with metabolic and endocrine dysregulations in women with PCOS, and to determine effects of vitamin D supplementation on metabolic and hormonal functions in PCOS patients. The literature search was undertaken through five databases until 16 January 2015 for both observational and experimental studies concerning relationships between vitamin D and PCOS. A total of 366 citations were identified, of which 30 were selected (n = 3182). We found that lower serum vitamin D levels were related to metabolic and hormonal disorders in women with PCOS. Specifically, PCOS patients with VDD were more likely to have dysglycemia (e.g., increased levels of fasting glucose and homeostatic model assessment-insulin resistance index (HOMA-IR)) compared to those without VDD. This meta-analysis found no evidence that vitamin D supplementation reduced or mitigated metabolic and hormonal dysregulations in PCOS. VDD may be a comorbid manifestation of PCOS or a minor pathway in PCOS associated metabolic and hormonal dysregulation. Future prospective observational studies and randomized controlled trials with repeated VDD assessment and better characterization of PCOS disease severity at enrollment are needed to clarify whether VDD is a co-determinant of hormonal and metabolic dysregulations in PCOS, represents a consequence of hormonal and metabolic dysregulations in PCOS or both.
Highlights
Polycystic ovary syndrome (PCOS) [1] is the most common female endocrine disorder, affecting approximately 4%–18% women of reproductive age [2,3,4,5]
A meta-analysis conducted by Moran et al demonstrated that PCOS is associated with a higher prevalence of impaired glucose tolerance (OR: 2.48; 95% confidence intervals (CIs): 1.63 to 3.77), type 2 diabetes mellitus (OR: 4.43; 95% CI: 4.06 to 4.82), and metabolic syndrome (OR: 2.88; 95% CI: 2.40 to 3.45) [80]
If Vitamin D deficiency (VDD) were causally related to PCOS and the subsequent development of metabolic and hormonal dysfunction in PCOS, vitamin D supplementation would be a promising alternative for the prevention and treatment of PCOS
Summary
Polycystic ovary syndrome (PCOS) [1] is the most common female endocrine disorder, affecting approximately 4%–18% women of reproductive age [2,3,4,5] It is a heterogeneous androgen excess disorder with different degrees of reproductive and metabolic dysfunctions. Positive associations of VDD with some well-known comorbidities of PCOS including type 2 diabetes, insulin resistance, metabolic syndrome, and cardiovascular diseases, are reported [17,18,19,20]. In this regard, an increasing number of studies have been conducted to investigate the specific relationship between vitamin D status and PCOS. Several studies have suggested that lower vitamin D levels are associated with increased risk of insulin resistance and metabolic disturbance among women with PCOS [21,22], the current findings are inconsistent
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