Abstract
The traditionally recognized role of vitamin D consists in the regulation of bone metabolism and calcium-phosphorus homeostasis but recently a lot of in vitro and in vivo studies recognized several “noncalcemic” effects of vitamin D metabolites. Accumulating evidence suggests that the metabolic pathways of this vitamin may play a key role in the developing of gynaecological/obstetric diseases. VDR-mediated signalling pathways and vitamin D levels seem to (deeply) affect the risk of several gynaecological diseases, such as polycystic ovary syndrome (PCOS), endometriosis, and ovarian and even breast cancer. On the other hand, since also the maternal-fetal unit is under the influence of vitamin D, a breakdown in its homeostasis may underlie infertility, preeclampsia, and gestational diabetes mellitus (GDM). According to our literature review, the relationship between vitamin D and gynaecological/obstetric diseases must be replicated in future studies which could clarify the molecular machineries behind their development. We suggest that further investigation should take into account the different serum levels of this vitamin, the several actions which arise from the binding between it and its receptor (taking into account its possible polymorphism), and finally the interplay between vitamin D metabolism and other hormonal and metabolic pathways.
Highlights
The traditionally recognized role of vitamin D consists in the regulation of bone metabolism and calcium-phosphorus homeostasis but recently a lot of in vitro and in vivo studies recognized several “noncalcemic” effects of vitamin D metabolites [1]
Another study [52] did not find evidence of an association between first-trimester maternal levels of 25(OH)D and subsequent development of gestational diabetes mellitus (GDM). All these results allow us to underline the strict correlation between vitamin D and glucose metabolisms, even if further studies based on larger population are needed to get crystal clear evidence about the topic
A large body of recent evidence suggests that abnormalities of vitamin D levels and its signaling may play a key role in the development of gynecological/obstetric pathologies in various age periods of woman’s life, including selected oncological diseases
Summary
The traditionally recognized role of vitamin D consists in the regulation of bone metabolism and calcium-phosphorus homeostasis but recently a lot of in vitro and in vivo studies recognized several “noncalcemic” effects of vitamin D metabolites [1]. Vitamin D response elements have been identified in numerous genes involved in many activities (i.e., cellular growth, differentiation, apoptosis, invasion and metastasis of tumour cells, and so on) Considering these assumptions, in this paper we aimed to review the most updated evidence which clearly suggests a key role for vitamin D pleiotropic actions in the reproductive physiology as well as development of several gynecologic/obstetric diseases. The conflicting findings might be due to the small sample sizes, the lack of adjustments for confounders, the use of different definitions for PCOS, the use of different assays for serum 25(OH)D measurement, the duration of intervention, the use of different amounts of vitamin D supplementation in the intervention trials, and the lack of an optimal serum 25(OH)D level in the general population They underline that only one well-designed randomized placebo-controlled trial demonstrating no effect of vitamin D3 supplementation on IR has been carried out until now [40]. Until screening women who are at risk of vitamin D deficiency and supplementation with vitamin D could be considered
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