The Role of Vitamin D Oral Supplementation in Insulin Resistance in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Karolina Łagowska,Małgorzata Jamka,Joanna Bajerska

doi:10.3390/nu10111637

Karolina Łagowska, Małgorzata Jamka + Show 1 more

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https://doi.org/10.3390/nu10111637

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Abstract

Objective: To evaluate the effect of vitamin D supplementation (alone or with co-supplementation) on insulin resistance in patients with polycystic ovary syndrome (PCOS). Methods: We performed a literature search of databases (Medline, Scopus, Web of Knowledge, Cochrane Library) and identified all reports of randomized controlled trials (RCTs) published prior to April 2018. We compared the effects of supplementation with vitamin D alone (dose from 1000 IU/d to 60,000 IU/week) or with co-supplements to the administration of placebos in women diagnosed with PCOS. The systematic review and meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (Prospero) as number CRD42018090572. Main results: Eleven of 345 identified studies were included in the analysis; these involved 601women diagnosed with PCOS. Vitamin D as a co-supplement was found to significantly decrease fasting glucose concentrations and the HOMA-IR value. HOMA-IR also declined significantly when vitamin D was supplemented with a dose lower than 4000 IU/d. Conclusions: Evidence from RCTs suggests that the supplementation of PCOS patients with continuous low doses of vitamin D (<4000 IU/d) or supplementation with vitamin D as a co-supplement may improve insulin sensitivity in terms of the fasting glucose concentration (supplementation with vitamin D in combination with other micronutrients) and HOMA-IR (supplementation with vitamin D in continuous low daily doses or as co-supplement).

Highlights

Polycystic ovary syndrome (PCOS) is a common endocrine disorder frequently diagnosed among women of reproductive age, and has a prevalence of 5–20% [1,2]
Evidence from randomized controlled trials (RCTs) suggests that the supplementation of PCOS patients with continuous low doses of vitamin D (
We identified publications that describe the effect of vitamin D supplementation on insulin resistance in women with PCOS, without any limitation on the date of study publication or age of study participants

Summary

Introduction

Polycystic ovary syndrome (PCOS) is a common endocrine disorder frequently diagnosed among women of reproductive age, and has a prevalence of 5–20% [1,2]. Most of the evidence shows that insulin resistance appears to potentiate excess androgen production in adolescent and adult PCOS patients. It has been repeatedly indicted that treatment of insulin resistance leads to an improvement in reproductive and metabolic abnormalities, and probably reduces the future risk of developing diabetes and cardiovascular disease in PCOS women [4,5,6,7]. Every action that might reduce hyperinsulinemia and its consequences in PCOS patients should be taken into consideration [5]

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