Abstract
Background: Conflicting evidence supports a role for vitamin D in women with reproductive disorders such as polycystic ovary syndrome (PCOS) but studies on large, unselected populations have been lacking. Methods: We conducted a general population-based study from the prospective Northern Finland Birth Cohort 1966 (NFBC1966). Serum 25-hydroksyvitamin D (25(OH)D) levels were evaluated in women with self-reported PCOS (n = 280) versus non-symptomatic controls (n = 1573) at the age of 31 with wide range of endocrine and metabolic confounders. Results: The levels of 25(OH)D were similar among women with and without self-reported PCOS (50.35 vs. 48.30 nmol/L, p = 0.051). Women with self-reported PCOS presented with a higher body mass index (BMI), increased insulin resistance, and low-grade inflammation and testosterone levels compared to controls. The adjusted linear regression model showed a positive association between total 25(OH)D levels in self-reported PCOS (β = 2.46, 95% confidence interval (CI) 0.84 to 4.08, p = 0.003). The result remained after adjustment for BMI, testosterone, homeostatic model assessment of insulin resistance (HOMA-IR), and high-sensitivity C-reactive protein (hs-CRP) levels. Conclusion: In this population-based setting, PCOS was associated with higher vitamin D levels when adjusting for confounding factors, without distinct beneficial effects on metabolic derangements.
Highlights
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age [1]
For the questionnaire conducted with 31-year-old participants, the existence of polycystic ovary syndrome (PCOS)-related symptoms was ascertained with the following questions: ‘Is your menstrual cycle often over 35 days?’ and ‘Do you have excessive body hair?’ Of those women who answered the questionnaire at the age of 31, 125 (4.2%) women answered ‘Yes’ to both the oligo-amenorrhea and hirsutism questions
Homeostatic model assessment of insulin resistance (HOMA-IR) values were calculated from fasting plasma glucose and serum insulin levels ([fP-Gluc * fS-Ins]/22.5) [34]
Summary
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age [1]. Clinical trials involving vitamin D supplementation in women with PCOS have shown conflicting or weak results in terms of improving insulin sensitivity and other metabolic factors, such as low-grade inflammation and androgen levels [19,20,21,22]. The interpretation of studies is complicated because only a few have assessed the possible presence of the important confounders of vitamin D status, for example, body mass index (BMI), lifestyle, seasonal, and latitudinal effect. The objective of this prospective population-based study, was to evaluate vitamin D status in 31-year-old women with self-reported PCOS symptoms and/or diagnosed PCOS, compared with non-PCOS controls. A comprehensive range of potential confounding factors of vitamin D and PCOS were assessed to test the hypothesis that women with self-reported PCOS are more likely to be vitamin D insufficient than are controls, and that vitamin D levels are negatively associated with BMI in PCOS
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