PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment

Abstract

Recent literature has stressed the importance of vitamin D (VD) in polycystic ovary syndrome (PCOS). Women with PCOS are deficient in VD, particularly those with a higher weight. Hypovitaminosis is a risk factor for glucose intolerance, and reduced levels of VD is associated with insulin resistance and increased diabetes risk. Since women with PCOS and hirsutism seem to have lower levels of VD than women with PCOS without hirsutism, a correlation between VD deficiency and hyperandrogenism may be suggested. Interestingly, VD is crucial for many human physiological functions, including to counteract inflammation and oxidative stress. Some studies evaluated effects of VD supplementation on glucose homeostasis variables, hormonal status, lipid concentrations, and biomarkers of inflammation and oxidative stress among VD-deficient women. Moreover, VD has been shown to play a role in egg quality and fertility. This review aims to show the relationship between VD and the endocrine and metabolic profile of PCOS patients, as well as its implications for their fertility. The supplement of VD to the common therapy can lead to an improvement of the insulin resistance and lipid metabolism, a reduction of circulating androgens, as well as a better response to the induction of ovulation in PCOS women.

Global Transcriptional Profiling of Granulosa Cells from Polycystic Ovary Syndrome Patients: Comparative Analyses of Patients with or without History of Ovarian Hyperstimulation Syndrome Reveals Distinct Biomarkers and Pathways

“…Conditions associated with insulin resistance, such as obesity and diabetes mellitus, are often accompanied by increased adiposity or hyperglycemia [ 44 ]. Obesity and diabetes are independently associated with an altered female reproductive function [ 13 , 45 , 46 ]. Interestingly, a recent study reported that ELOVL5 is involved in embryonic development and lipid metabolism [ 47 ].…”

“…Genome-wide studies in various cells, including granulosa cells from women with PCOS and non-PCOS controls, have revealed several potential genes and pathways, such as the ERK/MAPK and VEGF signaling pathways [ 6 , 11 ]. However, OHSS (and PCOS) has a complex etiology and genetic basis and the disease pathogenesis and mechanism still largely remain unclear [ 5 , 6 , 12 , 13 ]. In this study, we aimed to identify the potentially essential genes and pathways in PCOS patients who would be prone to developing OHSS and to identify potential markers that may be linked to the OHSS and its pathobiology using a transcriptomic approach.…”

Polycystic Ovarian Syndrome (PCOS): Does the Challenge End at Conception?

“…In Europe, the prevalence of GDM is around five percent [ 19 ]. However, the prevalence is steadily increasing, as maternal obesity is a major predisposing factor for GDM, and more women of child-bearing age are overweight or obese [ 20 ]. The risks of GDM include an increased risk of large babies, caesarean sections, birth trauma, still births, and neonatal jaundice.…”

“…It is also thought to increase the risk of future type 2 diabetes. Apart from hyperglycemia, GDM is associated with increased oxidative stress and inflammation in the placenta and fetus [ 20 , 21 ]. GDM also increases trans-placental fatty acid and lipoprotein transport and turnover [ 22 , 23 ].…”

“…Whereas most women can cope with this metabolic adaptation, some develop GDM. Another potential mechanism involved in the association between PCOS and GDM is low vitamin D levels [ 20 ]. Women with PCOS have been found to be deficient in vitamin D, particularly those with a higher weight.…”