Vitamin D, Bone Metabolism, and Fracture Risk in Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among premenopausal women. PCOS may have reproductive, metabolic, cardiovascular, and psychological implications. Vitamin D deficit is often encountered in PCOS women and may contribute to the pathophysiology of this disorder. As of the key role of vitamin D in bone and mineral metabolism, and because the vitamin D status appears to be closely linked with the PCOS manifestations including insulin resistance, obesity, ovulatory and menstrual irregularities, oxidative stress and PTH elevation, hypovitaminosis D may directly and indirectly via the different facets of PCOS impair bone health in these women. Although limited data are available on life-long fracture risk in women with PCOS, the importance of preserving bone health in youth and adults to prevent osteoporosis and related fractures is also recognized in PCOS women. Evidence of the association between vitamin D and the clinical hallmarks of PCOS are summarized and discussed. Vitamin D arises as a cornerstone in women with PCOS and contributes to the pathophysiological link between PCOS and bone metabolism.

Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice

“…However, they indicate that further studies, adjusting for confounding factors, are needed to clarify this possible relationship. In the recent review by Di Bari et al they indicate that there is an association between low 25(OH)D levels and obesity, hyperandrogenism, insulin resistance, and other metabolic dysfunctions related to PCOS [181]. Furthermore, they report that bone health may be influenced by various facets of PCOS, which may result in an increased risk of fracture over time and further exacerbated by hypovitaminosis D, as it is directly and indirectly related to poor bone health in PCOS.…”

Deficiencia de vitamina D y patologías ginecológicas de la mujer en edad reproductiva

“…La eficacia terapéutica de la suplementación de VitD en pacientes con SOPQ ha sido evaluada por varios estudios. La suplementación de VitD y calcio produce normalización de los ciclos menstruales después del inicio del tratamiento (19) . Otro estudio mostró regularización de los ciclos menstruales en la mitad de los casos, así como mejoría de la insulinorresistencia, sin cambios significativos en el IMC (15) .…”

Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

“…Kelly et al analyzed the impact of psychological distress, clinical implication, and treatment interaction, even suggesting the relevance of individualized approaches [9]. Moreover, recent studies explored the significant role of vitamin D and its association with anxious symptoms in postmenopausal women, as well as the predictive role of anxiety in determining a higher fracture risk [35][36][37][38]. Due to several existing therapies [39][40][41][42], which have demonstrated specific efficacy in the treatment of osteoporosis by reducing fracture risk, it could be interesting to investigate, in postmenopausal women, the potential role of psychological features in determining and influencing the osteoporosis treatment response.…”