Vitamin D predictors in polycystic ovary syndrome: a meta-analysis

Bacopoulou, Flora; Kolias, Evangelia; Efthymiou, Vasiliki; Antonopoulos, Constantine N.; Charmandari, Evangelia

doi:10.1111/eci.12800

Cited by 40 publications

(34 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Moreover, we found no evidence of any interaction between serum 25(OH)D levels and genetic variation in the vitamin D pathway on disease risk. Our finding that vitamin D deficiency associates independently with PCOS risk in women in Pakistan is consistent with reports from other settings including the Netherlands 10 , Iran 16 , Egypt 17 and the USA 18 , as well as with findings from a meta-analysis including these and other studies 19 , showing that mean 25(OH)D level was lower in women with PCOS than controls. The high prevalence of vitamin D deficiency seen among participants in the current study is in keeping with our previous study in Lahore showing a high prevalence of vitamin D deficiency among women of reproductive age 20 .…”

Section: Discussionsupporting

confidence: 91%

Genotype-independent association between vitamin D deficiency and polycystic ovarian syndrome in Lahore, Pakistan

Lone

Riaz

Eusaph³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Both vitamin D deficiency and single nucleotide polymorphisms (SNPs) in the gene encoding the vitamin D receptor (VDR) have been widely reported to associate with susceptibility to polycystic ovarian syndrome (PCOS). A case-control study was conducted to study the influence of vitamin D status and genotpye for 24 SNPs in four genes in the vitamin D pathway (VDR, DBP, CYP27B1, CYP24A1) on PCOS. Statistical analyses were conducted to identify phenotypic and genotypic factors associated with risk of pcoS and to test for interactions between genotype and vitamin D status. pcoS was independently associated with lower age, higher body mass index, lower waist-hip ratio, vitamin D deficiency (serum 25-hydroxyvitamin D concentration <10 ng/mL), lack of outdoor exercise, increased fasting glucose and a family history of PCOS in at least one first degree relative. No statistically significant association was observed between the genotype of any SNP investigated and risk of PCOS, either as a main effect or in interaction with vitamin D status. We report a strong and independent association between vitamin D deficiency and risk of PCOS in Pakistan, that was not modified by genetic variation in the vitamin D pathway.Polycystic ovary syndrome (PCOS) is the most common reproductive, endocrine and metabolic disorder in women of reproductive age 1 . Globally, the prevalence of PCOS ranges from 4 to 21%, as defined using NIH 1990 and Rotterdam 2003 criteria 2 . Epidemiological data from Pakistan are scarce, but the prevalence of PCOS has been reported to be particularly high among women of South Asian ethnic origin 3,4 .PCOS is thought to arise as a result of the interplay between genetic and environmental factors 5 . A growing body of literature indicates that vitamin D deficiency may be a risk factor: meta-analyses of observational studies reveal independent associations between PCOS and low serum concentrations of 25-hydroxyvitamin D (25[OH] D, the major circulating vitamin D metabolite) as well as single nucleotide polymorphisms [SNPs] in the gene encoding the vitamin D receptor (VDR) 6-11 . However, data relating to vitamin D status among women with PCOS in Pakistan are lacking. Moreover, studies in the field have not yet tested for main effects of SNPs in the genes encoding the 1-alpha hydroxylase enzyme CYP27B1 (which converts 25[OH]D to its active metabolite 1,25-dihydroxy vitamin D) or the vitamin D 24-hydroxylase enzyme CYP24A1 (which converts 25[OH]D to its major inactive catabolite 24R,25-dihydroxy vitamin D). Neither have they tested for interactions between SNPs in the vitamin D pathway and vitamin D status in influencing the risk of PCOS.We have previously demonstrated that genetic variation in the vitamin D pathway can modify the influence of vitamin D deficiency and supplementation on clinical phenotype in the context of tuberculosis 12-14 . We, therefore, conducted a case control study in Lahore, Pakistan, to determine whether vitamin D deficiency and SNPs in four vitamin D pathway genes might influence the risk ...

show abstract

Section: Discussionsupporting

confidence: 91%

Genotype-independent association between vitamin D deficiency and polycystic ovarian syndrome in Lahore, Pakistan

Lone

Riaz

Eusaph³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…4–6 Additionally, the vitamin has been implicated in a number of pathologies affecting women, 7,8 including polycystic ovary syndrome (PCOS), 9–11 yet little is known about how it affects androgen homeostasis in premenopausal, eumenorrheic women.…”

mentioning

confidence: 99%

Vitamin D is associated with bioavailability of androgens in eumenorrheic women with prior pregnancy loss

Kuhr

Sjaarda

Alkhalaf

et al. 2018

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

BACKGROUND: Prior studies have reported mixed results regarding relationships between vitamin D, androgens, and sex hormone—binding globulin in patients with polycystic ovary syndrome. However, less is known regarding these associations in eumenorrheic, premenopausal women. OBJECTIVE: Our objective was to study the relationships between serum vitamin D and androgen biomarkers in eumenorrheic women with a history of pregnancy loss who were attempting pregnancy. STUDY DESIGN: This was an analysis of a cohort of 1191 participants from the Effects of Aspirin in Gestation and Reproduction trial (2006e2012). Participants were attempting to conceive, aged 18—40 years, with 1—2 documented prior pregnancy losses and no history of infertility, and recruited from 4 academic medical centers in the United States. Serum vitamin D (25-hydroxyvitamin D) and hormone concentrations were measured at baseline. RESULTS: Vitamin D concentration was negatively associated with free androgen index (percentage change [95% confidence interval, —5% (—8% to —2%)] per 10 ng/mL increase) and positively associated with sex hormone—binding globulin (95% confidence interval, 4% [2—7%]), although not with total testosterone, free testosterone, or dehydroepiandrosterone sulfate after adjusting for age, body mass index, smoking status, race, income, education, physical activity, and season of blood draw. CONCLUSION: Overall, vitamin D was associated with sex hormone—binding globulin and free androgen index in eumenorrheic women with prior pregnancy loss, suggesting that vitamin D may play a role in the bioavailability of androgens in eumenorrheic women. We are limited in making assessments regarding directionality, given the cross-sectional nature of our study.

show abstract

“…Similar vitamin D levels were detected in the present study in PCOS and control participants regardless of the presence of Apa-I SNP. Interestingly, while two meta-analyses [ 5 , 6 ] comprising 3182 and 2262 women respectively showed that serum 25(OH)D concentrations were lower in PCOS compared to controls, the reported standardized mean difference between the groups in both studies seems of little clinical relevance – only 0.74 ng/mL (95%IC: -1.26 to − 0.22) [ 5 ] and 0.64 ng/mL (95%IC: -1.12 to − 0.15) [ 6 ]. In turn, the fact that our PCOS patients with MetS had lower vitamin D levels and higher frequency of CC polymorphism compared to those without MetS suggests that the Apa-I gene variant might impact vitamin D levels in PCOS with MetS.…”

Section: Discussionmentioning

confidence: 99%

“…While its etiology remains unclear, PCOS is considered a polygenic and multifactorial disease, with metabolic, endocrine, and reproductive alterations [ 4 ]. In PCOS women, evidence suggests that vitamin D levels may be decreased and related to hormone and metabolic disturbances [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Apa-I polymorphism in VDR gene is related to metabolic syndrome in polycystic ovary syndrome: a cross-sectional study

Santos

Lecke

Spritzer

2018

Reprod Biol Endocrinol

View full text Add to dashboard Cite

BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine disorder determined by polygenic traits as well as environmental factors. Lower vitamin D levels have been detected in PCOS women and related to hormone and metabolic disturbances. Vitamin D acts in tissues through the vitamin D receptor (VDR). VDR gene variants have been associated with worse metabolic profile in the general population. We investigated the genotype and haplotype distribution of the Bsm-I (rs1544410), Apa-I (rs7975232), and Taq-I (rs731236) VDR gene polymorphisms in PCOS and non-hirsute women from southern Brazil. We further investigated the associations of these gene variants and their haplotypes with PCOS, vitamin D levels, and metabolic abnormalities, including the metabolic syndrome (MetS).MethodsA group of 191 women with PCOS (Rotterdam criteria) and 100 non-hirsute controls with regular ovulatory cycles were genotyped for all polymorphisms by real-time PCR, with allelic discrimination assays. MetS and the cutoffs for its isolated components were defined in accordance with the Joint Scientific Statement.ResultsWomen with PCOS were younger and had significantly higher BMI and total testosterone levels than controls (p < 0.05). The frequency of MetS in PCOS and controls was 26.5% and 4.8% respectively. The CC genotype of Apa-I entailed higher risk of MetS in PCOS (OR: 2.133; 95% CI 1.020–4.464, p = 0.042), and was associated with higher systolic blood pressure (p = 0.009), total cholesterol (p = 0.040), and LDL-cholesterol (p = 0.038) in both PCOS and control groups (two-way ANOVA). The frequencies of VDR haplotypes were similar in PCOS and control women.ConclusionsThe present results suggest that the Apa-I variant in VDR gene may be associated with MetS in southern Brazilian women with PCOS, and with blood pressure, total cholesterol, and LDL-c in women with and without PCOS.

show abstract

Vitamin D predictors in polycystic ovary syndrome: a meta-analysis

Abstract: Serum 25-hydroxyvitamin D may be predicted positively by serum calcium and negatively by luteinising hormone in women with PCOS, and negatively by waist-to-hip ratio and positively by fasting glucose in both PCOS and non-PCOS women, independently of the presence of obesity.

Cited by 40 publications

References 31 publications

Genotype-independent association between vitamin D deficiency and polycystic ovarian syndrome in Lahore, Pakistan

Genotype-independent association between vitamin D deficiency and polycystic ovarian syndrome in Lahore, Pakistan

Vitamin D is associated with bioavailability of androgens in eumenorrheic women with prior pregnancy loss

Apa-I polymorphism in VDR gene is related to metabolic syndrome in polycystic ovary syndrome: a cross-sectional study

Contact Info

Product

Resources

About