Therapeutic implications of vitamin D and calcium in overweight women with polycystic ovary syndrome

Abstract

Objective To assess effects of vitamin D and Calcium (Ca) on hormonal and metabolic milieu of polycystic ovary syndrome (PCOS) Design Single arm open label trial Methods Twelve overweight and vitamin D deficient women with PCOS underwent a 2 hour oral glucose tolerance testing at baseline and following 3 month supplementation with vitamin D (daily dose of 3533 IU, increased to 8533 IU after the first 5 participants) and 530mg elemental Ca daily. Main Outcome Measures Blood pressure (BP), plasma glucose, insulin, total testosterone (T) androstenedione (A), sex hormone binding globulin, lifestyle parameters were assessed at baseline and following 3 months intervention. Insulin resistance and AUC for glucose and insulin were computed; paired analyses were conducted. Results Improved serum 25OHD (p<0.001) and reductions in total T (p=0.036) and A (p=0.090) levels were noted following 3 month supplementation, compared to baseline. Significant lowering in BP parameters was seen in participants with baseline BP ≥ 120/80 mmHg (n=8) and in those with baseline serum 25OHD ≤ 20ng/ml (n=9). Parameters of glucose homeostasis and insulin resistance remained unchanged (p>0.05). Conclusions Androgen and BP profiles improved followed three month intervention, suggesting therapeutic implications of vitamin D and Ca in overweight and vitamin D deficient women with PCOS.

The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review

“…Ten intervention trials had been carried out and published until our search in January 2013 (30,31,32,33,34,35,36,37,38,39,40). Among these, four had a randomized controlled trial (RCT) design (30,35,36,40), five an open-labeled single-arm design (32,33,37,38,39), and one a case-control study design (31).…”

“…Among these, four had a randomized controlled trial (RCT) design (30,35,36,40), five an open-labeled single-arm design (32,33,37,38,39), and one a case-control study design (31). One RCT carried out by Ardabili et al had a randomized placebo-controlled double-blind study design in which the effect of vitamin D3 supplementation on metabolic parameters and cardiovascular risk factors was evaluated in 50 PCOS women.…”

“…Seven intervention trials examined the effect of vitamin D supplementation on IR and other metabolic characteristics (30,32,33,36,37,39,40). The only randomized placebo-controlled trial that administered vitamin D3 and examined metabolic disturbances as primary prespecified outcomes did not indicate a significant effect on IR after the administration of three oral doses of vitamin D3 in 2 months.…”

“…The other intervention trials yielded conflicting results: Selimoglu et al (37) observed a significant decrease in HOMA-IR after the administration of a single oral dose of 300 000 IU cholecalciferol, whereas the others failed to find a positive effect on IR after the use of different regimens of vitamin D replacement (32,33,36,39).…”

“…Vitamin D status and BMI Data on the association between anthropometric parameters and serum 25OHD were provided in 23 of the 29 reviewed studies (18,19,20,21,22,23,24,26,27,28,29,30,31,32,33,34,36,37,38,39,41,43,45), and nine studies reported these data also for control women (19,20,22,23,24,27,28,41,45). After regression analyses of the weighted means including a total of 2045 PCOS women and 717 control women, BMI appeared to be an independent predictor of serum 25OHD in both PCOS and control women (B 1 ZK4.5, P!0.001 and B 1 ZK8.4, P!0.001; Fig.…”