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Horm Metab Res 2017; 49(03): 174-179
DOI: 10.1055/s-0043-103573
Review
© Georg Thieme Verlag KG Stuttgart · New York

The Effect of Vitamin D Supplementation on the Androgenic Profile in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Clinical Trials

Maryam Azadi-Yazdi
1   Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2   Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Azadeh Nadjarzadeh
1   Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2   Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
,
Hossein Khosravi-Boroujeni
3   Menzies Health Institute Queensland & School of Medicine, Griffith University, Queensland, Australia
,
Amin Salehi-Abargouei
1   Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2   Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
› Institutsangaben
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Publikationsverlauf

received 29. Juli 2016

accepted 09. Februar 2017

Publikationsdatum:
28. März 2017 (online)

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Abstract

It is suggested that vitamin D status is associated with androgenic profile in women with polycystic ovarian syndrome (PCOS). Although several clinical trials are known in this regard, the results were inconsistent. Therefore, this study was aimed to conduct a systematic review and meta-analysis of published clinical trials to elucidate the possible effect of vitamin D supplementation on the androgen levels in adult females with PCOS. PubMed, SCOPUS, and Google Scholar were searched to identify related articles published up to January 2017. Mean ± standard deviation (SD) of changes in serum total testosterone, sex hormone binding globulin (SHBG), and free testosterone were extracted to calculate Hedges’ g to be used as effect size for meta-analysis. DerSimonian and Liard random effects model was incorporated to summarize the effects. Six clinical trials with 183 participants aged 18–41 years with follow-up period between 3–24 weeks were included. Our analysis revealed that vitamin D supplementation significantly reduces total testosterone (Hedges’ g=−0.32, 95% CI: −0.55 to −0.10; p=0.005); this effect remained significant in single group trials after subgroup analysis. Vitamin D supplementation did not affect serum free testosterone (Hedges’ g=−0.21, 95% CI: −0.44 to 0.079; p=0.08) or SHBG levels (Hedges’ g=0, 95% CI, 0.22–0.22; p=0.98). The present systematic review and meta-analysis revealed that vitamin D supplementation might significantly affect serum total testosterone while it is not effective in improving other markers of androgenic profile. Future double-blind, placebo-controlled clinical trials are highly recommended.

Key words

vitamin D - androgens - polycystic ovary syndrome - systematic review - meta-analysis

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  • References

  • 1 Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE. The androgen excess and pcos society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril 2009; 91: 456-488
    CrossrefPubMedGoogle Scholar
  • 2 Rotterdam E, ASRM-Sponsored P. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod (Oxford, England) 2004; 19: 41
    CrossrefPubMedGoogle Scholar
  • 3 Pugeat M, Crave J, Tourniaire J, Forest M. Clinical utility of sex hormone-binding globulin measurement. Horm Res Paediatr 1996; 45: 148-155
    CrossrefPubMedGoogle Scholar
  • 4 Thomson RL, Spedding S, Buckley JD. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol 2012; 77: 343-350
    CrossrefPubMedGoogle Scholar
  • 5 Yildizhan R, Kurdoglu M, Adali E, Kolusari A, Yildizhan B, Sahin HG, Kamaci M. Serum 25-hydroxyvitamin D concentrations in obese and non-obese women with polycystic ovary syndrome. Arch Gynecol Obstet 2009; 280: 559-563
    CrossrefPubMedGoogle Scholar
  • 6 Hahn S, Haselhorst U, Tan S, Quadbeck B, Schmidt M, Roesler S, Kimmig R, Mann K, Janssen O. Low serum 25-hydroxyvitamin D concentrations are associated with insulin resistance and obesity in women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 2006; 114: 577-583
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 7 Mazloomi S, Sharifi F, Hajihosseini R, Kalantari S, Mazloomzadeh S. Association between hypoadiponectinemia and low serum concentrations of calcium and vitamin D in women with polycystic ovary syndrome. ISRN Endocrinol 2012 Article ID 949427
    PubMed
  • 8 Wehr E, Trummer O, Giuliani A, Gruber H-J, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol 2011; 164: 741-749
    CrossrefPubMedGoogle Scholar
  • 9 Panidis D, Balaris C, Farmakiotis D, Rousso D, Kourtis A, Balaris V, Katsikis I, Zournatzi V, Diamanti-Kandarakis E. Serum parathyroid hormone concentrations are increased in women with polycystic ovary syndrome. Clin Chem 2005; 51: 1691-1697
    CrossrefPubMedGoogle Scholar
  • 10 Li HWR, Brereton RE, Anderson RA, Wallace AM, Ho CK. Vitamin D deficiency is common and associated with metabolic risk factors in patients with polycystic ovary syndrome. Metabolism 2011; 60: 1475-1481
    CrossrefPubMedGoogle Scholar
  • 11 Mahmoudi T, Gourabi H, Ashrafi M, Yazdi RS, Ezabadi Z. Calciotropic hormones, insulin resistance, and the polycystic ovary syndrome. Fertil Steril 2010; 93: 1208-1214
    CrossrefPubMedGoogle Scholar
  • 12 Pal L, Berry A, Coraluzzi L, Kustan E, Danton C, Shaw J, Taylor H. Therapeutic implications of vitamin D and calcium in overweight women with polycystic ovary syndrome. Gynecol Endocrinol 2012; 28: 965-968
    CrossrefPubMedGoogle Scholar
  • 13 Raja-Khan N, Shah J, Stetter CM, Lott ME, Kunselman AR, Dodson WC, Legro RS. High-dose vitamin D supplementation and measures of insulin sensitivity in polycystic ovary syndrome: a randomized, controlled pilot trial. Fertil Steril 2014; 101: 1740-1746
    CrossrefPubMedGoogle Scholar
  • 14 Bonakdaran S, Khorasani ZM, Davachi B, Khorasani JM. The effects of calcitriol on improvement of insulin resistance, ovulation and comparison with metformin therapy in PCOS patients: a randomized placebo-controlled clinical trial. Iran J Reprod Med 2012; 10: 465-472
    PubMedGoogle Scholar
  • 15 Wehr E, Pieber T, Obermayer-Pietsch B. Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in polycystic ovary syndrome women: a pilot study. J Endocrinol Invest 2011; 34: 757-763
    PubMedGoogle Scholar
  • 16 Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996; 17: 1-12
    CrossrefPubMedGoogle Scholar
  • 17 Raja-Khan N, Shah J, Stetter CM, Lott ME, Kunselman AR, Dodson WC, Legro RS. High-dose vitamin D supplementation and measures of insulin sensitivity in polycystic ovary syndrome: a randomized, controlled pilot trial. Fertility and sterility 2014; 101: 1740-1746
    CrossrefPubMedGoogle Scholar
  • 18 Pal L, Berry A, Coraluzzi L, Kustan E, Danton C, Shaw J, Taylor H. Therapeutic implications of vitamin D and calcium in overweight women with polycystic ovary syndrome. Gynecol Endocrinol 2012; 28: 965-968
    CrossrefPubMedGoogle Scholar
  • 19 Bonakdaran S, Mazloom Khorasani Z, Davachi B, Mazloom Khorasani J. The effects of calcitriol on improvement of insulin resistance, ovulation and comparison with metformin therapy in PCOS patients: a randomized placebo- controlled clinical trial. Iran J Reprod Med 2012; 10: 465-472
    PubMedGoogle Scholar
  • 20 Wehr E, Pieber TR, Obermayer-Pietsch B. Effect of vitamin D3 treatment on glucose metabolism and menstrual frequency in polycystic ovary syndrome women: a pilot study. J Endocrinol Invest 2011; 34: 757-763
    PubMedGoogle Scholar
  • 21 Selimoglu H, Duran C, Kiyici S, Ersoy C, Guclu M, Ozkaya G, Tuncel E, Erturk E, Imamoglu S. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010; 33: 234-238
    CrossrefPubMedGoogle Scholar
  • 22 Garg G, Kachhawa G, Ramot R, Khadgawat R, Tandon N, Sreenivas V, Kriplani A, Gupta N. Effect of vitamin D supplementation on insulin kinetics and cardiovascular risk factors in polycystic ovarian syndrome: a pilot study. Endocr Connect 2015; 4: 108-116
    CrossrefPubMedGoogle Scholar
  • 23 DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986; 7: 177-188
    CrossrefPubMedGoogle Scholar
  • 24 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statistics in medicine 2002; 21: 1539-1558
    CrossrefPubMedGoogle Scholar
  • 25 Egger M, Davey Smith G, Schneider M. Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical research ed.). 1997; 315: 629-634
    CrossrefPubMedGoogle Scholar
  • 26 Sterne JA, Egger M, Smith GD. Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ (Clinical research ed.). 2001; 323: 101-105
    CrossrefPubMedGoogle Scholar
  • 27 Jones G, Strugnell SA, De Luca HF. Current understanding of the molecular actions of vitamin D. Physiol Rev 1998; 78: 1193-1231
    PubMedGoogle Scholar
  • 28 Ranjzad F, Mahban A, Shemirani AI, Mahmoudi T, Vahedi M, Nikzamir A, Zali MR. Influence of gene variants related to calcium homeostasis on biochemical parameters of women with polycystic ovary syndrome. J Assist Reprod Genet 2011; 28: 225-232
    CrossrefPubMedGoogle Scholar
  • 29 Mahmoudi T. Genetic variation in the vitamin D receptor and polycystic ovary syndrome risk. Fertil Steril 2009; 92: 1381-1383
    CrossrefPubMedGoogle Scholar
  • 30 Kinuta K, Tanaka H, Moriwake T, Aya K, Kato S, Seino Y. Vitamin D Is an important factor in estrogen biosynthesis of both female and male gonads 1. Endocrinology 2000; 141: 1317-1324
    CrossrefPubMedGoogle Scholar
  • 31 Parikh G, Varadinova M, Suwandhi P, Araki T, Rosenwaks Z, Poretsky L, Seto-Young D. Vitamin D regulates steroidogenesis and insulin-like growth factor binding protein-1 (IGFBP-1) production in human ovarian cells. Horm Metab Res 2010; 42: 754
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 32 Sander VA, Hapon MB, Sícaro L, Lombardi EP, Jahn GA, Motta AB. Alterations of folliculogenesis in women with polycystic ovary syndrome. J Steroid Biochem Mol Biol 2011; 124: 58-64
    CrossrefPubMedGoogle Scholar
  • 33 Panidis D, Balaris C, Farmakiotis D, Rousso D, Kourtis A, Balaris V, Katsikis I, Zournatzi V, Diamanti-Kandarakis E. Serum parathyroid hormone concentrations are increased in women with polycystic ovary syndrome. Clin Chem 2005; 51: 1691-1697
    CrossrefPubMedGoogle Scholar
  • 34 Thys-Jacobs S, Donovan D, Papadopoulos A, Sarrel P, Bilezikian JP. Vitamin D and calcium dysregulation in the polycystic ovarian syndrome. Steroids 1999; 64: 430-435
    CrossrefPubMedGoogle Scholar
  • 35 Lerchbaum E, Giuliani A, Gruber HJ, Pieber TR, Obermayer-Pietsch B. Adult-type hypolactasia and calcium intake in polycystic ovary syndrome. Clin Endocrinol 2012; 77: 834-843
    CrossrefPubMedGoogle Scholar
  • 36 Kinuta K, Tanaka H, Moriwake T, Aya K, Kato S, Seino Y. Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads. Endocrinology 2000; 141: 1317-1324
    CrossrefPubMedGoogle Scholar