Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 14 , ISSUE 3 ( May-June, 2022 ) > List of Articles

RESEARCH ARTICLE

Effect of Two Different Doses of Vitamin D Supplementation on Clinical, Metabolic, and Hormonal Profiles of Patients with Polycystic Ovary Syndrome (PCOS) with Insulin Resistance: A Randomized Controlled Trial

Anupama Bahadur, Ankita Yadav, Rajlaxmi Mundhra, Latika Chawla, Manisha Naithani, Jaya Chaturvedi

Keywords : Polycystic ovary syndrome, Randomized clinical trial, Vitamin D

Citation Information : Bahadur A, Yadav A, Mundhra R, Chawla L, Naithani M, Chaturvedi J. Effect of Two Different Doses of Vitamin D Supplementation on Clinical, Metabolic, and Hormonal Profiles of Patients with Polycystic Ovary Syndrome (PCOS) with Insulin Resistance: A Randomized Controlled Trial. J South Asian Feder Obs Gynae 2022; 14 (3):307-312.

DOI: 10.5005/jp-journals-10006-2052

License: CC BY-NC 4.0

Published Online: 27-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Objective: The rationale for using vitamin D in polycystic ovary syndrome (PCOS) with insulin resistance women is based on the fact that it reduces insulin resistance. Materials and methods: This was a prospective, open-label, randomized controlled trial involving supplementation of Vitamin D in two different doses in insulin-resistant PCOS women to assess the effects on clinical, metabolic, and hormonal profiles. We recruited 72 women of PCOS aged 20–35 years with HOMA-IR >2.5, Vitamin D levels <20 ng/mL, and BMI <30 kg/m2. Selected patients were randomized in two groups: Patients in group I received tablet Metformin 500 mg twice a day orally along with tablet vitamin D3 1000 IU orally per day for 3 months. Patients in group II received Metformin 500 mg twice a day orally along with tablet vitamin D3 4000 IU orally per day for 3 months. Results: This study showed that vitamin D supplementation in dose of 4000 IU for 12 weeks to insulin-resistant women with PCOS had more beneficial effect on HOMA-IR, mFG score, global acne score, menstrual cycle regularity, BMI, LH levels, LH:FSH ratio, triglyceride levels, DHEAS levels, FBS, PPBS, fasting insulin, and postprandial insulin as compared to vitamin D supplementation in dose of 1000 IU daily for 3 months. Conclusion: As it was a single-center study, results cannot be extrapolated to population as a whole. Major strength was that it was a randomized controlled trial comparing efficacy of both upper and lower limits of vitamin D supplementation in two groups having similar baseline characteristics. However, absence of consensus pertaining to optimal dose of vitamin D warrants need of further intervention trials with larger sample size.


PDF Share
  1. Azziz R, Woods KS, Reyna R, et al. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89(6):2745–2749. DOI: 10.1210/jc.2003-032046.
  2. Gupta T, Rawat M, Gupta N, et al. Study of effect of vitamin D supplementation on the clinical, hormonal and metabolic profile of the PCOS women. J Obstet Gynaecol India 2017;67(5):349–355. DOI: 10.1007/s13224-017-1008-1.
  3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81(1):19–25. DOI: 10.1016/j.fertnstert.2003.10.004.
  4. Badawy S, Weigert J, Marshall L, et al. The relation between obesity and testosteroneestradiol binding globulin levels in polycystic ovarian syndrome (PCO). Diagn Gynecol Obstet 1980;2:43–46. PMID: 7193560.
  5. Dunaif A, Graf M, Mandeli J, et al. Characterization of groups of hyperandrogenic women with acanthosis nigricans, impaired glucose tolerance, and/or hyperinsulinemia. J Clin Endocrinol Metab 1987;65:499. DOI: 10.1210/jcem-65-3-499.
  6. Thomson R, Spedding S, Buckley J. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol 2012;77(3):343–350. DOI: 10.1111/j.1365-2265.2012.04434.x.
  7. Khan H, Kunutsor S, Franco O, et al. Vitamin D, type 2 diabetes and other metabolic outcomes: a systematic review and meta-analysis of prospective studies. Proc Nutr Soc 2013;72(1):89–97. DOI: 10.1017/S0029665112002765.
  8. Krul-Poel Y, Snackey C, Louwers Y, et al. The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review. Eur J Endocrinol 2013;169(6):853–865. DOI: 10.1530/EJE-13-0617.
  9. Alvarez JA, Ashraf A. Role of vitamin D in insulin secretion and insulin sensitivity for glucose homeostasis. Int J Endocrinol 2010;2010:351385. DOI: 10.1155/2010/351385.
  10. Shi H, Norman AW, Okamura WH, et al. 1,25-Dihydroxyvitamin D3 inhibits uncoupling protein 2 expression in human adipocytes. FASEB J 2002;16(13):1808–1829. DOI: 10.1096/fj.02-0255fje.
  11. Dawson-Hughes B, Heaney R, Lips P, et al. Vitamin D round table. In: Dawson-Hughes B, Heaney R, Burckhardt P, editors. Nutritional aspects of osteoporosis. Academic Press: New York; 2004.
  12. Vieth R, Fraser D. Vitamin D insufficiency: no recommended dietary allowance exists for this nutrient. CMAJ 2002;166(12):1541–1542. PMID: 12074121.
  13. Barger-Lux MJ, Heaney RP. Effects of above average summer sun exposure on serum 25-hydroxyvitamin d and calcium absorption. J Clin Endocrinol Metab 2002;87:4952–4956. DOI: 10.1210/jc.2002-020636.
  14. Jamilian M, Foroozanfard F, Rahmani E, et al. Effect of two different doses of vitamin D supplementation on metabolic profiles of insulin-resistant patients with polycystic ovary syndrome. Nutrients 2017;9(12):1280. DOI: 10.3390/nu9121280. PII: E1280.
  15. Wild RA, Vesely S, Beebe L, et al. Ferriman gallwey selfscoring I: performance assessment in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90(7):4112–4114. DOI: 10.1210/jc.2004-2243.
  16. Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermato 1997;36(6): 416–418. DOI: 10.1046/j.1365-4362.1997.00099.x.
  17. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28(7):412–419. DOI: 10.1007/BF00280883.
  18. Selimoglu H, Duran C, Kiyici S, et al. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010;33(4):234–238. DOI: 10.1007/BF03345785.
  19. Kotsa K, Yavropoulou MP, Anastasiou O, et al. Role of vitamin D treatment in glucose metabolism in polycystic ovary syndrome. Fertil Steril 2009;92(3):1053–1058. DOI: 10.1016/j.fertnstert.2008.07.1757.
  20. Firouzabadi RD, Aflatoonian A, Modarresi S, et al. Therapeutic effects of calcium & vitamin D supplementation in women with PCOS. Complement Ther Clin Pract 2012;18(2):85–88. DOI: 10.1016/j.ctcp.2012.01.005.
  21. Garg G, Kachhawa G, Ramot R, et al. Effect of vitamin D supplementation on insulin kinetics and cardiovascular risk factors in polycystic ovarian syndrome: a pilot study. Endocr Connect 2015;4(2):108–116. DOI: 10.1530/EC-15-0001.
  22. Advani K, Batra M, Tajpuriya S, et al. Efficacy of combination therapy of inositols, antioxidants and vitamins in obese and non-obese women with polycystic ovary syndrome: an observational study. J Obstet Gynaecol 2020;40(1):96–101. DOI: 10.1080/01443615.2019.1604644.
  23. Garg R, Malhotra J, Singh S, et al. Relationship between vitamin D and insulin resistance in polycystic ovary syndrome women. J South Asian Feder Obstet Gynaecol 2017;9(3):211–215. DOI: 10.5005/jp-journals-10006-1497.
  24. Madusudhanan RR, Nambisan B, Brahmanandan M, et al. Study on the prevalence and characteristics of metabolic syndrome in women of reproductive age group with polycystic ovarian syndrome. J South Asian Feder Obstet Gynaecol 2017;9(4):341–347. DOI: 10.5005/jp-journals-10006-1526.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.