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Abstract：
Background Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. It is characterized by dyslipidemia, hormonal imbalances, and metabolic dysfunctions. Vitamin D deficiency may be implicated in the pathogenesis of PCOS, potentially exacerbating its metabolic syndrome. However, the exact interplay between these factors remains underexplored. Aim This study aimed to evaluate serum levels of vitamin D and its association with modalities of PCOS among women with PCOS and healthy controls. Methods This was a hospital-based case-control study where 60 women newly diagnosed with PCOS and 56 non-PCOS controls were consecutively recruited within a 10-month period. The women aged 20-40 were recruited at the gynecology clinics of Lagos State University Teaching Hospital and Lagos Island Maternity Hospital. PCOS was diagnosed using the Rotterdam\'s criteria. The biodata, anthropometry, clinical features, serum vitamin D, cortisol, progesterone, testosterone, estradiol, prolactin, anti-Mullerian hormone (AMH), thyroid-stimulating hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and very-low-density lipoprotein cholesterol (VLDL-C) levels of PCOS-diagnosed women were assessed and compared with those of women without PCOS. The exclusion criteria comprised known diabetics, women with gynecological pathologies such as fibroids, and women on medications affecting the study analytes or hormones. Statistical analyses included chi-square or Fisher\'s exact tests for categorical variables, student t-test for continuous variables, and Pearson\'s correlation for assessing relationships between continuous variables. The significance level was set at p<0.05 and a confidence interval of 95%. Results Individuals with PCOS exhibited a younger mean age (26.90±3.73 versus 29.95±5.00 years, p=0.001) and a higher prevalence of irregular menstrual patterns (46.7% versus 14.3%, p=0.0001) and acne (58.3% versus 37.5%, p=0.025). Moreover, PCOS was associated with elevated levels of TC (p = 0.03), TG (p = 0.03), LDL-C (p = 0.014), FBG (p = 0.001), LH:FSH ratio (p = 0.002), AMH (p = 0.0001), and testosterone (p = 0.003), but low progesterone (p = 0.001) and vitamin D (p = 0.033), alongside a higher incidence of vitamin D deficiency (33.3% versus 26.1%) and insufficiency (66.7% versus 56.5%). Additionally, significant but weak correlations were observed between serum vitamin D levels and waist-hip ratio (r = 0.4, p = 0.016) and FBG (r = -0.4, p = 0.036) in the PCOS group, suggesting potential metabolic implications. Conclusion The PCOS subjects in this study had decreased vitamin D and progesterone levels, with elevated concentrations of testosterone, AMH, lipid profile (TC, LDL, and TG), FBG, and LH:FSH ratio. Studies on the therapeutic effect of vitamin D administration in managing PCOS will need to be further evaluated.
摘要：
背景多囊卵巢综合征（PCOS）是一种常见的影响育龄妇女的内分泌疾病。它的特点是血脂异常，荷尔蒙失衡,和代谢功能障碍。维生素D缺乏可能与PCOS的发病机制有关,可能加剧其代谢综合征。然而,这些因素之间的确切相互作用仍未得到充分探索。目的本研究旨在评估PCOS女性和健康对照者的血清维生素D水平及其与PCOS模式的关系。方法这是一项基于医院的病例对照研究，在10个月内连续招募60名新诊断为PCOS的妇女和56名非PCOS对照。在拉各斯州立大学教学医院和拉各斯岛妇产医院的妇科诊所招募了20-40岁的妇女。使用鹿特丹标准诊断PCOS。生物数据，人体测量学,临床特征,血清维生素D,皮质醇,黄体酮,睾丸激素，雌二醇,催乳素,抗苗勒管激素（AMH），促甲状腺激素,卵泡刺激素（FSH），黄体生成素(LH),胰岛素，空腹血糖（FBG），总胆固醇(TC),高密度脂蛋白胆固醇（HDL-C），低密度脂蛋白胆固醇（LDL-C），甘油三酯（TG），对诊断为PCOS的女性的极低密度脂蛋白胆固醇(VLDL-C)水平进行了评估,并与无PCOS的女性进行了比较.排除标准包括已知的糖尿病患者，患有子宫肌瘤等妇科疾病的妇女，和影响研究分析物或激素的药物的妇女。统计分析包括分类变量的卡方检验或Fisher精确检验，连续变量的学生t检验，和皮尔逊相关性，用于评估连续变量之间的关系。显著性水平设定为p<0.05,置信区间为95%。结果PCOS患者的平均年龄较年轻（26.90±3.73对29.95±5.00岁，p=0.001）和月经不调的患病率较高（46.7％对14.3％，p=0.0001)和痤疮(58.3%对37.5%，p=0.025)。此外，PCOS与TC水平升高相关(p=0.03),TG（p=0.03），LDL-C（p=0.014），FBG（p=0.001），LH：FSH比值（p=0.002），AMH（p=0.0001），和睾酮（p=0.003），但低孕酮（p=0.001）和维生素D（p=0.033），此外，维生素D缺乏（33.3%对26.1%）和维生素D缺乏（66.7%对56.5%）的发生率更高。此外,在PCOS组中，血清维生素D水平与腰臀比（r=0.4，p=0.016）和FBG（r=-0.4，p=0.036）之间存在显著但弱相关性，提示潜在的代谢影响。结论本研究中PCOS受试者维生素D和孕酮水平降低,睾酮浓度升高，AMH,血脂谱（TC，LDL,和TG），FBG,和LH：FSH比率。关于维生素D在管理PCOS中的治疗效果的研究将需要进一步评估。
