Vitamin D and metabolic disturbances in polycystic ovary syndrome (PCOS): A cross-sectional study

Objective To compare vitamin D status in women with PCOS versus fertile women and subsequently evaluate the association between vitamin D status and metabolic disturbances in PCOS women. Methods We conducted a cross-sectional comparison study of 639 women with PCOS and 449 fertile women. Serum 25-hydroxyvitamin D (25(OH) D) was stratified into a severe deficient (< 25 nmol/l), insufficient (25-50 nmol/l), moderate (50-75 nmol/l) and adequate (> 75 nmol/l) status. The main outcome measures were the difference in vitamin D status between PCOS and fertile women, and the association between serum 25(OH)D and metabolic disturbances in PCOS women only. Results Serum 25(OH) D was significantly lower in PCOS women compared to fertile controls (mean 25(OH) D of 49.0 nmol/l versus 64.5 nmol/l). An adjusted significant difference was seen between serum 25(OH) D and homeostasis model assessment (HOMA-IR) (beta = 0.76; 95% CI: 0.63-0.91; p < 0.01), HDL-cholesterol (beta = 0.20; 95% CI: 0.05-0.60, p < 0.01) and apolipoprotein A1 (beta = 26.2; 95% CI: 7.5-45.0, p < 0.01) between the highest vitamin D group compared to the lowest vitamin D group. Conclusions This study demonstrates that women with PCOS have a significantly lower serum 25(OH) D compared to fertile controls. A compromised vitamin D status in PCOS women is associated with a higher HOMA- IR and an unfavourable lipid profile. Large randomized controlled trials are necessary to explore the causality of this linkage.