The influences of vitamin D and omega-3 co-supplementation on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome

Objective: The aim of this study was to evaluate the effect of the co-administration of vitamin D and omega-3 fatty acid on clinical, metabolic and genetic parameters in women with polycystic ovary syndrome (PCOS). Methods: This randomized, double-blinded, placebo-controlled clinical trial was conducted on 60 subjects, aged 18-40 years old with PCOS. Subjects were randomly allocated to take either 50,000 IU vitamin D every 2 weeks plus 2000 mg/day omega-3 fatty acid from fish oil (n=30) or placebo (n=30) for 12 weeks. Gene expression analysis of inflammatory cytokines was conducted on peripheral blood mononuclear cells (PBMCs) of PCOS women using RT-PCR method. Results: Vitamin D and omega -3 fatty acid co-supplementation significantly decreased serum total testosterone levels (-0.2 +/- 0.5 vs. + 0.1 +/- 0.4 ng/mL, P=0.02) compared with the placebo. In addition, vitamin D and omega-3 fatty acid co-supplementation resulted in a significant improvement in beck depression inventory (-1.4 +/- 1.6 vs. -0.5 +/- 0.6, P=0.01), general health questionnaire scores (-4.5 +/- 4.3 vs. -1.9 +/- 2.3, P=0.005) and depression anxiety and stress scale scores (-5.0 +/- 5.1 vs. -2.3 +/- 3.5, P=0.01) compared with the placebo. Additionally, vitamin D and omega-3 fatty acid co-administration significantly decreased serum high-sensitivity C-reactive protein (hs-CRP) (-1.2 +/- 1.9 vs. + 0.1 +/- 0.7 mg/L, P=0.001) and malondialdehyde (MDA) levels (-0.4 +/- 0.4 vs. + 0.2 +/- 0.6 mu mol/L, P<0.001), and significantly increased plasma total antioxidant capacity (TAC) levels (+114.6 +/- 122.2 vs. -2.4 +/- 168.2 mmol/L, P=0.003) compared with the placebo. Results of RT-PCR demonstrated that vitamin D and omega-3 fatty acid co-supplementation significantly downregulated gene expression of interleukin-1 (IL-1) (P=0.03), and upregulated vascular endothelial growth factor (VEGF) (P=0.004) in PBMCs of subjects with PCOS, when compared with placebo. Conclusions: Overall, the co-administration of vitamin D and omega-3 fatty acid for 12 weeks had beneficial effects on mental health parameters, serum total testosterone, hs-CRP, plasma TAC and MDA levels, and gene expression of IL-1 and VEGF among women with PCOS.