The Research About Vitamin D Levels And Other Indicators Of Patients With Polycystic Ovary Syndrome

Objective:Studying whether the serum vitamin D?VitD?level of patients with polycystic ovary syndrome?PCOS?and women of normal childbearing age have differences,whether the VitD level of PCOS patients related with their sex hormones and insulin resistance.So we can further understand the pathogenesis of PCOS and then provide new ideas for clinical diagnosis and treatment.Method:The subjects were selected from the Affiliated Hospital of Yan'an University,who admitted to the reproductive obstetrics and gynecology,from November2018 to January 2020.According to Rotterdam diagnostic criteria in 2003,136 patients with polycystic ovary syndrome aged 18-35 years were selected as the PCOS group,and62 women of childbearing age with normal ovarian function were selected as the control group.The general information,sex hormones,fasting plasma glucose,fasting insulin,serum calcium ions and serum 25-hydroxyvitamin D₃ levels were collected from the two groups,calculate body mass index?BMI?and insulin resistance index?HOMA-IR?,then compare the difference of serum vitamin D level and other indexes between PCOS patients and women of normal childbearing age.The PCOS group was further grouped according to the characteristics of body mass index?obese,overweight and normal?,the levels of vitamin D,insulin resistance and non-insulin resistance,hyperandrogenism and non-hyperandrogenism.Pearson correlation analysis and multiple linear regression analysis were performed.Compare the correlation between serum vitamin D level and other indicators of two groups.All the data were accurate to 2 decimal places,and using statistical software SPSS 22.0 to analysis.Result:1.Comparison between PCOS group and the control group:There is no significant difference in Age and E₂ between the two groups?P>0.05?.BMI,LH,LH/FSH,T,FPG,FINS and HOMA-IR in the PCOS group are higher than those in the control group,while FSH,serum 25?OH?D₃ and Ca²⁺levels are lower than those in the control group,all differences are statistically significant?P<0.05?.And the proportion of25?OH?D₃ deficiency?<20ng/ml?in the PCOS group is as high as 91.17%,higher than66.13%in the normal control group.The proportion of 25?OH?D₃ severe deficiency?<10ng/ml?in the PCOS group is 43.38%,which is significantly higher than 12.90%in the normal control group,and the differences are statistically significant?P<0.05?.2.Comparison of PCOS group with different BMI:There is no significant difference in Age,FSH,LH,LH/FSH,E₂ and Ca²⁺between the three groups?P>0.05?.The differences of T,FPG,FINS HOMA-IR and serum 25?OH?D₃ level between the three groups are statistically significant?P<0.05?.There is no significant difference in serum25?OH?D₃ level between obese and overweight?P>0.0167?.There are significant differences in the pairwise comparisons of remaining groups?P<0.0167?.To further compare the serum 25?OH?D₃ level between the PCOS group and the control group with different BMI,The difference in serum 25?OH?D₃ levels of overweight and the control group are statistically significant?P<0.05?,while there is no statistical significance in obese?P>0.05?.3.Comparison of PCOS groups with different vitamin D levels:There is no significant difference in Age,FSH,LH,LH/FSH,E₂,FPG and serum Ca²⁺level between the two groups?P>0.05?.BMI,T,FINS and HOMA-IR of the 25?OH?D₃<10ng/ml group are significantly higher than those of the 25?OH?D₃ is 10-20ng/ml group,all with significant difference?P<0.05?.4.Comparison of insulin resistance and non-insulin resistance in PCOS group:There is no significant difference in Age,FSH,LH,LH/FSH,E₂ and Ca²⁺level between the two groups?P>0.05?.Compared with HOMA-IR<2.69 group,BMI and T in the HOMA-IR?2.69 group are increased,serum 25?OH?D₃ level is decreased,all with significant difference?P<0.05?.5.Comparison of hyperandrogenism and non-hyperandrogenism in PCOS group:There is no significant difference in Age,FSH,LH,LH/FSH,E₂ and Ca²⁺level between the two groups?P>0.05?.Compared with T<2.44nmol/L group,BMI,FPG,FINS and HOMA-IR in the T?2.44nmol/L group are increased,serum 25?OH?D₃ level is decreased,all with significant difference?P<0.05?.6.Pearson correlation coefficient analysis of serum 25?OH?D₃ level and other indicators in the PCOS group:Serum 25?OH?D₃ level and BMI?r=-0.71?,T?r=-0.53?,FPG?r=-0.27?,FINS?r=-0.52?and HOMA-IR?r=-0.54?are negatively correlated?P<0.05?,and have no correlation with age,FSH,LH,LH/FSH,E₂ and Ca²⁺levels?P>0.05?.7.Using multiple linear regression analysis in the PCOS group:serum 25?OH?D₃level is used as the dependent variable,and other indicators are used as independent variables,it is found that the serum 25?OH?D₃ level in the PCOS patients have a linear regression relationship with BMI,T and FINS?P<0.05?.Conclusion:1.The serum vitamin D level of the sample population in this research is generally low,but the serum vitamin D level in PCOS patients is significantly lower than that of women of normal reproductive age,and is negatively correlated with BMI,T,FPG,FINS and HOMA-IR.2.The elevation of BMI,T and FINS are risk factors for low vitamin D level in PCOS,individual vitamin D supplementation therapy should be given to PCOS patients with obesity,hyperandrogenism and hyperinsulinemia to improve their insulin resistance and endocrine and metabolic disorders.