Effects Of Vitamin D And Its Receptor Gene Polymorphisms On Glucose And Lipid Metabolism In Women With PCOS

ObjectiveTo investigate the relationship between serum vitamin D(VD)level and polymorphism of receptor genes(Fok I,Apa I,Bsm I)and susceptibility to polycystic ovary syndrome(PCOS)and lipid metabolism.To further understand the potential pathogenesis of polycystic ovary syndrome in order to seek better treatment and intervention measures for patients in the future.Materials and methodsIn this study,90 PCOS women and 82 healthy women who visited the Obstetrics and Gynecology Outpatient Center of Taizhou People’s Hospital from January 2022 to December 2022 were selected as controls.According to the inclusion criteria:(1)18years ≤ Age ≤ 35 years;(2)The PCOS group was in accordance with the diagnostic criteria for PCOS established in Rotterdam in 2003.(3)The control group was nonPCOS women who underwent physical examination in the outpatient center of obstetrics and gynecology.They were divided into PCOS group 90 cases and control group 82 cases.Vitamin D levels were detected by enzyme-linked immunoassay,and the polymorphism of vitamin D receptor genes(Fok I,Apa I,Bsm I)was analyzed by polymerase chain reaction(PCR).Meanwhile,glucolipid metabolism and other parameters were detected by chemiluminescence method,and relevant basic data were recorded.Appropriate statistical methods were used to analyze the differences of vitamin D level,frequency distribution of vitamin D receptor gene polymorphism and glycolipid metabolism between PCOS group and control group,and to explore the effects of vitamin D level and receptor gene polymorphism on susceptibility and glycolipid metabolism of polycystic ovary syndrome,and the relationship between vitamin D levels and vitamin D receptor gene polymorphism.Results(1)Analysis showed that FINS(89.19±50.89 VS 71.29±45.32 pmol/l,P=0.016)and HOMA-IR(3.21±2.49 VS 2.60±3.30 pmol/l,P=0.041)in PCOS group were higher than those in control group.The difference was statistically significant.There was no significant difference in FPG levels(5.40±1.39 VS5.23±1.24mmol/l,P > 0.05).The level of LDL-C in PCOS group was higher than that in control group(3.01±0.87 VS 2.74±0.62mmol/l,P=0.023),and the level of HDL-C was lower than that in control group(1.29±0.27 VS 1.37±0.25mmol/l,P=0.030),and the differences were statistically significant.There was no significant difference in TC(4.64±1.19 VS 4.55±0.94mmol/l,P > 0.05)and TG(1.43±0.78 VS 1.44±1.83mmol/l,P > 0.05)between the two groups.(2)There was no significant difference in serum vitamin D level between PCOS group and control group(13.54±4.45 VS 13.57±4.73mmol/l,P=0.030).However,Pearson correlation analysis showed that serum vitamin D was negatively correlated with TG levels(r =-0.294,P < 0.05),and serum vitamin D was negatively correlated with FINS value(r =-0.2593,P < 0.05)in PCOS group.There was no correlation between residual and TC,LDH-C,HDL-C,FPG and HOMA-IR levels.(3)PCR-RFLP method was used to analyze the polymorphism of VDR gene related loci in the two groups.The results showed that compared with the control group,the frequency distribution of VDR Fok I,Apa I and Bsm I loci genotypes in PCOS group had no significant difference(P> 0.05).In the PCOS group,multiple Logstic regression analysis showed that the CC genotype of Fok I at the loci Fok I was associated with a higher frequency of CC genotype compared with CT genotype(OR=0.980,95%CI 0.963-0.996,P<0.05).Compared with CA genotype,the higher HOMR-IR value of CC genotype at locus Apa I,the higher CC genotype frequency was(OR=0.694,95%CI 0.501-0.962,P < 0.05).(4)The current international diagnostic criteria for vitamin D levels are as follows:serum 25(OH)D≤10ng/ml is considered as a serious deficiency;10～20ng/ml is deficient.The analysis showed that the VDR gene locus Fok I polymorphism had statistical significance with serum vitamin D deficiency and severe deficiency group(P=0.032),but there was no statistical difference between the VDR gene locus Apa I and Bsm I polymorphism and serum vitamin D deficiency and severe deficiency group(P > 0.05).The FINS values of CC,CT and TT genotypes at Fok I sites were 61.15±30.35 pmol/l,84.58±50.80 pmol/l and 81.76±50.94 pmol/l,respectively(P=0.046),and the differences between groups were statistically significant.The HDL-C values of the CC,CT and TT genotypes at Fok I sites were1.47±0.28 mmol/l,1.30±0.26 mmol/l and 1.31±0.25 mmol/l,respectively,P=0.024,and the difference between groups was statistically significant.Conclusions(1)Compared with healthy women,PCOS women showed obvious obesity,abnormal sex hormone levels and disorders of glucose and lipid metabolism.(2)There was no correlation between the polymorphism of serum VD and its receptor gene and the susceptibility to PCOS,but the deficiency of serum VD and the polymorphism of VDR gene affected the disorder of glucose and lipid metabolism in PCOS women.(3)Both PCOS women and healthy women had significant vitamin D deficiency,and the degree of deficiency was related to the polymorphism of site FokI.