scholarly journals The Effect of Vitamin D3 and Co-enzyme Q10 Supplementation on Metabolic Biomarkers in Women with Clomiphene Citrate Resistant Polycystic Ovary Syndrome

2018 ◽  
pp. 142-150
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Vitamin D3 ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Vitamin D Status ◽  
Ovary Syndrome ◽  
Metabolic Biomarkers

Polycystic ovary syndrome (PCOS) one of the most common endocrine disorders in women of reproductive age, the pathogenesis of PCOS imitated to be as a vicious cycle involving both hyperandrogenaemia and insulin resistance/hyperinsulinemia. Vitamin D deficiency (VDD) is common among women with PCOS (approximately 67%–85% women with PCOS have VDD). Vitamin D3 and CoQ10 could affect glucose metabolism and insulin sensitivity and improve metabolic abnormalities in PCOS. The study was designed to evaluate the effect of combining oral vitamin D3 tablet or CoQ10 capsule with clomiphene citrate on metabolic biomarkers in women with clomiphene citrate resistance PCOS patients. A prospective interventional randomized-controlled, open-label study include 41 PCOS patients aged range (18-34)years who are clomiphene citrate resistant divided into two groups, group 1 (n=24) whose endogenous vitamin D status less than 20ng/ml receive clomiphene citrate 100mg daily(for 5 days monthly induction) plus vitamin D 10000IU daily (2 months) and group 2 (n=17) whose endogenous vitamin D status equal or more than 20ng/ml receive clomiphene citrate 100mg daily(for 5 days monthly induction) plus CoQ10 200mg daily (2 months). Fasting blood samples were taken at baseline and 2 months after intervention to measure metabolic biomarkers [fasting serum insulin (FSI), fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI)]. After 2 months both interventions result in non-significant change in FSI and FBG while HOMA-IR and QUICKI decreased by both interventions, but the decrease is significant only with CoQ10 supplementations. In conclusion, Vitamin D and CoQ10 supplementation result in improvement in HOMA-IR and QUICKI but the improvement was more obvious in CoQ10 group.

scholarly journals Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome

2011 ◽  
Vol 164 (5) ◽  
pp. 741-749 ◽  
Author(s):  
Elisabeth Wehr ◽  
Olivia Trummer ◽  
Albrecht Giuliani ◽  
Hans-Jürgen Gruber ◽  
Thomas R Pieber ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Oral Glucose ◽  
Model Assessment ◽  
Ovary Syndrome ◽  
Vitamin D Metabolism ◽  
Endocrine Parameters

IntroductionWomen with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances including insulin resistance (IR), which might be related to vitamin D metabolism. We aimed to investigate the association of polymorphisms in the vitamin D receptor (VDR) gene as well as vitamin D level-associated genes with metabolic and endocrine parameters in PCOS women. Moreover, we examined whether there are associations with PCOS susceptibility.MethodsMetabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed in 545 PCOS and 145 control women. Genotyping of VDR (Cdx2, Bsm-I, Fok-I, Apa-I, and Taq-I), GC, DHCR7, and CYP2R1 polymorphisms was performed.Results25-Hydroxyvitamin D (25(OH)D) levels showed significant negative correlation with IR and positive correlation with insulin sensitivity (P<0.05 for all) in PCOS women. In PCOS women, the VDR Cdx2 ‘AA’ genotype was associated with lower fasting insulin (P=0.039) and homeostatic model assessment-IR (P=0.041) and higher quantitative insulin-sensitivity check index (P=0.012) and MATSUDA index (P=0.003). The VDR Apa-I ‘AA’ genotype was associated with lower testosterone (P=0.028) levels. In PCOS women, 170 women (31.2%) presented with 25(OH)D levels <20 ng/ml. PCOS women carrying the GC ‘GG’ genotype and the DHCR7 ‘GG’ genotype had a significantly higher risk for 25(OH)D levels <20 ng/ml (OR 2.53 (1.27–5.06), P=0.009, and OR 2.66 (1.08–6.55), P=0.033 respectively) compared with PCOS women carrying the GC ‘TT’ genotype and DHCR ‘TT’ genotype in multivariate analyses. We observed no association of genetic variations and PCOS susceptibility.ConclusionVDR and vitamin D level-related variants are associated with metabolic and endocrine parameters including 25(OH)D levels in PCOS women.

scholarly journals The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review

2013 ◽  
Vol 169 (6) ◽  
pp. 853-865 ◽  
Author(s):  
Y H M Krul-Poel ◽  
C Snackey ◽  
Y Louwers ◽  
P Lips ◽  
C B Lambalk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Vitamin D Status ◽  
Regression Analyses ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Weighted Means

ContextMetabolic disturbances, in particular, insulin resistance (IR) and dyslipidemia, are common in women suffering from polycystic ovary syndrome (PCOS). Evidence is accumulating that vitamin D status may contribute to the development of metabolic disturbances in PCOS.ObjectiveThe aim of this study was to carry out a systematic review addressing the association between vitamin D status, vitamin D receptor polymorphisms, and/or polymorphisms related to vitamin D metabolism and metabolic disturbances in women with PCOS.Design and methodsA systematic search of electronic databases was carried out up to January 2013 for observational studies and clinical trials in women suffering from PCOS with outcome measures that were related to vitamin D status. We conducted univariate and multivariate regression analyses of the weighted means to gain insights into the association between vitamin D, BMI, and IR based on existing literature.ResultsWe found 29 eligible trials with inconsistency in their results. One well-designed randomized controlled trial has been carried out until now. Univariate regression analyses of the weighted means revealed vitamin D to be a significant and independent predictor of IR in both PCOS and control women. The significance disappeared after adjustment for BMI in PCOS women.ConclusionsCurrent evidence suggests an inverse association between vitamin D status and metabolic disturbances in PCOS. Owing to the heterogeneity of the studies, it is hard to draw a definite conclusion. The causal relationship between vitamin D status and metabolic disturbances in PCOS remains to be determined in well-designed placebo-controlled randomized clinical trials.

scholarly journals Hyperandrogenism and Insulin Resistance, Not Changes in Body Weight, Mediate the Development of Endothelial Dysfunction in a Female Rat Model of Polycystic Ovary Syndrome (PCOS)

Endocrinology ◽  
2015 ◽  
Vol 156 (11) ◽  
pp. 4071-4080 ◽  
Author(s):  
Amanda Hurliman ◽  
Jennifer Keller Brown ◽  
Nicole Maille ◽  
Maurizio Mandala ◽  
Peter Casson ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Weight ◽  
Weight Gain ◽  
Insulin Sensitivity ◽  
Endothelial Dysfunction ◽  
Polycystic Ovary Syndrome ◽  
Rat Model ◽  
Polycystic Ovary ◽  
Phase 1 ◽  
Ovary Syndrome

This study was designed to differentiate the contributions of hyperandrogenism, insulin resistance (IR), and body weight to the development of endothelial dysfunction in polycystic ovary syndrome and determine the effectiveness of insulin sensitization and antiandrogenic therapy after the establishment of vascular and metabolic dysfunction using a rat model of polycystic ovary syndrome. We hypothesized that the observed endothelial dysfunction was a direct steroidal effect, as opposed to changes in insulin sensitivity or body weight. Prepubertal female rats were randomized to the implantation of a pellet containing DHT or sham procedure. In phase 1, DHT-exposed animals were randomized to pair feeding to prevent weight gain or metformin, an insulin-sensitizing agent, from 5 to 14 weeks. In phase 2, DHT-exposed animals were randomized to treatment with metformin or flutamide, a nonsteroidal androgen receptor blocker from 12 to 16 weeks. Endothelial function was assessed by the vasodilatory response of preconstricted arteries to acetylcholine. Serum steroid levels were analyzed in phase 1 animals. Fasting blood glucose and plasma insulin were analyzed and homeostasis model assessment index calculated in all animals. Our data confirm the presence of endothelial dysfunction as well as increased body weight, hypertension, hyperinsulinemia, and greater IR among DHT-treated animals. Even when normal weight was maintained through pair feeding, endothelial dysfunction, hyperinsulinemia, and IR still developed. Furthermore, despite weight gain, treatment with metformin and flutamide improved insulin sensitivity and blood pressure and restored normal endothelial function. Therefore, the observed endothelial dysfunction is most likely a direct result of hyperandrogenism-induced reductions in insulin sensitivity, as opposed to weight gain.

scholarly journals Association of Androgen Excess with Glucose Intolerance in Women with Polycystic Ovary Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Bingjie Zhang ◽  
Jing Wang ◽  
Shanmei Shen ◽  
Jiayi Liu ◽  
Jie Sun ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Glucose Intolerance ◽  
Cell Function ◽  
Polycystic Ovary ◽  
Sensitivity Index ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Family History Of Diabetes

Women with polycystic ovary syndrome (PCOS) show high prevalence of glucose intolerance. This study aimed to investigate the association of androgen excess with glucose intolerance in PCOS. A total of 378 women with PCOS participated in the study. Free androgen index (FAI) was selected as indicator of hyperandrogenism. Insulin sensitivity was assessed by 1/homeostasis model assessment of insulin resistance (1/HOMA-IR) and Matsuda insulin sensitivity index (ISIM); β-cell function was assessed by disposition index (DI). We found that women with glucose intolerance had higher FAI levels compared to women with normal glucose tolerance (NGT) (prediabetes 6.2, T2DM 7.9 versus NGT 5.0, resp.; p<0.001). Furthermore, there was a direct association between FAI levels and frequency of glucose intolerance (OR = 2.480, 95% CI 1.387–4.434), even after adjusting for age, BMI, waist circumference, hypertension, fasting insulin, testosterone, SHBG, and family history of diabetes. In addition, with FAI increase, glycosylated hemoglobin (HbA1c), plasma glucose concentrations, and serum insulin levels increased, while insulin sensitivity and β-cell function decreased. Our results suggested that androgen excess indicated by high FAI levels might serve as indicator of glucose intolerance, as it might promote insulin resistance and β-cell dysfunction in women with PCOS.

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