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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 272-276    DOI: 10.31083/j.ceog.2020.02.5248
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The effect of correction of serum level of vitamin D on hyperandrogenism in women with polycystic ovary syndrome and hypovitaminosis D
A. M. Maysara1, *(), A. T. Nassar2, H. K. Jubran3
1Department of Obstetrics & Gynecology, College of Medicine- University of Basra, Iraq
2AI Faiha Specialized Diabetes, Endocrine and Metabolic Centre, Iraq
3Department of Clinical Pharmacy, College of Pharmacy, University of Basra, Iraq
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Abstract  Background: Polycystic ovary syndrome (PCOS) is a common condition among female of reproductive age. Vitamin D may involve in the pathogenesis of PCOS. Vitamin D deficiency may exacerbate the symptom of PCOS through precipitating insulin resistance, menstrual irregularities, subfertility, hyperandrogenism, and cardiovascular dysfunction. Aim: The aim of the study is to determine whether normalization of vitamin D level in women with PCOS and hyperandrogenism (clinical and/or biochemical) would result in improvement in the parameters of hyperandrogenism. Materials and Methods: One hundred one women with PCOS and vitamin D deficiency were involved in the study, BMI, and Gallwey-Ferriman score were estimated, 25 (OH) vitamin D, total testosterone, sex hormone binding globulin (SHBG), follicular stimulating hormone (FSH), and luteinizing hormone (LH) were measured and pelvic ultrasound was performed. Forty-nine of these women received weight reduction and lifestyle modification advice and metformin only, while the remaining 52 women received vitamin D in addition, after six months all parameters were re-examined. Results: Adding vitamin D did not result in significant reduction in the Ferriman-Gallwey score or in total testosterone level, also normalization of vitamin D had insignificant effect on the level of sex hormone binding globulin and ovarian polycystic morphology, however it was associated with significant reduction in LH level. Conclusion: Despite the fact that correction of vitamin D deficiency is important for general health, however it is of limited beneficial effect on the biochemical and clinical parameters of hyperandrogenism in women with PCOS.
Key words:  Vitamin D      Hyperandrogenism      Polycystic ovary syndrome     
Published:  15 April 2020     
*Corresponding Author(s):  A. M. Maysara     E-mail:  Maysaram1979@gmail.com
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A. M. Maysara, A. T. Nassar, H. K. Jubran. The effect of correction of serum level of vitamin D on hyperandrogenism in women with polycystic ovary syndrome and hypovitaminosis D. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 272-276.

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https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5248     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/272

Table 1  — General characteristic of the patients at the beginning of the study in both groups.
Group 1 (n=52) Group 2 (n=49) p
Mean ± SD Mean ± SD
Age (years) 23.12 5.78 24.71 6.25 0.060
BMI (kg/m2) 32.05 13.01 30.84 6.75 0.422
FGS 24.92 7.05 25.59 6.99 0.633
Serum Vit. D (ng/dl) 13.8 4.78 14.1 5.21 0.764
TT (ng/dl) 55.70 16.86 52.45 25.53 0.450
SHBG (nmol/L) 33.09 22.72 37.08 20.92 0.282
LH (IU/L) 12.07 5.52 11.80 8.14 0.846
FSH (IU/L) 5.25 2.37 4.89 2.39 0438
LH/FSH ratio 2.78 1.65 2.77 2.21 0.984
Table 2  — Comparison of clinical and biochemical parameters of hyperandrogenism between both groups after treatment.
Group 1 Group 2 p
Mean ±SD Mean ±SD
FGS 11.94 5.67 15.63 8.03 0.009
FGS reduction 12.98 6.17 10.69 5.40 0.083
TT 46.12 14.00 34.12 22.32 0.002
TT reduction 12.12 17.75 11.33 24.45 0.852
SHBG 56.13 33.92 52.48 39.42 0.618
SHBG elevation 23.04 20.72 14.68 35.78 0.151
LH 5.96 1.79 8.23 6.69 0.020
FSH 5.38 1.77 6.16 5.71 0.351
LH/FSH ratio 1.24 0.58 1.46 0.94 0.161
LH/FSH ratio reduction 1.54 1.53 1.32 2.24 0.555
Table 3  — Frequency and percentage of normalization of FGS, TT, LH/FSH ratio, and polycystic changes at the end of the study.
Group 1 n = 52 Group 2 n = 49 OR 95% CI p
n % n % Lower Upper
FGS <= 8 12 23.1 9 18.4 1.33 0.51 3.51 0.369
TT < 50 32 61.5 39 79.6 0.41 0.17 1.00 0.038
LH/FSH ratio < 2 46 88.5 36 73.5 1.77 0.79 3.97 0.047
Polycystic changes No 33 63.5 31 63.5 1.01 0.45 2.27 0.574
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