Avaliação dos níveis séricos de vitamina D e fatores associados à Sindrome dos Ovários Policísticos

Abstract

Polycystic ovarian syndrome (PCOS) is considered the most common endocrinopathy in the reproductive phase of women, with a prevalence of up to 26%, as well as being the major cause of infertility among women. Evidence suggests that vitamin D deficiency has been associated with fertility, adipogenesis, insulin resistance, diabetes and obesity which may be primary factors in the development of PCOS. The objective of this study was to evaluate the relationship between serum vitamin D levels and factors associated with PCOS. The study population consisted of 100 women with the syndrome, aged between 18 and 40 years, recruited at the Januário Cicco Maternity School (MEJC), Natal-RN. In the present study, we performed a survey of clinical information presenting mean, standard deviation and age frequencies, body mass index (BMI), fat distribution, menarche age and menstrual pattern, presence of hirsutism through the Ferriman-Gallwey score, infertility, arterial hypertension, diabetes mellitus 2, presence of acanthosis nigricans, hemodynamic values of blood pressure and clinical history of the family: diseases such as hypertension, diabetes, cancer, among others; The body composition of the volunteers was evaluated using a Dual Energy X-ray Absorptiometry (DEXA) equipment. Glucose serum concentrations, oral glucose tolerance test (TOTG), total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, urea, creatinine and gamma glutamyltransferase (GGT) were determined. All dosages were performed by enzymatic-colorimetric assays with commercial kits (Labtest Diagnostica-SA®, Lagoa Santa / MG) in Labmax Plenno equipment (Labtest Diagnostica-SA®, determination of vitamin D by chemiluminescent immunoassay (CLIA). A Pearson correlation test was performed to evaluate the possible relationships of serum vitamin D values with the other study variants. The tests were considered statistically significant at p <0.05. The mean age was 26.74 ± 5.52 years and BMI 30.07 ± 5.37 kg / m2 respectively. Most of the women were obese and overweight 47% and 39%. In relation to the Ferriman-Gallwey score, the mean was 11.95 ± 5.96, presenting a high score for hirsutism and 55% presented infertility. In relation to vitamin D, it presented hypovitaminosis with a frequency of 57% (insufficiency 49% and deficiency 8%). Serum vitamin D levels correlated positively with fertility (r = 0.209, p = 0.03 *), and negatively with gynoid fat (r = -0.225, p = 0.04). socio-demographic characteristics of the volunteers remained similar compared to previous studies of PCOS. Most of the women had obesity, mainly androids, most of them had infertility and hypovitaminosis D. The mean of the biochemical test results was within the reference values, although some women present glycemic and lipid alterations.We observed a statistical correlation of vitamin D status with fertility, gynoid fat, where there is room for vitamin D supplementation to help improve ovulation parameters, since it is important to have a good status of vitamin D for the improvement of infertility and in the biochemical and metabolic parameters. and to determine the effect of vitamin D on the clinical parameters of PCOS, it is necessary to perform more randomized clinical trials in these large-scale patients.