Ovarian 25OH-vitamin D production in young women affected by polycystic ovary syndrome
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ORIGINAL ARTICLE
Ovarian 25OH‑vitamin D production in young women affected by polycystic ovary syndrome R. Mioni1 · M. Gallea1 · M. Granzotto1 · F. Dassie1 · M. Parolin1 · P. Maffei1 · D. Faggian2 · F. De Marchi3 · P. Litta3 · R. Vettor1 Received: 10 August 2019 / Accepted: 2 April 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Introduction Vitamin D is involved in the regulatory mechanisms of ovarian function and is frequently low in PCOS patients. Since obesity and hyperinsulinemic state negatively influenced vitamin D levels, therefore, we evaluated the production of vitamin D at the ovarian level only in lean and normoinsulinemic PCOS subjects. Basal, GnRH analogue-induced ovarian production of 25OH-vitamin D (VitD) and a direct sampling at ovarian vein level were investigated. Methods Basal and GnRH analogue-induced hormone levels were evaluated at peripheral level in 45 subjects, aged 18–39 years, and in 22 healthy women with age- and BMI-matched as controls. In 12 PCOS patients, undergoing laparoscopy, a venous sampling at both peripheral and ovarian level was further done. All subjects presented low VitD levels, appropriate to the season and with no difference between PCOS and control subjects. Results GnRH analogue significantly stimulated plasma LH, FSH, 17-OHP and estradiol secretion (p from 40 µg/L), pituitary or thyroid diseases, Cushing’s
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Journal of Endocrinological Investigation
syndrome, acanthosis nigricans) or adrenal enzyme deficiency. All these diseases were excluded by hormone determinations and specific tests, such as ACTH-test (0.250 mg iv, Synacthen-CIBA). None consumed any medication for at least 3 months before the study. For each patient, BMI and WHR were calculated. Each subject was initially submitted to a 3-h oral glucose tolerance test (OGTT: 75 g of glucose) with the introduction of at least 300 g of glucose in 2 days before the test. Secretion area under the curve (AUC), the ISI-OGTT, according to the DeFronzo formula) [19], and. the homeostatic model assessment—insulin resistance (HOMA-ir) were then calculated. All patients were lean (BMI between 18.0 and 24.9) and normoinsulinemic [20]. After an interview in which the study protocol was explained in detail, each subject gave her informed consent.
Study protocol In Fig. 1 we summarized all the steps of the study. Anthropometric measurements were taken for each patient and basal hormone and biochemical parameters (LH, FSH, T, 17-OHP, E2, SHBG, 25OH-vitamin D, PTH, Ca, P, AMH) were then assessed through a blood sample after an overnight fast. All samples were obtained in the early follicular phase or, in case of persistent amenorrhea (more than 3 months), after βhCG, and a pelvic ultrasound, to study the endometrium. Blood samples were immediately centrifuged at 4 ℃ and stored at − 20 ℃ until the assay. Thirty-eight patients of the PCOS group and all control subjects were also submitted to a GnRH analogue test with the administration of triptorelin (Decapeptyl 0.100 mg s.c.) in the follicular phase: previ
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