FUNCTIONAL FEATURES OF THE RELATIONSHIP BETWEEN LEVELS OF VITAMIN D, MARKERS OF CHRONIC INFLAMMATION, HOMOCYSTEINE AND HORMONAL-METABOLIC PARAMETERS IN WOMEN WITH POLYCYSTICOVARY SYNDROME
DOI:
https://doi.org/10.21856/j-PEP.2021.1.01Keywords:
polycystic ovary syndrome, vitamin D, C-reactive protein, interleukin-6, homocysteine, dyslipidemia, insulin resistanceAbstract
Objective: to study the levels of vitamin D, C-reactive protein (CRP), interleukin-6 (IL-6), homocysteine (HC) and to evaluate their correlation with hormonal-metabolic parameters, the violation of which is inherent in polycystic ovary syndrome (PCOS).
Materials and methods. 60 patients with PCOS (24.2 ± 0.2 years) and 30 healthy women of the appro- priate age were examined. Depending on the level of vitamin D, the examined were divided into subgroups: 44 women with PCOS and vitamin D ≤ 30 ng/ml (average 12.9 ± 0.2 ng/ml); 16 patients with an average level of vitamin D ≥ 30 ng/ml (31.4 ± 0.3 ng/ml); 12 healthy women with vitamin D ≤ 30 ng/ml (24.2 ± 0.3 ng/ml); 18 healthy subjects with vitamin D ≥ 30 ng/ml (35.6 ± 0.3 ng/ml). The blood lipid spectrum, indicators of carbo- hydrate metabolism, total testosterone (T), estradiol (E2), sex hormone binding globulin, CRP, IL-6, HC were determined.
Results. Vitamin D deficiency in PCOS is characterized by a higher degree of severity. There is a nega- tive correlation between levels of vitamin D and abdominal adipose tissue distribution (r = – 0,501, P < 0,001), dyslipidemia (P < 0,001), insulin resistance (r = – 0,351, P < 0,01), hypeandrogenemia (r = – 0,603, P < 0,001). It was found that in patients with PCOS levels of CRP and IL-6 were significantly (P < 0,05) higher than the women in the control group and were associated with vitamin D deficiency (CRP r = – 0,375, Р < 0,01; IL-6 r = – 0,281, Р < 0,05), insulin resistance (CRP r = 0,351, Р < 0,01; IL-6 r = 0,270; Р < 0,05), dyslipidemia (P < 0,05) hyperandrogenemia (CRP r = 0,441, Р < 0,001; IL-6 r = 0,437, Р < 0,001). It was shown that hyperho- mocysteinemia in PCOS is caused by impaired androgen-estrogen balance (T/E2 r = 0,279, P < 0,05), systemic chronic inflammation (CRP r = 0,283, P < 0,05; IL-6 r = 0,261, P < 0,05) and deficiency of vitamin D (r = – 0,319; P < 0,02).
Conclusion. PCOS is accompanied by an increase in levels of CRP and IL-6, which indicates the existence of a link between this pathological process and low-grade systemic inflammation. Vitamin D deficiency contribu- tes to a further increase in markers of chronic inflammation and HC.
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