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تقييم مستويات فيتامين د في مصل الدم وتغاير الجين المشفر لمستقبلات فيتامين د لدى النساء المصابات بمتلازمة تكيس المبايض == Assessment of SerumVitamin D Levels and Vitamin D Receptor Gene Polymorphism in Women with Polycystic Ovary Syndrome
Author name:
رنا علي حمدي
Supervisor name:
زينا حسن عبد القهار
General topic:
Medicine
Specific topic:
Clinical Biochemistry
Degree:
Doctorate
University:
University of Baghdad - Faculty Of Medicine
Language:
English
University location:
Baghdad
First pages:
19T1452 - p.pdf
Abstract:
Polycystic ovary syndrome is a common endocrinopathy in women of reproductive age with primary manifestations of infertility, menstrual irregularity, and clinical or biochemical evidence of hyperandrogenism.Insulin resistance is predominant in women with this disorder independently of obesity and is contributed to reproductive and metabolic defect seen in this syndrome.Vitamin D was assumed to have a physiological effect in reproduction through binding to nuclear receptors which have been distributed in the uterus, oviduct, ovary, placenta, and fetal membranes. Besides, genes included in vitamin D metabolism have been assumed as candidate genes for the polycystic ovary syndrome susceptibility. Vitamin D receptor gene polymorphisms were suggested to play an influential role on insulin secretion and sensitivity in women with this syndrome.Objective : This study was planned to evaluate serum 25 - hydroxy vitamin D3 levels in women with polycystic ovary syndrome and compare their levels with age and body mass index matched healthy controls. Also, assess the correlation between insulin resistance and 25 - hydroxy vitamin D3 among women with this syndrome. In addition, investigate the possible association between Cdx2 (G/A) single nucleotide polymorphism of vitamin D receptor gene and the risk of polycystic ovary syndrome.Materials and Methods : This case - control study involved eighty eight (88) women from 18 to 34 years of age. Women were attended to Infertility Center in Baghdad Teaching Hospital during the period from March 2017 to June 2017. Women were divided into two groups : group 1 - consisted of forty five (45) newly diagnosed women with polycystic ovary syndrome and group 2 - consisted of forty three (43) healthy women (as controls). Women with polycystic ovary syndrome were diagnosed according to Rotterdam criteria when two out of three following criteria are found, these include oligoovulation and/orIIIanovulation, clinical and/or biochemical hyperandrogenism and polycystic ovaries as defined by ultrasonography.Each serum sample was analyzed for measuring 25 - hydroxy vitamin D3, luteinizing hormone, follicle - stimulating hormone, free testosterone, and insulin by enzyme linked immunosorbent assay. While serum calcium and fasting serum glucose were measured by spectrophotometer. Moreover, DNA samples were amplified and analyzed for the Cdx2 polymorphism of vitamin D receptor gene using allele specific multiple - polymerase chain reaction.Results : Significantly lower levels and higher prevalence of vitamin D deficiency were found in women with polycystic ovary syndrome compared to age and body mass index matched healthy controls (p=0.0001). Also, significant negative correlations were found between serum 25 - hydroxy vitamin D3 levels and fasting serum glucose (r= - 0.484, p=0.01), insulin (r= - 0.422, p=0.04) and HOMA - IR (r= - 0.542, p=0.0001) in patients group. Besides, no significant difference in genotypic distribution of Cdx2 polymorphism of vitamin D receptor gene between patients and controls. GG carriers (p=0.141), GA carriers (p=0.189), and AA carriers (p=1). However, the results found significantly higher serum levels of luteinizing hormone (p=0.002) and luteinizing hormone/follicle - stimulating hormone ratio (p=0.003) in GG carriers than GA and AA carriers for patients group and lower levels of serum 25 - hydroxy vitamin D3 in GG carriers than GA and AA carriers for both patients (p=0.00001) and controls (p=0.00001).Conclusion : Cdx2 polymorphism of vitamin D receptor gene has an association with severity of clinical features seen in polycystic ovary syndrome, but not with risk of development of the disease meaning that genetic variation are not directly linked to risk of this syndrome but may indirectly affect disease development via regulation of vitamin D and/or calcium levels.
