多囊卵巢综合征患者维生素D与空腹血糖的水平及差异

doi:10.3760/cma.j.cn441417-20250208-14008

摘要/Abstract

摘要：

目的　探讨血清维生素D与空腹血糖在多囊卵巢综合征（PCOS）患者中的表达差异。方法　采用回顾性研究，选取2022年1月至2024年12月在天津医科大学总医院就诊的20～40岁育龄期PCOS患者88例作为PCOS组，同时纳入87例20～40岁非PCOS女性作为对照组。比较PCOS组和对照组基线数据、维生素D与空腹血糖的表达差异。采用独立样本t检验进行统计比较，受试者操作特征曲线（ROC）分析维生素D和空腹血糖对PCOS高风险的预测效能。Pearson检验分别分析PCOS组、对照组维生素D与空腹血糖的相关性。结果　PCOS组患者体重［（65.330±12.031）kg］、BMI［（24.708±4.256）kg/m²］、空腹血糖水平［（4.953±0.495）mmol/L］均高于对照组［（59.989±8.438）kg、（22.737±3.169）kg/m²、（4.790±0.377）mmol/L］，而血清维生素D水平［（42.804±23.084）nmol/L］低于对照组［（53.083±18.366）nmol/L］，差异均有统计学意义（均P<0.05）。受试者操作特征曲线（ROC）显示，单独应用指标进行预测时，体重的灵敏度为0.545、特异度为0.701，BMI分别为0.489、0.759，空腹血糖分别为0.545、0.724，维生素D分别为0.511、0.874；4项指标联合预测的灵敏度为0.545，特异度为0.828。PCOS组、对照组中，维生素D与空腹血糖的相关性均不强（r=-0.093、-0.017，均P>0.05）。结论　体重、BMI、空腹血糖水平、血清维生素D水平联合预测PCOS高风险的灵敏度和特异度均优单一指标。曲线模型性能一般，可适当用于辅助临床中PCOS的高风险预测。

关键词: 多囊卵巢综合征, 维生素D, 空腹血糖

Abstract:

Objective　To explore the differences in the expression levels of serum vitamin D and fasting blood glucose in patients with polycystic ovary syndrome (PCOS). Methods　A retrospective study was conducted. Eighty-eight 20-40 years old patients with PCOS of childbearing age treated at Tianjin Medical University General Hospital from January 2022 to December 2024 were enrolled as a PCOS group. At the same time, 87 non-PCOS women who were 20-40 years old were included as a control group. The baseline data and expression levels of vitamin D and fasting blood glucose were compared between the PCOS group and the control group. The independent sample t test was used for the statistical comparisons. The receiver operating characteristic curve (ROC) was used to analyze the efficacy of vitamin D and fasting blood glucose for PCOS. The correlations between vitamin D and fasting blood glucose in the PCOS group and the control group were analyzed by Pearson test. Results　The body weight, body mass index (BMI), and serum fasting blood glucose level in the PCOS group were higher than those in the control group [(65.330±12.031) kg vs. (59.989±8.438) kg, (24.708±4.256) kg/m² vs. (22.737±3.169) kg/m², and (4.953±0.495) mmol/L vs. (4.790±0.377) mmol/L], while the serum vitamin D level was lower [(42.804±23.084) nmol/L vs. (53.083±18.366) nmol/L], with statistical differences (all P<0.05). The results of the ROC analysis showed that when the indicators were applied individually for prediction, the sensitivity and specificity of body weight were 0.545 and 0.701; the sensitivity and specificity of BMI were 0.489 and 0.759; the sensitivity and specificity of fasting blood glucose were 0.545 and 0.724; the sensitivity and specificity of vitamin D were 0.511 and 0.874. When the four indicators were combined for prediction, the sensitivity and specificity were 0.545 and 0.828. However, regardless of whether in the PCOS group or the control group, the correlation between vitamin D and fasting blood glucose was not strong (r=-0.093, -0.017, both P>0.05). Conclusions　The sensitivity and specificity of the combined prediction of high risk of PCOS using the four indicators are superior to any single indicator. However, the performance of the curve model is average. It can be appropriately used to assist in the prediction of high risk of PCOS in clinical practice.

Key words: Polycystic ovary syndrome, , Vitamin D, , Fasting blood glucose

许艳萍孙越王瑾田烨.

多囊卵巢综合征患者维生素D与空腹血糖的水平及差异 [J]. 国际医药卫生导报, 2025, 31(14): 2324-2328.

Xu Yanping, Sun Yue, Wang Jin, Tian Ye.

Levels and differences of vitamin D and fasting blood glucose in patients with polycystic ovary syndrome [J]. International Medicine and Health Guidance News, 2025, 31(14): 2324-2328.

参考文献

[1]Delrue C, Speeckaert MM. Vitamin D and vitamin D-binding protein in health and disease[J]. Int J Mol Sci, 2023, 24(5): 4642. DOI: 10.3390/ijms24054642.

[2]Li J, Li M, Li Y, et al. Do serum vitamin D levels affect assisted reproductive outcomes and perinatal outcomes in young non-PCOS patients? A retrospective study[J]. Arch Gynecol Obstet, 2024, 309(5): 2099-2106. DOI:10.1007/s00404-024-07410-8.

[3]何湘娇,赵静,张琼,等.血清与卵泡液25-羟维生素D水平与体外受精-胚胎移植妊娠结局的相关性研究[J].中华生殖与避孕杂志, 2020, 40(4): 271-278. DOI:10.3760/cma.j.cn101441-20190508-00186.

[4]Piltonen TT, Arffman RK, Joham AE. Natural history of polycystic ovary syndrome and new advances in the epidemiology[J]. Semin Reprod Med, 2021, 39(3/4): 94-101. DOI: 10.1055/s-0041-1735211.

[5]Meza-Meza MR, Ruiz-Ballesteros I, de la Cruz-Mosso U. Functional effects of vitamin D: fromnutrient to immunomodulator[J].Crit Rev Food Sci Nutr, 2022, 62(11): 3042-3062. DOI: 10.1080/10408398.2020.1862753

[6]Miao ZG, Wang S, Wang YM,et al. A potential linking between vitamin D and adipose metabolic disorders[J]. Can J Gastroenterol Hepatol,2020,2020: 2656321. DOI: 10.1155/2020/2656321.

[7]Cui A, Zhang T, Xiao P,et al. Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: a pooled analysis of 7.9 million participants[J]. Front Nutr, 2023, 10: 1070808. DOI: 10.3389/fnut.2023.1070808.

[8]Cai S, Li J, Zeng S,et al. Impact of vitamin D on human embryo implantation-a prospective cohort study in women undergoing fresh embryo transfer[J]. Fertil Steril, 2021, 115(3): 655-664. DOI: 10.1016/j.fertnstert.2020.09.005.

[9]Singh V, Tamar N, Lone Z, et al. Association between serum 25-hydroxy vitamin D level and menstrual cycle length and regularity: a cross-sectional observational study[J]. Int J Reprod Biomed, 2021, 19(11): 979-986. DOI: 10.18502/ijrm.v19i11.9913.

[10]温卫安,宋宁,李靖遐,等.维生素D、肥胖与多囊卵巢综合征:两样本与多变量孟德尔随机化研究[J].中国循证医学杂志, 2025, 25(2): 148-154.

[11]杨洪艳.维生素D与糖尿病发生及发展的相关性研究进展[J].现代医药卫生, 2020, 36(13): 2028-2031. DOI:10.3969/j.issn.1009-5519.2020.13.022.

[12]Abiri B, Valizadeh M, Ramezani Ahmadi A, et al. Association of vitamin D levels with anthropometric and adiposity indicators across all age groups: a systematic review of epidemiologic studies[J]. Endocr Connect, 2024, 13(2): e230394. DOI: 10.1530/EC-23-0394.

[13]Li P, Li K, Yuan W,et al. 1α, 25(OH)(2)D(3) ameliorates insulin resistance by alleviating γδ T cell inflammation via enhancing fructose-1, bisphosphatase1 expression[J]. Theranostics, 2023, 13(15): 5290-5304. DOI: 10.7150/thno.84645.

[14]Morró M, Vilà L, Franckhauser S, et al. Vitamin D receptor overexpression in β-cells ameliorates diabetes in mice[J]. Diabetes,2020, 69(5): 927-939. DOI: 10.2337/db19-0757.

[15]Argano C, Mirarchi L, Amodeo S, et al. The role of vitamin D and its molecular bases in insulin resistance, diabetes, metabolic syndrome, and cardiov ascular disease: state of the art[J]. Int J Mol Sci, 2023, 24(20): 15485. DOI: 10.3390/ijms242015485.

[16]Zakhary CM, Rushdi H, Hamdan JA, et al. Protective role of vitamin D therapy in diabetes mellitus type II[J]. Cureus, 2021, 13(8): e17317. DOI: 10.7759/cureus.17317

[17]任留留,陈爱荣,陆静,等.维生素Ｄ与1型糖尿病及其微血管并发症相关性的研究进展[J].中国医药, 2022, 17(11): 1743-1746. DOI:10.3760/j.issn.1673-4777.2022.11.033.

[18]Newsholme P, Keane KN, Carlessi R, et al. Oxidative stress pathways in pancreatic β-cells and insulin-sensitive cells and tissues: importance to cell metabolism, function, and dysfunction[J]. Am J Physiol Cell Physiol, 2019, 317(3): C420-C433. DOI: 10.1152/ajpcell.00141.2019.

[19]Helal BAF, Ismail GM, Nassar SE, et al. Efect of vitamin D on experimental model of polycystic ovary syndrome in female rats[J].Life Sci, 2021, 283: 119558. DOI: 10.1016/j.lfs.2021.119558.

[20]丛晓庆,刘晓,赵娟,等.大剂量维生素D联合胰岛素泵持续注射对妊娠期糖尿病患者血糖水平及妊娠结局的影响[J].国际医药卫生导报,2023, 29(4): 501-505. DOI:10.3760/cma.j.issn.1007-1245.2023.04.014.

[21]Wang N, Wang C, Chen X, et al. Vitamin D, prediabetes and type 2 diabetes: bidirectional Mendelian randomization analysis[J]. Eur J Nutr, 2020, 59(4): 1379-1388. DOI: 10.1007/s00394-019-01990-x.

[22]Pieńkowska A, Janicka J, Duda M,et al. Controversial impact of vitamin D supplementation on reducing insulin resistance and prevention of type 2 diabetes in patients with prediabetes: a systematic review[J]. Nutrients, 2023, 15, 983. DOI: 10.3390/nu15040983.

[23]吴於萍,薛惠,卢艺.维生素D联合二甲双胍对多囊卵巢综合征不孕合并肥胖患者妊娠结局和血清指标的影响[J].中华内分泌外科杂志, 2024, 18(2): 293-298. DOI:10.3760/cma.j.cn.115807-20230817-00061.

[24]Menichini D, Facchinetti F. Effects of vitamin D supplementation in women with polycystic ovary syndrome: a review[J]. Gynecol Endocrinol, 2020, 36(1):1-5. DOI: 10.1080/09513590.2019.1625881.