Vol 15, Issue 12, 2022
Online - 2455-3891
Print - 0974-2441
ASSESSMENT OF VITAMIN D AND CALCIUM LEVELS IN WOMEN WITH PCOS: AN
OBSERVATIONAL STUDY
SARU ARORA
1
, PARNEET KAUR
1
, RAMA GARG
1
, MANINDER KAUR
2
, SANGEETA RANI
1
*
1
Department of Obstetrics and Gynaecology, Government Medical College, Patiala, Punjab, India.
2
Department of Biochemistry,
Government Medical College, Patiala, Punjab, India. Email: drsangeetaaggarwal@gmail.com
Received: 04 August 2022, Revised and Accepted: 28 September 2022
ABSTRACT
Objectives: Polycystic ovarian syndrome (PCOS) is a prevalent endocrinal disorder in the women of reproductive age group. The present study aims
to investigate the correlation between Vitamin D and calcium levels in PCOS subjects as well as to establish the correlation between body mass index,
hyperandrogenism, and metabolic syndrome in various phenotypes of PCOS.
Methods: In the present prospective and observational study, a total of 80 patients diagnosed with PCOS were recruited. The recruited patients were
divided in the following two groups - study group (60 women diagnosed with PCOS based on Rotterdam criteria); and control group (20 women
without PCOS recruited from outpatient department and infertility clinics). Baseline characteristics, Vitamin D level, and serum calcium levels were
measured in the two groups and then compared.
Results: The mean age of patients in both the groups was found to be comparable (study group: 26.45±5.95 years versus control group:
28.40±6.65 years; p=0.221). The difference of mean 25-Hydroxy Vitamin D3 level was found to be statistically highly significant (study group 14.71
[±9.12] ng/mL versus control group was 22.47 [±6.71] ng/mL; p=0.0008). The difference of mean serum calcium level was also found to be statistically
highly significant (study group 9.14 [±0.50] mg/mL, and control group 9.74 [±0.45] mg/mL; p<0.0001).
Conclusion: Women with PCOS have a significantly lower serum 25-hydroxyvitamin D and calcium levels as compared to controls. There is need for
routine Vitamin D3 and calcium screening in all patients of PCOS for better insight into its role in the syndrome. Screening and correction of Vitamin
D3 and calcium deficiency may prevent PCOS and its manifestations.
Keywords: Vitamin D, Polycystic ovarian syndrome, Calcium.
INTRODUCTION
A gynecological disease complex called polycystic ovarian syndrome
(PCOS) affects 3–26% of women [1]. Stein and Leventhal first
described the disease as a triad of oligomenorrhea or anovulation,
hyperandrogenism and hirsutism in 1935 [2]. It is also regarded
as a metabolic disorder since PCOS frequently has characteristics
similar to the primary components of the metabolic syndrome,
such as obesity, glucose intolerance, atherogenic dyslipidemia, and
hypertension [3]. Among PCOS patients, the prevalence of metabolic
syndrome ranges from 10% to 43% [4]. Pregnant women with this
condition are more likely to have perinatal mortality, fetal macrosomia,
pre-eclampsia, gestational diabetes mellitus, and small-for-gestational-
age newborns [5]. Type 2 diabetes mellitus, endometrial cancer, and
cardiovascular disease are long-term health hazards [6,7].
The underlying mechanisms of PCOS are still poorly understood,
which makes it difficult for gynecologists and endocrinologists
to diagnose and treat patients [8]. In addition, PCOS manifests
as a variety of phenotypes, thus necessitating individualized
treatment [5,9]. The causative roles of many implicated factors have
been analyzed to explore the underlying mechanisms of PCOS. One
such factor is Vitamin D, which has been linked to insulin or glucose
metabolism and has been shown in PCOS patients to have an inverse
relationship with metabolic abnormalities. However, it is unclear
whether or not women with and without PCOS have different levels
of serum Vitamin D [10].
In the current study, to decide whether to implement screening
programs or supplement Vitamin D and calcium for PCOS patients,
the correlation between their levels in these subjects in the local
community was studied. In addition, in various PCOS phenotypes, the
correlation between body mass index (BMI), hyperandrogenism, and
metabolic syndrome was assessed.
Aims and objectives
The aims are as follows:
1. To study levels of 25 hydroxyvitamin D and calcium in women with
PCOS
2. To study the correlation between serum 25 hydroxyvitamin D
concentration and calcium in normal women and women with PCOS
3. To study prevalence of metabolic syndrome in various phenotypes
of PCOS.
METHODS
This study was a prospective and observational study.
Source of data
Patients enrolled in the study were recruited from the out-patient
department and infertility clinic of Obstetrics and Gynaecology,
Rajindra hospital, Government Medical College, Patiala from a period
from January 2019 to June 2020.
Inclusion criteria
The following criteria were included in the study:
1. Women aged 18–45 years
2. Women who had been diagnosed with PCOS based on Rotterdam
criteria [11]. These criteria included 2 of 3:
a. Different clinical manifestations of oligo and/or anovulation
b. Clinical and/or biochemical evidence of hyperandrogenism
including hirsutism, acne, and elevated testosterone
© 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/
licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ajpcr.2022v15i12.46060. Journal homepage: https://innovareacademics.in/journals/index.php/ajpcr
Research Article