Associations between vitamin D levels and polycystic ovary syndrome phenotypes
Open accessAbstract
BACKGROUND: Studies comparing serum 25-hydroxyvitamin D concentrations in women with and without polycystic ovary syndrome (PCOS) have produced inconsistent results. Additionally, no previous studies have evaluated associations between vitamin D and specific PCOS phenotypes. METHODS: This case-control study was conducted among women undergoing intrauterine insemination. Cases (N.=137) were diagnosed with PCOS and then further classified into 3 diagnostic phenotypes based on combinations of the Rotterdam criteria (ovulatory dysfunction+polycystic ovaries [N.=55]; ovulatory dysfunction +androgen excess [N.=15]; and ovulatory dysfunction, +polycystic ovaries, +androgen excess [N.=67]). Controls (N.=103) were ovulatory women without PCOS who were undergoing IUI. Serum total 25-hydroxyvitamin D concentrations were categorized as deficient (≤20 ng/mL), insufficient (21-29 ng/mL), and sufficient (≥30 ng/mL). Prevalence odds ratios (PORs) were calculated using logistic regression. RESULTS: A higher proportion (59.9%) of PCOS cases lacked sufficient vitamin D levels compared to controls (47.6%; P value=0.06). The odds of vitamin D deficiency in all PCOS cases were twice that of controls (POR=2.03, 95% CI 0.97-4.26); however, the association was attenuated after adjusting for Body Mass Index (BMI) and race/ethnicity (adjPOR=1.43, 95% CI 0.62, 3.26). When examining PCOS phenotypes exhibiting androgen excess, crude associations were observed for deficient vitamin D levels (unadjPOR=2.93, 95% CI: 1.27, 6.77); however, the association decreased after adjustment for BMI and race/ethnicity (adjPOR=2.03, 95% CI: 0.79, 5.19). CONCLUSIONS: Vitamin D deficiency occurred more frequently in PCOS cases with androgen excess, but associations were attenuated after adjusting for BMI and race/ethnicity. Combining etiologically distinct PCOS subgroups may obscure associations with lower vitamin D levels and other potential risk factors.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Vitamin D deficiency occurs commonly in obese PCOS patients.
“There is evidence implying that vitamin D deficiency occurs commonly in obese PCOS patients [48,49].”
From PCOS and nutritional approaches: Differences between lean and obese phenotype (2021) · cites this paper as [49]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Holick, M. F., Binkley, N., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., Murad, M. H., & Weaver, C. M. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2011-0385 · Cited by 10,556 · see citing works
Decreased bioavailability of vitamin D in obesity
Wortsman, J., Matsuoka, L. Y., Chen, T. C., Lu, Z., & Holick, M. F. (2000) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/72.3.690 · Cited by 3,204 · see citing works
World Health Organization reference values for human semen characteristics*‡
Cooper, T. G., Noonan, E., von Eckardstein, S., Auger, J., Baker, H. W. G., Behre, H. M., Haugen, T. B., Kruger, T., Wang, C., Mbizvo, M. T., et al. (2010) · Human Reproduction Update · doi:10.1093/humupd/dmp048 · Cited by 2,827 · see citing works
The Prevalence and Features of the Polycystic Ovary Syndrome in an Unselected Population
Azziz, R., Woods, K. S., Reyna, R., Key, T. J., Knochenhauer, E. S., & Yıldız, B. O. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-032046 · Cited by 2,715 · see citing works
Legro, R. S., Arslanian, S. A., Ehrmann, D. A., Hoeger, K. M., Murad, M. H., Pasquali, R., & Welt, C. K. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2350 · Cited by 1,919 · see citing works
Ehrmann, D. A. (2005) · New England Journal of Medicine · doi:10.1056/nejmra041536 · Cited by 1,884 · see citing works
March, W. A., Moore, V. M., Willson, K. J., Phillips, D. I. W., Norman, R. J., & Davies, M. J. (2010) · Human Reproduction · doi:10.1093/humrep/dep399 · Cited by 1,799 · see citing works
Legro, R. S. (1999) · Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.84.1.165 · Cited by 1,743 · see citing works
Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome.
Ehrmann, D. A., Barnes, R. B., Rosenfield, R. L., Cavaghan, M. K., & Imperial, J. (1999) · Diabetes Care · doi:10.2337/diacare.22.1.141 · Cited by 1,257 · see citing works
Demographic Differences and Trends of Vitamin D Insufficiency in the US Population, 1988-2004
Ginde, A. A., Liu, M. C., & Camargo, C. A. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.604 · Cited by 1,120 · see citing works
Body Fat Content and 25-Hydroxyvitamin D Levels in Healthy Women
Arunabh, S., Pollack, S. Z., Yeh, J. K., & Aloia, J. F. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020978 · Cited by 623 · see citing works
Recent Trends in Waist Circumference and Waist-Height Ratio Among US Children and Adolescents
Li, C.-Y., Ford, E., Mokdad, A., & Cook, S. R. (2006) · Pediatrics · doi:10.1542/peds.2006-1062 · Cited by 537 · see citing works
Azziz, R., Ehrmann, D. A., Legro, R. S., Whitcomb, R. W., Hanley, R. M., Fereshetian, A. G., O’Keefe, M., & Ghazzi, M. N. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.4.7375 · Cited by 537 · see citing works
Glueck, C. J., Papanna, R., Wang, P., Goldenberg, N., & Sieve-Smith, L. (2003) · Metabolism · doi:10.1016/s0026-0495(03)00104-5 · Cited by 396 · see citing works
Replete vitamin D stores predict reproductive success following in vitro fertilization
Özkan, S., Jindal, S., Greenseid, K., Shu, J., Zeitlian, G., Hickmon, C., & Pal, L. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.05.019 · Cited by 392 · see citing works
Azziz, R. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.86.4.1626 · Cited by 378 · see citing works
Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome
Wehr, E., Pilz, S., Schweighofer, N., Giuliani, A., Kopera, D., Pieber, T. R., & Obermayer-Pietsch, B. M. (2009) · European Journal of Endocrinology · doi:10.1530/eje-09-0432 · Cited by 325 · see citing works
Hahn, S., Haselhorst, U., Tan, S., Quadbeck, B., Schmidt, M. D., Roesler, S., Kimmig, R., Mann, K., & Janssen, O. (2006) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-2006-948308 · Cited by 309 · see citing works
Diagnosis of Polycystic Ovarian Syndrome: In Defense of the Rotterdam Criteria
Franks, S. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-2501 · Cited by 278 · see citing works
Li, R., Brereton, R. E., Anderson, R. A., Wallace, A. M., & Ho, C. K. M. (2011) · Metabolism · doi:10.1016/j.metabol.2011.03.002 · Cited by 264 · see citing works
Serum Vitamin D Levels and Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis
He, C., Lin, Z., Robb, S., & Ezeamama, A. (2015) · Nutrients · doi:10.3390/nu7064555 · Cited by 242 · see citing works
Analytical and clinical validation of the 25 OH vitamin D assay for the LIAISON® automated analyzer
Ersfeld, D. L., Rao, D. S., Body, J.-J., Sackrison, J. L., Miller, A. B., Parikh, N. J., Eskridge, T. L., Polinske, A., Olson, G. T., & MacFarlane, G. D. (2004) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2004.06.006 · Cited by 241 · see citing works
Serum 25-hydroxyvitamin D concentrations in obese and non-obese women with polycystic ovary syndrome
Yıldızhan, R., Kurdoğlu, M., Adalı, E., Kolusarı, A., Yıldızhan, B., Şahin, H. G., & Kamacı, M. (2009) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-009-0958-7 · Cited by 231 · see citing works
Measuring 25-hydroxyvitamin D in a clinical environment: challenges and needs
Hollis, B. W. (2008) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/88.2.507s · Cited by 223 · see citing works
Polycystic ovary syndrome and cancer
Balen, A. (2001) · Human Reproduction Update · doi:10.1093/humupd/7.6.522 · Cited by 216 · see citing works
Seasonality in human reproduction: an update
Rojansky, N., Brzezinski, A., & Schenker, J. G. (1992) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137729 · Cited by 212 · see citing works
Mai, X., Chen, Y., Camargo, C. A., & Langhammer, A. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kwr456 · Cited by 181 · see citing works
Gilbert‐Diamond, D., Baylín, A., Mora‐Plazas, M., et al. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2010.29746 · Cited by 180 · see citing works
NHANES Monitoring of Serum 25-Hydroxyvitamin D: A Roundtable Summary
Yetley, E. A. D., Pfeiffer, C. M., Schleicher, R. L., Phinney, K. W., Lacher, D. A., Christakos, S., Eckfeldt, J. H., Fleet, J. C., Howard, G., Hoofnagle, A. N., et al. (2010) · Journal of Nutrition · doi:10.3945/jn.110.121483 · Cited by 155 · see citing works
Adult polycystic ovary syndrome begins in childhood
Franks, S. (2002) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1053/beem.2002.0203 · Cited by 142 · see citing works
Serum Parathyroid Hormone Concentrations Are Increased in Women with Polycystic Ovary Syndrome
Panidis, D., Balaris, C., Farmakiotis, D., Rousso, D., Kourtis, A., Balaris, V., Katsikis, I., Zournatzi, V., & Diamanti‐Kandarakis, E. (2005) · Clinical Chemistry · doi:10.1373/clinchem.2005.052761 · Cited by 136 · see citing works
Stein and Leventhal: 80 years on
Azziz, R., & Adashi, E. Y. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.12.013 · Cited by 130 · see citing works
Calciotropic hormones, insulin resistance, and the polycystic ovary syndrome
Mahmoudi, T., Gourabi, H., Ashrafi, M., Yazdi, R. S., & Ezabadi, Z. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.11.031 · Cited by 129 · see citing works
Vitamin D and pregnancy: An old problem revisited
Barrett, H. L., & McElduff, A. (2010) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2010.05.010 · Cited by 127 · see citing works
Hypovitaminosis D and incidence of obesity: a prospective study
González-Molero, I., Rojo‐Martínez, G., Morcillo, S., Gutiérrez, C., Rubio, E., Perez‐Valero, V., Esteva, I., de Adana, M. S. R., Almaraz, M. C., Colomo, N., et al. (2013) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2013.48 · Cited by 126 · see citing works
Kotsopoulos, J., Tworoger, S. S., Campos, H., Chung, F., Clevenger, C. V., Franke, A. A., Mantzoros, C. S., Ricchiuti, V., Willett, W. C., Hankinson, S. E., et al. (2010) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-09-1318 · Cited by 121 · see citing works
Serum 25-Hydroxyvitamin D Is Unaffected by Multiple Freeze-Thaw Cycles
Antoniucci, D. M., Black, D. M., & Sellmeyer, D. E. (2004) · Clinical Chemistry · doi:10.1373/clinchem.2004.041954 · Cited by 120 · see citing works
Strathmann, F. G., Sadílková, K., Laha, T. J., et al. (2011) · Clinica Chimica Acta · doi:10.1016/j.cca.2011.09.028 · Cited by 114 · see citing works
Ngo, D. T. M., Chan, W. P. A., Rajendran, S., Heresztyn, T., Amarasekera, A. T., Sverdlov, A. L., O’Loughlin, P. D., Morris, H. A., Chirkov, Y. Y., Norman, R. J., et al. (2011) · Nitric Oxide · doi:10.1016/j.niox.2011.06.005 · Cited by 75 · see citing works
Mazloomi, S., Sharifi, F., Hajihosseini, R., Kalantari, S., & Mazloomzadeh, S. (2012) · ISRN Endocrinology · doi:10.5402/2012/949427 · Cited by 69 · see citing works
Bodnar, L. M., Catov, J. M., Wisner, K. L., & Klebanoff, M. A. (2008) · British Journal Of Nutrition · doi:10.1017/s0007114508981460 · Cited by 68 · see citing works
Variability and Reproducibility of Circulating Vitamin D in a Nationwide U.S. Population
Major, J. M., Graubard, B. I., Dodd, K. W., Iwan, A., Alexander, B. H., Linet, M. S., & Freedman, D. M. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-2643 · Cited by 54 · see citing works
Zhao, G., Ford, E. S., Tsai, J., Li, C., & Croft, J. B. (2012) · ISRN Obstetrics and Gynecology · doi:10.5402/2012/691486 · Cited by 39 · see citing works
Bloom, M. S., Schisterman, E. F., & Hediger, M. L. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.09.066 · Cited by 32 · see citing works
Şahin, S., Eroğlu, M., Selcuk, S., Turkgeldi, L. S., Kozalı, Ş., Davutoğlu, S., & Muhçu, M. (2014) · PubMed · Cited by 26 · see citing works
Nestler, J. E., Reilly, E. R., Cheang, K. I., Bachmann, L. M., & Downs, R. W. (2012) · PubMed Central · Cited by 18 · see citing works
Flagged first, then by citations
Research works printed but not linked: 5
- [28]Evidence-based Methodology Workshop on Polycystic Ovary Syndrome Washington D.C.: Office of Disease Prevention and the Eunice Kennedy Shriver National Institute of Child Health; 2012.
- [29]WHO Laboratory Manual for the Examination of Human Semen and Sperm-cervical mucus interaction Cambridge: Cambridge University Press; 1999.
- [30]WHO laboratory manual for the Examination and processing of human semen Cambridge: Cambridge University Press; 2010.
- [32]Institue of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium Washington DC: The National Academies Press; 2011
- [46]Greenland S, Lash T. Bias analysis. In: Rothman KG S, Lash T, eds. Modern Epidemiology 3rd ed. Philadelphia: Lippincott, Williams & Wilkins; 2008.
Cited by
Sorted by citations
PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment
Morgante, G., Darino, I., Spanò, A., Luisi, S., Luddi, A., Piomboni, P., Governini, L., & De Leo, V. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11154509 · Cited by 95 · see citing works
Lee, I., Cooney, L. G., Saini, S., Sammel, M. D., Allison, K. C., & Dokras, A. (2019) · Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity · doi:10.1007/s40519-018-0533-y · Cited by 92 · see citing works
PCOS and nutritional approaches: Differences between lean and obese phenotype
Barrea, L., Frias-Toral, E., Verde, L., Ceriani, F., Cucalón, G., Garcia-Velasquez, E., Moretti, D., Savastano, S., Colao, A., & Muscogiuri, G. (2021) · Metabolism Open · doi:10.1016/j.metop.2021.100123 · Cited by 86 · see citing works
- Authors
- Davis, E. M., Peck, J. D., Hansen, K. R., Neas, B. R., & Craig, L. B.
- Affiliations
- University of Louisville (US)
- University of Oklahoma Health Sciences Center (US)
- Corresponding author
- Davis, Erin M.
- Venue
- Minerva Endocrinologica
- Publisher
- Edizioni Minerva Medica
- Published
- 2019-05
- Volume
- 44
- Issue
- 2
- Pages
- 176-184
- ISSN
- 0391-1977 (ISSN-L)
- 1827-1634
- PMC
- PMC6467740
- OpenAlex
- W2945344744
- Cited by
- 39
- References
- 46
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 2 · 2019: 3 · 2018: 1
- FWCI
- 5.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Minerva Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (U54GM104938)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Keywords
- polycystic ovary syndrome, vitamin D deficiency, 25-hydroxyvitamin D, PCOS phenotypes, hyperandrogenism, ovulatory dysfunction, body mass index, race and ethnicity, intrauterine insemination
- MeSH terms
- Adult, Female, Humans, Infertility, Insemination, Artificial, Phenotype, Polycystic Ovary Syndrome, Risk Factors, Vitamin D, Vitamin D Deficiency, Prevalence, Case-Control Studies, Hyperandrogenism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
