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Patil P, D'Souza N, Ghate SD, Nagendra L, Girijashankar HB. Free-androgen Index in Women with Polycystic Ovarian Syndrome: A Meta-Analysis. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1757445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Objectives Hyperandrogenism, a key feature of polycystic ovarian syndrome (PCOS), is caused by excess androgen secretion, most commonly of ovarian origin. Although the serum total testosterone (TT) levels have long been used as a traditional measure of hyperandrogenemia in women with PCOS, it is associated with many fallacies due to the fact that a component of TT is linked to sex hormone-binding globulin (SHBG). Recent research has discovered that measuring free testosterone levels and computing the free androgen index (FAI), which is a ratio of TT and SHBG, are better predictors of androgen excess in PCOS. The aim of this meta-analysis is to determine the association of FAI in diagnosing hyperandrogenism and its ability to discriminate PCOS from controls.
Materials and Methods The publicly available databases PubMed, Scopus and Web of Science were searched using MeSH terms, ‘Polycystic Ovarian Syndrome’ OR ‘PCOS’ OR ‘PCOD’ AND ‘Testosterone’ AND ‘Sex Hormone Binding Globulin’ OR ‘SHBG’ to collect the full-text articles for the retrieval of related data of case–control and cross-sectional studies. The studies quality was assessed using the Newcastle–Ottawa scale, and a sub-group analysis and publication bias between the studies was evaluated by funnel plot.
Statistical Analysis The R program (v4.0.3) and R packages ‘metafor’ and ‘dmetar’ were used for statistical analyses of quantitative data and the plots were generated using ‘ggplot2’ package through a comparison of pooled SMD by Egger's linear regression and Beggs-Mazumdar tests.
Results Twenty-four studies involving 7,847 participants including 3,290 controls and 4,557 PCOS were included in the meta-analysis. The pooled data analysis of the included studies showed that the PCOS women had higher FAI than controls, with SMD of 1.56 (95%CI 1.08–2.04; p < 0.01). The publication bias was tested using a funnel plot and Egger's regression asymmetry test, which revealed no risk of publishing bias (p = 0.1727). Additionally, the sub-group meta-analysis of geographic region revealed that FAI levels were more significant in PCOS subjects of Asia and Europe, compared with the American region.
Conclusion Overall, this meta-analysis indicates that FAI could be a reliable marker to differentiate PCOS patients from controls in Asian and European ethnicities.
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Affiliation(s)
- Prakash Patil
- Central Research Laboratory, KS Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Neevan D'Souza
- Center for Bioinformatics and Biostatistics, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Sudeep D. Ghate
- Center for Bioinformatics and Biostatistics, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Lakshmi Nagendra
- Department of Endocrinology, Justice KS Hegde Charitable Hospital, K S Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, Karnataka, India
| | - Harish B. Girijashankar
- Department of Anesthesiology, Justice KS Hegde Charitable Hospital, K S Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, Karnataka, India
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Vulcan T, Filip GA, Lenghel LM, Suciu T, Ilut P, Procopciuc LM. Polymorphisms of Vitamin D Receptor and the Effect on Metabolic and Endocrine Abnormalities in Polycystic Ovary Syndrome: A Review. Horm Metab Res 2021; 53:645-653. [PMID: 34544196 DOI: 10.1055/a-1587-9336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorder in women of reproductive age. Vitamin D and its receptor are thought to play an important role in PCOS susceptibility, although the impact of vitamin D receptor (VDR) polymorphisms on the hormonal and metabolic profile is still controversial. A literature search in PubMed and Embase was performed up to September 2020 for case-control studies in women suffering from PCOS, with outcome related to VDR polymorphisms effect on metabolic/endocrine disturbances. We have found 16 eligible studies including 2566 women with PCOS and 2430 controls. ApaI polymorphism seemed to be associated with hyperandrogenism in both Asian and Caucasian population. FokI variant was correlated with metabolic/endocrine parameters especially in Asian population, while a relation between Cdx2 genotypes and insulin sensitivity was observed in both ethnicities. VDR polymorphisms have an important role in PCOS development and related hormonal and metabolic abnormalities. Few case-control studies analysed the interaction between VDR variants and metabolic/endocrine parameters with the majority of the articles focused on the Asian region. Further research on various ethnic populations with larger sample size are still needed for a definitive conclusion, in order to allow early diagnosis and prevention of PCOS comorbidities.
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Affiliation(s)
- Talida Vulcan
- Iuliu Hatieganu University of Medicine and Pharmacy Faculty of Medicine, Dermatology Cluj Napoca, Romania
| | - Gabriela Adriana Filip
- Iuliu Hatieganu University of Medicine and Pharmacy Faculty of Medicine, Physiology Cluj Napoca, Romania
| | - Lavinia Manuela Lenghel
- Iuliu Hatieganu University of Medicine and Pharmacy Faculty of Medicine, Radiology, Cluj Napoca, Romania
| | - Tudor Suciu
- Iuliu Hatieganu University of Medicine and Pharmacy Faculty of Medicine, Maxillofacial Surgery and Radiology, Cluj Napoca, Romania
| | - Paula Ilut
- Iuliu Hatieganu University of Medicine and Pharmacy Faculty of Medicine, Dermatology Cluj Napoca, Romania
| | - Lucia Maria Procopciuc
- Iuliu Hatieganu University of Medicine and Pharmacy Faculty of Medicine, Medical Biochemistry, Cluj Napoca, Romania
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Isbilen E, Ulusal H, Karaer K, Kul S, Yaman DM, Tepe NB, Kanbur HC, Tarakcioglu M, Ozyurt AB. VDR gene polymorphisms as a significant factor in unexplained infertility. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mu Y, Cheng D, Yin TL, Yang J. Vitamin D and Polycystic Ovary Syndrome: a Narrative Review. Reprod Sci 2020; 28:2110-2117. [PMID: 33113105 DOI: 10.1007/s43032-020-00369-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/19/2020] [Indexed: 12/31/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of reproductive age women and contributes to metabolic dysfunctions including insulin resistance (IR) and dyslipidemia. Vitamin D is a steroid hormone, which is involved in calcium metabolism and bone structure and has a potential role in the prevention of many illnesses, including cancers, autoimmune disorders, hypertension, diabetes, and obesity. Recently, it has been reported that vitamin D deficiency was a common complication of PCOS and vitamin D status was associated with reproductive ability, metabolic alterations, and mental health of PCOS patients. This review summarizes the advances between vitamin D status and the pathophysiological process of PCOS. Vitamin D level was negatively associated with serum androgen level. Vitamin D treatment could reduce serum androgen and anti-MüllerianHormone (AMH) levels, and decrease endometrial thickness, which resulted in improvement of menstrual cycle and folliculogenesis of PCOS patients. Moreover, vitamin D concentrations were negatively correlated with parameters of IR and body fat mass. Vitamin D supplementation has beneficial effects on IR and lipid metabolism. In addition, a positive of vitamin D on mental health of PCOS patients was proposed. Understanding the relationship between vitamin D status and the symptoms of PCOS patients is of great clinical significance to treat and prevent the progression of PCOS.
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Affiliation(s)
- Yang Mu
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan University, Jiefang Road 238, Wuhan, 430060, China
| | - Dan Cheng
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan University, Jiefang Road 238, Wuhan, 430060, China
| | - Tai-Lang Yin
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan University, Jiefang Road 238, Wuhan, 430060, China.
| | - Jing Yang
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan University, Jiefang Road 238, Wuhan, 430060, China.
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Ramezani N, Ostadsharif M, Nayeri H. Association of BsmI variant of vitamin D receptor gene with polycystic ovary syndrome: A case-control study. Int J Reprod Biomed 2020; 18:877-884. [PMID: 33134800 PMCID: PMC7569712 DOI: 10.18502/ijrm.v13i10.7772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/12/2020] [Accepted: 05/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background Polycystic ovarian syndrome (PCOS) is an endocrine disorder that affects women's fertility and causes alterations such as obesity, insulin resistance, menstrual irregularities, and polycystic ovaries. The results of the studies show that the issue of vitamin D and vitamin D receptor (VDR) is controversial for PCOS susceptibility. Objective To investigate the association of BsmI polymorphism in the VDR gene with metabolic parameters in obese PCOS women. Materials and Methods In this case-control study, 38 obese subjects with PCOS and 40 unrelated obese individuals were evaluated to determine the allelic and genotypic frequency of BsmI variant by Polymerase Chain Reaction Restriction Fragment Length Polymorphism method. Body Mass Index, parathyroid hormone, phosphorus, and calcium were evaluated in all participants. Results BsmI (rs1544410), (A/G) AA, AG, GG, A, and G percentage of genotypic/allelic frequencies were 65.8, 26.3, 7.9, 78.9, and 21.1 in cases and 57.5, 40, 2.5, 77.5, and 22.5 in controls, respectively. Statistical analysis revealed that the differences in genotypic (p = 0.31)/allelic (p = 0.83) frequencies and dominant (p = 0.45)/recessive (p = 0.35) models between the cases and controls were not significant. This study indicates no association between the BsmI genotypes and metabolic parameters. Conclusion It can be concluded that VDR BsmI (rs1544410) Intron 8 (A > G) was not associated with obesity along with PCOS susceptibility in the studied groups.
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Affiliation(s)
- Nasim Ramezani
- Department of Biochemistry, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Maryam Ostadsharif
- Department of Medical Basic Sciences, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran.,Department of Medical Biotechnology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Hashem Nayeri
- Department of Biochemistry, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
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Irgam K, Reddy BM, Annamaneni S, Rayabarapu P. The genetic susceptibility profile of the South Indian women with polycystic ovary syndrome and the universality of the lack of association of type 2 diabetes genes. Gene 2019; 701:113-120. [PMID: 30910557 DOI: 10.1016/j.gene.2019.03.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/05/2019] [Accepted: 03/20/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Kumuda Irgam
- Department of Genetics, Osmania University, Hyderabad, India
| | - Battini Mohan Reddy
- Department of Genetics, Osmania University, Hyderabad, India; Molecular Anthropology Group, Indian Statistical Institute, Hyderabad, India.
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Shi XY, Huang AP, Xie DW, Yu XL. Association of vitamin D receptor gene variants with polycystic ovary syndrome: a meta-analysis. BMC MEDICAL GENETICS 2019; 20:32. [PMID: 30764792 PMCID: PMC6376757 DOI: 10.1186/s12881-019-0763-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/31/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-age women. Multiple susceptible gene as well as environmental factors and their interaction each other are contributed to the PCOS risk. Several case-control studies have researched the associations of the vitamin D receptor gene (VDR) polymorphisms with PCOS susceptibility, but the jury is still out. Here, we carried out a meta-analysis to clarify polymorphisms between ApaI (C/A) (rs7975232), BsmI (G/A) (rs1544410), FokI (C/T) (rs10735810), TaqI (T/C) (rs731236) and Tru9I (G/A) (rs757343) in the VDR gene and PCOS susceptibility based on relative lager sample size. METHODS English database of PubMed and Embase, and Chinese database of Wanfang and China National Knowledge Infrastructure (CNKI) databases were retrivaled for the relationship between VDR gene variates and PCOS susceptibility published before 31th, May 2018. Crude odds ratios (ORs) and its 95% confidence intervals (95% CIs) in different comparisons were used to detected the strength of the association. All the statistical analyses of the present meta-analysis were performed by STATA version 12.0 software. RESULTS Totally, 3587 (PCOS group 1922; control group 1665) participants from 13 studies were included which met our inclusion criteria. A statistically significant association between VDR ApaI (rs7975232) polymorphism and PCOS susceptibility (C vs. A: OR = 1.19, 95%CI = 1.06~1.34, P = 0.004) was found in the overall population. After stratified by ethnicity, we showed that there is a significant association between VDR ApaI (rs7975232) polymorphism and susceptibility to PCOS in the Asian (C vs. A: OR = 1.21, 95%CI = 1.04~1.42, P = 0.016) population, but this association was not found in the Caucasian population. Additionally, a significant relationship between VDR BsmI (rs1544410) variates with PCOS susceptibility in the Asian (G vs. A: OR = 1.27, 95%CI = 1.06~1.53, P = 0.011) population, but this association was not found in the Caucasian population. We didn't find any association between VDR FokI (rs2228570), VDR TaqI (rs731236), VDR Tru9I (rs757343) and PCOS susceptibility in the overall and the subgroup populations. CONCLUSIONS Our findings demonstrated that VDR ApaI (rs7975232) and VDR BsmI (rs1544410) polymorphisms are correlated with susceptibility to PCOS in the Asian population and VDR TaqI (rs731236), VDR FokI (rs2228570), VDR Tru9I (rs757343) did not reveal a relationship with the PCOS susceptibility.
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Affiliation(s)
- Xiao-Yuan Shi
- Lanzhou University Second Hospital, Medical Record Department, Lanzhou, 730030, Gansu Province, China
| | - Ai-Ping Huang
- Blood Center of Zhejiang Province, Blood Donation Service Department, Hangzhou, 310006, Zhejiang Province, China
| | - Duo-Wen Xie
- Lanzhou University Second Hospital, Intensive Care Unit 2, Lanzhou, 730030, Gansu Province, China
| | - Xiao-Long Yu
- Zhejiang Hospital, Department of nutrition, Hangzhou, 310013, Zhejiang Province, China.
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Deswal R, Nanda S, Dang AS. Unveiling the association between Vitamin D Receptor and Poly Cystic Ovary Syndrome - a systematic review and meta-analysis. INT J VITAM NUTR RES 2019; 87:207-218. [PMID: 30702031 DOI: 10.1024/0300-9831/a000298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Low Vitamin D status observed in the populations globally and its associations with diverse systems have kindled the interest for Vitamin D in medical literature in last two decades. Accumulating evidence manifest that deficiency of Vitamin D might be a causal factor in the pathogenesis of various features of Poly Cystic Ovary Syndrome (PCOS). This notion is supported by the fact that > 3 % of the human genome is regulated by vitamin D receptor (VDR). Therefore, this meta-analysis was carried out to quantify the magnitude of risk associated with VDR polymorphisms (BsmI, TaqI, FokI and ApaI) and PCOS susceptibility. Methods: Pub-med, EMBASE, Cochrane database, Science direct, Scirus, ISI web of knowledge and Google scholar were searched for all years until July 2016. The case control studies related to VDR polymorphism and PCOS risk were selected according to inclusion and exclusion criteria. Nine studies of the initial 553 hits reporting VDR polymorphism in PCOS were included. All statistical analysis was performed using the STATA 11.0 software and odd ratio with 95 % confidence intervals was used as effect size to assess the strength of associations. Results: Nine studies comprising 1558 cases and 1033 controls were included in this meta-analysis. Significant association between VDR Fok1 polymorphisms and PCOS risk was observed. In further stratified analysis, an increased risks were observed among Asian and African populations for Taq1 polymorphism. Apa1 and Bsm1 polymorphism was found not to be a risk factor for PCOS susceptibility. Conclusion: The FokI polymorphism is found to be a significant risk factor for PCOS.
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Affiliation(s)
- Ritu Deswal
- 1 Centre for Medical Biotechnology, Maharshi Dayanand University, Haryana, India
| | - Smiti Nanda
- 2 Department of Obstetrics and Gynecology, PGIMS, Haryana, India
| | - Amita Suneja Dang
- 1 Centre for Medical Biotechnology, Maharshi Dayanand University, Haryana, India
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Xavier LB, Gontijo NA, Rodrigues KF, Cândido AL, Dos Reis FM, de Sousa MCR, Silveira JN, Oliveira Silva IDF, Ferreira CN, Gomes KB. Polymorphisms in vitamin D receptor gene, but not vitamin D levels, are associated with polycystic ovary syndrome in Brazilian women. Gynecol Endocrinol 2019; 35:146-149. [PMID: 30182771 DOI: 10.1080/09513590.2018.1512966] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
This study aimed to investigate the association between vitamin D (VitD) levels, polymorphisms in VDR gene (ApaI, BsmI, FokI, and TaqI) and the polycystic ovary syndrome (PCOS) in a group of Brazilian women. A total of 100 patients with PCOS and 100 control women were included. The quantification of 25-hydroxyvitamin D (25(OH)D) was performed in high-performance liquid chromatography (HPLC). Polymorphisms on VDR gene were performed by PCR-RFLP. The BsmI AG genotype was more frequent in PCOS group, while the GG genotype was more frequent in the control group (p = .007). The frequency of the Taql CC genotype was higher in PCOS group, while the CT genotype was the most frequent in the control group (p = .021). Mean serum VitD levels were similar between the groups. However, there was a negative correlation between VitD levels and Ferriman-Gallwey score (p = .031, r = -.260) in the PCOS group. The TaqI and BsmI polymorphisms were associated with PCOS. Moreover, VitD levels are associated with the clinical hyperandrogenism. The data suggest the role of VitD in PCOS development and its complications.
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Affiliation(s)
- Luana Bernardes Xavier
- a Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Natália Alves Gontijo
- b Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Kathryna Fontana Rodrigues
- a Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Ana Lúcia Cândido
- c Departamento de Clínica Médica, Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Fernando Marcos Dos Reis
- c Departamento de Clínica Médica, Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Maira Cândida Rodrigues de Sousa
- b Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Josianne Nicácio Silveira
- b Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Ieda de Fátima Oliveira Silva
- b Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Cláudia Natália Ferreira
- d Colégio Técnico , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
| | - Karina Braga Gomes
- a Instituto de Ciências Biológicas , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
- b Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Minas Gerais, Brazil
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Niu YM, Wang YD, Jiang GB, Bai G, Chai HB, Li XF, Hu YY, Shen M. Association Between Vitamin D Receptor Gene Polymorphisms and Polycystic Ovary Syndrome Risk: A Meta-Analysis. Front Physiol 2019; 9:1902. [PMID: 30687119 PMCID: PMC6335351 DOI: 10.3389/fphys.2018.01902] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 12/18/2018] [Indexed: 12/19/2022] Open
Abstract
Objective: Published studies have demonstrated a closer association between vitamin D receptor (VDR) gene polymorphisms and polycystic ovary syndrome (PCOS) risk, but the results were inconsistent. We therefore performed this meta-analysis to explore the precise associations between VDR gene polymorphisms and PCOS risk. Methods: Five online electronic databases (PubMed, Embase, SCI index, CNKI and Wanfang) were searched. Odds ratios (ORs) with 95% confidence interval (CIs) were calculated to assess the association between VDR Fok I C/T (rs10735810), BsmI A/G (rs1544410), ApaI A/C (rs7975232), and TaqI T/C (rs731236) polymorphisms and PCOS risk. In addition, heterogeneity, accumulative/sensitivity analysis and publication bias were conducted to check the statistical power. Results: Overall, 10 publications (31 independent case-control studies) involving 1,531 patients and 1,174 controls were identified. We found that the C mutation of ApaI A/C was a risk factor for PCOS (C vs. A: OR = 1.20, 95%CI = 1.06–1.35, P < 0.01, I2 = 29.7%; CC vs. AA: OR = 1.49, 95%CI = 1.17–1.91, P < 0.01, I2 = 0%; CC vs. AA+AC: OR = 1.36, 95%CI = 1.09–1.69, P = 0.01, I2 = 12.8%). Moreover, the BsmI A/G polymorphism also showed a dangerous risk for PCOS in Asian population (G vs. A: OR = 1.62, 95%CI = 1.24–2.11, P < 0.01, I2 = 0%; AG vs. AA: OR = 2.08, 95%CI = 1.26–3.20, P < 0.01, I2 = 0%; GG vs. AA: OR = 2.21, 95%CI = 1.29–3.77, P < 0.01, I2 = 0%; AG+GG vs. AA: OR = 2.12, 95%CI = 1.42–3.16, P < 0.01, I2 = 0%). In addition, no significant association of Fok I C/T, and TaqI T/C polymorphisms was observed. Conclusions: In summary, our meta-analysis suggested that VDR gene polymorphisms contribute to PCOS development, especially in Asian populations.
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Affiliation(s)
- Yu-Ming Niu
- Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ya-Dong Wang
- Department of Oral and Maxillary Surgery, Gui Zhou Provincial People's Hospital, Guiyang, China
| | - Guang-Bin Jiang
- Department of Radiology, Suizhou Central Hospital, Suizhou, China
| | - Gang Bai
- Department of Medical Ultrasound, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Hong-Bo Chai
- Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xue-Feng Li
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yuan-Yuan Hu
- Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Department of Radiology, Suizhou Central Hospital, Suizhou, China
| | - Ming Shen
- Department of Stomatology and Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.,Jiangsu Key Laboratory of Oral Diseases, Department of Dental Implant, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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Al Thomali A, Daghestani MH, Daghestani MH, Kaya N, Warsy A. Polymorphic Variations in VDR Gene in Saudi Women with and Without Polycystic Ovary Syndrome (PCOS) and Significant Influence of Seven Polymorphic Sites on Anthropometric and Hormonal Parameters. J Med Biochem 2018; 37:415-425. [PMID: 30584400 PMCID: PMC6298478 DOI: 10.2478/jomb-2018-0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 02/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND This study was designed to evaluate the associations between vitamin D receptor (VDR) gene polymorphisms and biochemical characteristics of Saudi women with polycystic ovary syndrome (PCOS). METHODS Serum levels of LH, FSH, and Vitamin D were measured in 33 women: 16 patients and 17 normal controls (18 to 36 years). DNA was extracted and used for sequencing of the exons of VDR gene using ABI PRISM 3730xi Genetic Analyzer. RESULTS Weight, BMI, Vit D, LH and FSH levels were higher in the PCOS patients compared to control group, where Vit D level correlated positively and significantly with FSH, in the control, but showed a negative and non-significant correlation in the PCOS patients. Sequencing results showed extensive polymorphisms in both groups, but the differences in the frequencies were not significant. Demographic and hormonal parameters were compared in the different genotypes of the SNPs. Significant differences were ob served in the values of the studied parameters in rs11168276, rs11168266, rs3858733, rs121909790, rs11168265 and rs731236. Vitamin D level was influenced significantly by the genotypes of rs11168265 (AA) (p=0.008), rs11168276 (AA; p=0.018) and rs731236 (CC; p=0.024). CONCLUSION Vitamin D deficiency does not associate with PCOS in Saudi females. Several SNPs are identified in the VDR gene, in normal and PCOS females, but there is no difference in their frequencies between the two groups. The results show that polymorphism in VDR gene influences certain anthropometric and hormonal parameters in PCOS patients. Further detailed studies are required to confirm the associations between VDR and PCOS.
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Affiliation(s)
- Arwa Al Thomali
- Department of Zoology, College of Science, King Saud University, RiyadhSaudi Arabia
- Central Laboratory, Center for Science and Medical Studies for Girls, King Saud University, Riyadh, Saudi Arabia
| | - Maha H. Daghestani
- Department of Zoology, College of Science, King Saud University, RiyadhSaudi Arabia
- Central Laboratory, Center for Science and Medical Studies for Girls, King Saud University, Riyadh, Saudi Arabia
| | - Mazin H. Daghestani
- Department of Obstetrics and Gynecology, Umm-Al-Qura University, Makkah, Saudi Arabia
| | - Namik Kaya
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Arjumand Warsy
- Central Laboratory, Center for Science and Medical Studies for Girls, King Saud University, Riyadh, Saudi Arabia
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Chen Y, Fang SY. Potential genetic polymorphisms predicting polycystic ovary syndrome. Endocr Connect 2018; 7:R187-R195. [PMID: 29622662 PMCID: PMC5937197 DOI: 10.1530/ec-18-0121] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/05/2018] [Indexed: 01/28/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a heterogenous endocrine disorder with typical symptoms of oligomenorrhoea, hyperandrogenism, hirsutism, obesity, insulin resistance and increased risk of type 2 diabetes mellitus. Extensive evidence indicates that PCOS is a genetic disease and numerous biochemical pathways have been linked with its pathogenesis. A number of genes from these pathways have been investigated, which include those involved with steroid hormone biosynthesis and metabolism, action of gonadotropin and gonadal hormones, folliculogenesis, obesity and energy regulation, insulin secretion and action and many others. In this review, we summarize the historical and recent findings in genetic polymorphisms of PCOS from the relevant publications and outline some genetic polymorphisms that are potentially associated with the risk of PCOS. This information could uncover candidate genes associating with PCOS, which will be valuable for the development of novel diagnostic and treatment platforms for PCOS patients.
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Affiliation(s)
- Yao Chen
- Hangzhou Fuyang Women and Children HospitalHangzhou, China
| | - Shu-Ying Fang
- Hangzhou Fuyang Women and Children HospitalHangzhou, China
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Santos BR, Lecke SB, Spritzer PM. Apa-I polymorphism in VDR gene is related to metabolic syndrome in polycystic ovary syndrome: a cross-sectional study. Reprod Biol Endocrinol 2018; 16:38. [PMID: 29669566 PMCID: PMC5907412 DOI: 10.1186/s12958-018-0355-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/06/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common endocrine disorder determined by polygenic traits as well as environmental factors. Lower vitamin D levels have been detected in PCOS women and related to hormone and metabolic disturbances. Vitamin D acts in tissues through the vitamin D receptor (VDR). VDR gene variants have been associated with worse metabolic profile in the general population. We investigated the genotype and haplotype distribution of the Bsm-I (rs1544410), Apa-I (rs7975232), and Taq-I (rs731236) VDR gene polymorphisms in PCOS and non-hirsute women from southern Brazil. We further investigated the associations of these gene variants and their haplotypes with PCOS, vitamin D levels, and metabolic abnormalities, including the metabolic syndrome (MetS). METHODS A group of 191 women with PCOS (Rotterdam criteria) and 100 non-hirsute controls with regular ovulatory cycles were genotyped for all polymorphisms by real-time PCR, with allelic discrimination assays. MetS and the cutoffs for its isolated components were defined in accordance with the Joint Scientific Statement. RESULTS Women with PCOS were younger and had significantly higher BMI and total testosterone levels than controls (p < 0.05). The frequency of MetS in PCOS and controls was 26.5% and 4.8% respectively. The CC genotype of Apa-I entailed higher risk of MetS in PCOS (OR: 2.133; 95% CI 1.020-4.464, p = 0.042), and was associated with higher systolic blood pressure (p = 0.009), total cholesterol (p = 0.040), and LDL-cholesterol (p = 0.038) in both PCOS and control groups (two-way ANOVA). The frequencies of VDR haplotypes were similar in PCOS and control women. CONCLUSIONS The present results suggest that the Apa-I variant in VDR gene may be associated with MetS in southern Brazilian women with PCOS, and with blood pressure, total cholesterol, and LDL-c in women with and without PCOS.
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Affiliation(s)
- Betânia Rodrigues Santos
- 0000 0001 0125 3761grid.414449.8Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003 Brazil
- 0000 0001 2200 7498grid.8532.cDepartment of Physiology, Laboratory of Molecular Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Sheila Bunecker Lecke
- 0000 0001 0125 3761grid.414449.8Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003 Brazil
- 0000 0004 0444 6202grid.412344.4Department of Diagnostic Methods, Universidade Federal de Ciências Médicas de Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Poli Mara Spritzer
- 0000 0001 0125 3761grid.414449.8Division of Endocrinology, Gynecological Endocrinology Unit, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-003 Brazil
- 0000 0001 2200 7498grid.8532.cDepartment of Physiology, Laboratory of Molecular Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Reginatto MW, Pizarro BM, Antunes RA, Mancebo ACA, Hoffmann L, Fernandes P, Areas P, Chiamolera MI, Silva R, de Souza MDCB, Bloise E, Ortiga-Carvalho TM. Vitamin D Receptor TaqI Polymorphism Is Associated With Reduced Follicle Number in Women Utilizing Assisted Reproductive Technologies. Front Endocrinol (Lausanne) 2018; 9:252. [PMID: 29892263 PMCID: PMC5985330 DOI: 10.3389/fendo.2018.00252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 05/02/2018] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Calcitriol, or 1,25-hydroxycholecalciferol, is the active form of vitamin D. It binds and activates vitamin D receptor (VDR). Infertility and defective folliculogenesis have been observed in female vdr-knockout mice; however, whether VDR polymorphisms affect human ovarian responses to controlled ovarian stimulation (COS) remains unclear. We hypothesized that VDR polymorphisms are associated with infertility and COS responses. Thus, we evaluated the association between the TaqI, BsmI, and FokI VDR polymorphisms and ovarian responses in women undergoing COS. METHODS In this study, we recruited a control group (n = 121) comprising volunteers with a history of natural conception and a second group of women undergoing COS (n = 70). TaqI, BsmI, and FokI genotyping was performed via restriction fragment length polymorphism analysis or TaqMan qPCR and Sanger sequencing. Intrafollicular 25(OH)D contents were measured in follicular fluid collected from COS patients during oocyte retrieval. Ovarian response parameters were obtained from patient medical records. RESULTS There were no significant differences in the genotype frequencies of VDR polymorphisms (TaqI, BsmI and FokI) between the control and COS groups. However, the allele frequency of TaqI (C allele) was significantly lower in the COS group than in the control group (p = 0.02). Follicle number but not oocyte number was lower in patients with TaqI polymorphic (TC/CC) genotypes (p = 0.03). Importantly, the ratio between the number of follicles retrieved and intrafollicular estradiol concentrations was higher in patients with the TC/CC TaqI genotypes (p < 0.02). CONCLUSION We identified an association between the VDR TaqI polymorphism and reduced follicle number in women undergoing COS, suggesting that VDR signaling affects the ovarian response to stimulation via unknown mechanisms.
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Affiliation(s)
- Mila W. Reginatto
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bartira M. Pizarro
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto A. Antunes
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Fertipraxis – Centro de Reprodução Humana, Rio de Janeiro, Brazil
- Maternidade Escola, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luísa Hoffmann
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pâmela Fernandes
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patrícia Areas
- Fertipraxis – Centro de Reprodução Humana, Rio de Janeiro, Brazil
| | - Maria I. Chiamolera
- Departmento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rosane Silva
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Enrrico Bloise
- Departamento de Morfologia, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Tânia M. Ortiga-Carvalho
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Tânia M. Ortiga-Carvalho,
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Muscogiuri G, Altieri B, de Angelis C, Palomba S, Pivonello R, Colao A, Orio F. Shedding new light on female fertility: The role of vitamin D. Rev Endocr Metab Disord 2017; 18:273-283. [PMID: 28102491 DOI: 10.1007/s11154-017-9407-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In the last decades several studies suggested that vitamin D is involved in the modulation of the reproductive process in women due to the expression of VDR and 1α-hydroxylase in reproductive tissues such as ovary, uterus, placenta, pituitary and hypothalamus. Vitamin D has also a role in the regulation of sex hormone steroidogenesis. Increasing evidence suggests that vitamin D might have a regulatory role in polycystic ovary syndrome (PCOS)-associated symptoms, including ovulatory dysfunction, insulin resistance and hyperandrogenism. Vitamin D deficiency also has been reported to contribute to the pathogenesis of endometriosis due to its immunomodulatory and anti-inflammatory properties. Although most of the studies supported a role of vitamin D in the onset of these diseases, randomized controlled trials to assess the efficacy of vitamin D supplementation have never been performed. In this review we critically discuss the role of vitamin D in female fertility, starting from in vitro and in vivo studies, focusing our attention on the two most frequent causes of female infertility: PCOS and endometriosis.
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Affiliation(s)
- Giovanna Muscogiuri
- Ios and Coleman Medicina Futura Medical Center, Department of Clinical Medicine and Surgery, Section of Endocrinology, University "Federico II", Via Sergio Pasini, 580121, Naples, Italy.
| | - Barbara Altieri
- Division of Endocrinology and Metabolic Diseases, Institute of Medical Pathology, Catholic University of the Sacred Heart, Rome, Italy
| | - Cristina de Angelis
- Ios and Coleman Medicina Futura Medical Center, Department of Clinical Medicine and Surgery, Section of Endocrinology, University "Federico II", Via Sergio Pasini, 580121, Naples, Italy
| | - Stefano Palomba
- Department of Obstetrics and Gynecology, Arcispedale Santa Maria Nuova-IRCCS, 42123, Reggio Emilia, Italy
| | - Rosario Pivonello
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University "Federico II", Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
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Han FF, Lv YL, Gong LL, Liu H, Wan ZR, Liu LH. VDR Gene variation and insulin resistance related diseases. Lipids Health Dis 2017; 16:157. [PMID: 28822353 PMCID: PMC5563043 DOI: 10.1186/s12944-017-0477-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/01/2017] [Indexed: 01/10/2023] Open
Abstract
Background Vitamin D status may influence the risk of Insulin resistance related diseases such as Type 2 diabetes (T2DM), metabolic syndrome (MetS), and polycystic ovarian syndrome (PCOS). Several studies have assessed vitamin D receptor (VDR) gene polymorphism in relationship with these diseases; however, results remain inconsistent. Our study was conducted to elucidate whether VDR Gene polymorphisms could predict insulin resistance on a large scale. Methods A meta-analysis using MEDLINE and EMBASE, was performed up to December 16th, 2016. Studies reporting association of vitamin D gene polymorphism with incident T2DM, MetS and PCOS outcomes were included and sub-group analysis by pigment of skin and latitude were performed. Results A total of 28 articles based on four gene variation, and comprising 9232 participants with 5193 Insulin resistance related diseases patients were included. No significant associations of the VDR ApaI, BsmI, FokI and TaqI variant with Insulin resistance related diseases were found. However, sub-group analysis analysis showed that PCOS in TaqI (OR = 1.47, 95% CI = 1.03–2.09, P = 0.03) for T allele and MetS for G allele (OR = 1.41, 95% CI = 1.07–1.85, P = 0.01) in BsmI was significant association with VDR gene polymorphism. Simultaneously, sub-group analysis showed VDR ApaI rs7975232(G > T)variant was associated with insulin resistance related diseases in Asians (GG/GT + TT) (OR, 1.62; 95% CI, 1.03–2.53; P = 0.04) and population who lived in middle latitude district (30–60°) (GG/GT + TT) (OR, 1.22; 95% CI, 1.04–1.43; P = 0.02), VDR BsmI rs1544410 (A > G)and VDR Taq1rs731236 (T/C) variant were associated with insulin resistance related diseases in Caucasian (dark-pigmented). Conclusion The results suggested that the association between insulin resistance related diseases and VDR ApaI, BsmI, FokI variant was more obvious in dark-pigmented Caucasians and Asians but not in Caucasian with white skin.
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Affiliation(s)
- Fei-Fei Han
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Ya-Li Lv
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Li-Li Gong
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - He Liu
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Zi-Rui Wan
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Li-Hong Liu
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China.
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Reis GVOPD, Gontijo NA, Rodrigues KF, Alves MT, Ferreira CN, Gomes KB. Vitamin D receptor polymorphisms and the polycystic ovary syndrome: A systematic review. J Obstet Gynaecol Res 2017; 43:436-446. [PMID: 28127831 DOI: 10.1111/jog.13250] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/13/2016] [Accepted: 10/31/2016] [Indexed: 11/30/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most frequent endocrinological disorder that affects women of reproductive age, leading to metabolic alterations, such as hyperandrogenism, obesity, menstrual irregularities, insulin resistance, and polycystic ovaries. The etiology remains unclear, but several genetic and environmental factors have been correlated with manifestations of this syndrome. Vitamin D plays important roles in metabolic pathways affected by PCOS, including calcium homeostasis, the insulin pathway, and sex hormone synthesis. Vitamin D concentration has been related with the severity of this disorder, and vitamin D receptor polymorphisms have been shown in some studies to have an association with some of the patterns presented by PCOS. The objective of this study is to provide an up-to-date review about vitamin D receptor polymorphisms and their association with PCOS.
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Affiliation(s)
| | - Natália Alves Gontijo
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Kathryna Fontana Rodrigues
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Michelle Teodoro Alves
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Karina Braga Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Vitamin D-Related Gene Polymorphisms, Plasma 25-Hydroxy-Vitamin D, Cigarette Smoke and Non-Small Cell Lung Cancer (NSCLC) Risk. Int J Mol Sci 2016; 17:ijms17101597. [PMID: 27669215 PMCID: PMC5085630 DOI: 10.3390/ijms17101597] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/22/2016] [Accepted: 09/13/2016] [Indexed: 01/08/2023] Open
Abstract
Epidemiological studies regarding the relationship between vitamin D, genetic polymorphisms in the vitamin D metabolism, cigarette smoke and non-small cell lung cancer (NSCLC) risk have not been investigated comprehensively. To search for additional evidence, the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique and radioimmunoassay method were utilized to evaluate 5 single-nucleotide polymorphisms (SNPs) in vitamin D receptor (VDR), 6 SNPs in 24-hydroxylase (CYP24A1), 2 SNPs in 1α-hydroxylase (CYP27B1) and 2 SNPs in vitamin D-binding protein (group-specific component, GC) and plasma vitamin D levels in 426 NSCLC cases and 445 controls from China. Exposure to cigarette smoke was ascertained through questionnaire information. Multivariable linear regressions and mixed effects models were used in statistical analysis. The results showed that Reference SNP rs6068816 in CYP24A1, rs1544410 and rs731236 in VDR and rs7041 in GC were statistically significant in relation to reduction in NSCLC risk (p < 0.001-0.05). No significant connection was seen between NSCLC risk and overall plasma 25-hydroxyvitamin D [25(OH)D] concentrations, regardless of smoking status. However, the mutation genotype of CYP24A1 rs6068816 and VDR rs1544410 were also significantly associated with increased 25(OH)D levels only in both the smoker and non-smoker cases (p < 0.01-0.05). Meanwhile, smokers and non-smokers with mutated homozygous rs2181874 in CYP24A1 had significantly increased NSCLC risk (odds ratio (OR) = 2.14, 95% confidence interval (CI) 1.47-3.43; p = 0.031; OR = 3.57, 95% CI 2.66-4.74; p = 0.019, respectively). Smokers with mutated homozygous rs10735810 in VDR had significantly increased NSCLC risk (OR = 1.93, 95% CI 1.41-2.76; p = 0.015). However, smokers with mutated homozygous rs6068816 in CYP24A1 had significantly decreased NSCLC risk (OR = 0.43, 95% CI 0.27-1.02; p = 0.006); and smokers and non-smokers with mutated homozygous rs1544410 in VDR had significantly decreased NSCLC risk (OR = 0.51, 95% CI 0.34-1.17; p = 0.002; OR = 0.26, 95% CI 0.20-0.69; p = 0.001, respectively). There are significant joint effects between smoking and CYP24A1 rs2181874, CYP24A1 rs6068816, VDR rs10735810, and VDR rs1544410 (p < 0.01-0.05). Smokers with mutated homozygous rs10735810 in VDR had significantly increased NSCLC risk (OR = 1.93, 95% CI 1.41-2.76; p = 0.015). In summary, the results suggested that the lower the distribution of vitamin D concentration, the more the genetic variations in CYP24A1, VDR and GC genes may be associated with NSCLC risk. In addition, there are significant joint associations of cigarette smoking and vitamin D deficiency on NSCLC risk.
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