Τομέας Υγείας - Μητέρας - ΠαιδιούLibrary of the School of Health Sciences
Γεώργιος Χρούσος, Καθηγητής, Ιατρική, ΕΚΠΑ,
Δεληγεώρογλου Ευθύμιος, Καθηγητής, Ιατρική, ΕΚΠΑ.
Χαρμανδάρη Ευαγγελία, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Γιαννακούλια Μαρία,Τμήμα Διατροφής,Χαρακοπείου ,
Μπακοπούλου Φλώρα, Επίκουρη Καθηγήτρια, Ιατρική, ΕΚΠΑ
Αραβατινός Λέων, Καθηγητής,Ιατρική,ΕΚΠΑ
Μιχαλά Σταυρούλα, Επίκουρη Καθηγήτρια , Ιατρική, ΕΚΠΑ
Τυχαιοποιημένη συγκριτική μελέτη με τη χορήγηση βιταμίνης D ή ωμέγα 3 λιπαρών οξέων σε έφηβες με Σύνδρομο Πολυκυστικών Ωοθηκών (ΣΠΩ)
Randomized controlled trial with the supplementation of vitamin D or omega 3 fatty acids in adolescent girls with Polycystic Ovary Syndrome (PCOS)
Background-objective: Polycystic Ovary Syndrome (PCOS) characterized by various reproductive and metabolic abnormalities is the most prevalent endocrine disorder afflicting women of reproductive age. There is some evidence that vitamin D deficiency might be linked to the endocrine and metabolic abnormalities, in PCOS such as insulin resistance, visceral obesity, hyperandrogenism and menstrual dysfunction. In addition, although only a few studies have assessed the potential benefits of vitamin D on PCOS components, it seems that vitamin D supplementation has positive effects on the outcome of the syndrome. Other studies show that supplementing the diet of patients with PCOS with ω-3 long chain polyunsaturated fatty acids (LCPUFA’s) and specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) ameliorates the aforementioned metabolic and endocrine parameters of the syndrome. This study was designed to compare the effect of a six month supplementation of :1) vitamin D or 2)ω-3 LCPUFA’s (EPA,DHA) on the clinical, biochemical bone density , metabolic, endocrine and ultrasound markers in adolescents with PCOS.
Methods: The population studied, consists of adolescents ranging in age from 14-18 years diagnosed with PCOS. The diagnosis of PCOS was based on the Rotterdam criteria. Exclusion criteria include patients with serious chronic disease, patients on medication and/or contraception or dietary supplements. On the subjects involved a full evaluation was performed at baseline and after the six month intervention period. The evaluation included: clinical markers, laboratory markers, ultrasound, bone density and fat determination. Sufficiency in vitamin D (25(OH)D≥ 30 mg/ml) was a prerequisite for all patients before entering the 6 month intervention.
Results: 30 adolescents participated (average age 15.7±2.1 years), 11 in the vitamin D group, 10 in the ω-3 and 9 patients in the control group. Statistically significant differences were not observed in the adolescents’clinical and anthropometric characteristics (demographic, socio- economic, age, weight, height) at baseline and after the intervention. In the vitamin D group, a significant increase was observed in plasma creatinine (p=0.019), DHEA (p=0.044) and DHEA-S(p=0.017) concentra¬tions, as well as the thickness of the endometrium (p=0.002) whilst a decrease was observed in ALP(p=0.043). In the omega-3 group a statistically significant decrease in γ-GT (p=0.046), 25(OH)D (p=0.007), PTH (p=0.043) and an increase in LDL (p=0.046) ApoB (p=0.023) and in the number of menstrual periods (p=0.046) was noted. In all three groups a statistically significant positive correlation was found between waist circumference (WC) measurements and insulin values from OGTT. However, this positive correlation did not remain significant in the ω-3 group after the six month intervention period. In the control group the concentrations of 25(OH)D decreased while TSH increased both in a statistically significant rate (p=0.039)
Conclusions: In all three groups a positive correlation was observed between the WC and the insulin values (from OGTT) before the intervention. However this positive correlation did not remain after the six month intervention in the ω-3 group. These results have been reported by other researchers.
The ω-3 group showed an improvement in the menstrual cycle, although an increase in the plasma values of LDL-C and Apo B was also observed. In the vitamin D group an increase in the plasma androgens (DHEA, DHEAS) was observed.
Main subject category:
Polycystic ovary syndrome, Adolescense ,Girl
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