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RCT: Heart health and Polycystic Oviarian Syndrome

Posted on: June 11, 2012   by  John Cannell, MD

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Thanks to medical student Hania Rahimi-Ardabili of the Tabriz University of Medical Sciences in Iran and senior scientist Dr. Laya Farzadi, we have another randomized controlled trial (RCT) using vitamin D, this one on cardiovascular risk factors. The scientists decided to use a group of young patients known to have elevated cardiovascular risk factors, patients with Polycystic Ovarian Syndrome (PCOS).

Rahimi-Ardabili H, Pourghassem Gargari B, Farzadi L. Effects of vitamin D on cardiovascular disease risk factors in polycystic ovary syndrome women with vitamin D deficiency. J Endocrinol Invest. 2012 Mar 22.

As reported in blogs past, polycystic ovary syndrome (PCOS) is very common, affecting 5-10% of women of childbearing age. It is heartbreaking because it is the leading cause of infertility. The principal features are failure to ovulate, resulting in irregular or no periods, excessive masculinizing hormones, acne and excessive hair growth.

In relevance to this study, PCOS often leads to elevated risk factors for cardiovascular disease. The presentation varies greatly among women affected with PCOS. The cause is unknown.

Ms. Rahimi-Ardabili studied the effect of an unusual dose of vitamin D in 24 women (50,000 IU every 20 days for two months), comparing that to 26 women who took placebo. All 50 women had vitamin D levels less than 20 ng/ml to begin. At the end of the study, in the vitamin D group, 76% of patients had serum 25(OH) D levels higher the 20 ng/ml. Nevertheless, just 17% of the vitamin D group reached levels greater than 30ng/ml.

The main finding was that even this small dose of vitamin D (we know it is small from its lack of significantly raising vitamin D levels) decreased serum cholesterol, triglycerides, and VLDL levels, while it did not affect other risk factors. However, their conclusions disappointed me, “Further randomized clinical trials with longer duration and greater doses of vitamin D are needed in women with PCOS and vitamin D deficiency, to investigate these findings.”

Yes, that is true, but I was disappointed in that they had no trouble finding so many women with PCOS with vitamin D levels below 20 ng/ml. At the very least, the authors should have called for widespread testing of women with PCOS to treat their vitamin D deficiency. On a more positive note, the authors admitted that their dose of vitamin D, 50,000 IU every 20 days was insufficient.

Ms. Rahimi-Ardabili’s study opens the door for the study that really needs doing, a RCT of women with PCOS using vitamin D doses that will obtain natural levels (50 ng/ml), and then not just seeing if it helps cardiovascular risk factors, but does it help the PCOS? Millions of women would like to know.

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