Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2023; 11(23): 5468-5478
Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5468
Effect of vitamin supplementation on polycystic ovary syndrome and key pathways implicated in its development: A Mendelian randomization study
Jia-Yan Shen, Li Xu, Yang Ding, Xiao-Yun Wu
Jia-Yan Shen, Xiao-Yun Wu, Department of Reproductive Medicine, Huzhou Maternity & Child Health Care Hospital, Huzhou 313000, Zhejiang Province, China
Li Xu, Department of Obstetrics and Gynecology, Huzhou Maternity & Child Health Care Hospital, Huzhou 313000, Zhejiang Province, China
Yang Ding, Department of Dermatology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Shen JY, Xu L, Ding Y, and Wu XY designed the research study; Shen JY and Xu L performed the research; Shen JY and Ding Y contributed new reagents and analytic tools; Shen JY and Wu XY analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Supported by the Huzhou Science and Technology Plan, No. 2022GY27.
Institutional review board statement: No institutional review board statement is required since this study was based on public databases.
Informed consent statement: The data was from large sample size GWAS, and no informed consent statement is required.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
Data sharing statement: The data can be accessed from the following website: https://gwas.mrcieu.ac.uk/. Additionally, we have presented the relevant data in Supplementary Tables 1–20.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Yun Wu, MD, Doctor, Department of Reproductive Medicine, Huzhou Maternity & Child Health Care Hospital, No. 2 East Street, Wuxing District, Huzhou 313000, Zhejiang Province, China. wxy2103859@163.com
Received: March 29, 2023
Peer-review started: March 29, 2023
First decision: July 3, 2023
Revised: July 7, 2023
Accepted: July 17, 2023
Article in press: July 17, 2023
Published online: August 16, 2023
Processing time: 139 Days and 15.9 Hours
Abstract
BACKGROUND

Many epidemiologic investigations have explored the relationship between viatmins and polycystic ovary syndrome (PCOS). However, the effectiveness of vitamin, vitamin-like nutrient, or mineral supplementation in reducing the risk of PCOS remains a subject of debate.

AIM

To investigate the impact of plasma levels of vitamins A, B12, D, E, and K on PCOS and key pathways implicated in its development, namely, insulin resistance, hyperlipidemia, and obesity, through Mendelian randomization (MR) analysis.

METHODS

Single nucleotide polymorphisms associated with vitamin levels were selected from genome-wide association studies. The primary analysis was performed using the random-effects inverse-variance-weighted approach. Complementary analyses were conducted using the weighted median, MR-Egger, MR-robust adjusted profile score, and MR-PRESSO approaches.

RESULTS

The results provided suggestive evidence of a decreased risk of PCOS with genetically predicted higher levels of vitamin E (odds ratio [OR] = 0.118; 95% confidence interval [CI]: 0.071–0.226; P < 0.001) and vitamin B12 (OR = 0.753, 95%CI: 0.568–0.998, P = 0.048). An association was observed between vitamin E levels and insulin resistance (OR = 0.977, 95%CI: 0.976–0.978, P < 0.001). Additionally, genetically predicted higher concentrations of vitamins E, D, and A were suggested to be associated with a decreased risk of hyperlipidemia. Increased vitamins K and B12 levels were linked to a lower obesity risk (OR = 0.917, 95%CI: 0.848–0.992, P = 0.031).

CONCLUSION

The findings of this MR study suggest a causal relationship between increased vitamins A, D, E, K, and B12 levels and a reduced risk of PCOS or primary pathways implicated in its development.

Keywords: Vitamin levels, Polycystic ovary syndrome, Key pathways, Mendelian randomization, Casual effect

Core Tip: Higher vitamins A, D, E, K, and B12 levels were casually related to a reduced risk of polycystic ovary syndrome (PCOS) or main pathways implicated in its development, as suggested by our Mendelian randomization investigation. More prospective and functional in vivo and in vitro trials are required to clarify the role of vitamin supplements in the onset of PCOS and main pathways implicated in its development.