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
ARTICLE HIGHLIGHTS
Research background

Outcomes from conventional observational investigations are often based on the limited sample size and influenced by confounding factors.

Research motivation

To conduct a two-sample mendelian randomization (MR) analysis to assess the impact of plasma levels of vitamins A, B12, D, E, and K on polycystic ovary syndrome (PCOS) and key pathways implicated in its development, namely, insulin resistance, hyperlipidemia, and obesity.

Research objectives

To explore the causal relationship between increased vitamins A, D, E, K, and B12 values and a reduced risk of PCOS or primary pathways implicated in its development.

Research methods

The inverse variance weighted (IVW) method is considered highly reliable when there is no evidence of directional pleiotropy among the selected instrumental variables. Complementary analyses were conducted using the weighted median and MR-Egger methods as supplements to the IVW method. Furthermore, the MR-robust adjusted profile score (MR-RAPS) and MR-PRESSO approaches were used to identify outlier single nucleotide polymorphisms (SNPs) and provide causal estimations after removing probable outliers, assuming that the employed SNPs are valid.

Research results

This MR analysis, based on large-scale genetic consortia, provided suggestive evidence supporting a causal effect of higher vitamins E and B12 levels on a decreased risk of PCOS. Our findings indicated that genetically predicted levels of vitamins K and B12 were related to a lower risk of obesity. Additionally, genetically predicted higher levels of vitamins E, D, and A were suggestively associated with a decreased risk of hyperlipidemia, while higher vitamin E levels were suggestively linked to a lower risk of insulin resistance.

Research conclusions

Higher levels of vitamins A, D, E, K, and B12 are causally related to a reduced risk of PCOS or key pathways implicated in its development.

Research perspectives

Further prospective population-based studies and in vivo and in vitro trials are required to clarify the precise role of vitamin supplements in the onset of PCOS and key pathways implicated in its development.