Vitamin D increases serum levels of the soluble receptor for advanced glycation end products in women with PCOS

Context: Elevation of serum proinflammatory advanced glycation end products (AGEs) is involved in the pathogenesis of polycystic ovary syndrome (PCOS). The soluble receptor for AGEs (sRAGE) acts as a decoy by binding circulating AGEs. Vitamin D supplementation attenuates the deposition of AGEs in the vascular system of diabetic animals and improves some metabolic aspects of vitamin D-deficient women with PCOS. Additionally, serum anti-Mullerian hormone (AMH) is elevated in women with PCOS, reflecting abnormal ovarian folliculogenesis. Objective: The objective of the study was to evaluate the effect of 1,25 dihydroxyvitamin D3 (vit D3) supplementation on serum sRAGE and AMH in vitamin D-deficient women with PCOS. Design, Settings, Participants, and Intervention: Sixty-seven women with (n = 22) or without (control; n = 45) PCOS who were diagnosed with vitamin D deficiency were enrolled. Fifty-one women were replaced with oral vit D3 for 8 weeks (16 with PCOS and 35 controls) and 16 women were not treated (six with PCOS and 10 controls). Serum 25-hydroxyvitamin D (25 OH-D), sRAGE, and AMH concentrations were measured at baseline and after vit D3 supplementation in the treated group and 8 weeks apart in the nontreated group. Main Outcome Measure(s): Changes in serum sRAGE and AMH concentrations after vit D3 replacement were measured. Results: In all participants, there was a negative correlation between body mass index and serum sRAGE levels (r=-0.3, P = .01). In women with PCOS, but not in controls, vit D3 increased serum sRAGE (P=.03) and decreased serumAMHlevels (P<.001). The increase in serum sRAGE positively correlated with the increase in serum 25 OH-D after supplementation inwomenwith PCOS (r=0.6, P .01). Conclusion: In women with PCOS, vit D3 might exert a protective effect against the inflammatory action of AGEs by increasing circulating sRAGE. The normalization in serumAMHinduced by vit D3 replacement suggests an improvement in folliculogenesis.