ROLE OF VITAMIN D AND MAGNESIUM IN ASSOCIATION WITH INSULIN RESISTANCE IN POLYCYSTIC OVARY SYNDROME (PCOS) PATIENTS

Arushi Khaneja, Nutakki Sridevi*, Kirmani Natukula, Pativada Madhusudan

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. It is characterized by hyperandrogenism, anovulation, and polycystic ovaries. Various metabolic abnormalities associated with PCOS such as insulin resistance (IR), which plays a central role in PCOS pathophysiology. IR is also responsible for the exacerbation of hyperandrogenism and metabolic complications like type 2 diabetes mellitus and cardiovascular disease. The role of micronutrients such as Vitamin D and Magnesium in metabolic regulation becomes more significant clinical interest in recent years. Both have been implicated in glucose metabolism and insulin signaling pathways, but their specific role in PCOS remains inadequately studied and somewhat controversial. Many studies suggested these micronutrients may influence metabolic outcomes in PCOS. Objective: To assess the association between serum Vitamin D and Magnesium levels with insulin resistance in women diagnosed with PCOS. The aim of this study is to determine whether deficiencies in these micronutrients could lead to increased insulin resistance in PCOS patients. Methods: An observational cross-sectional study was conducted on 50 women with confirmed PCOS based on the Rotterdam criteria. Serum Vitamin D (ng/ml), Magnesium (mg/dl), and insulin resistance values were recorded. Participants were recruited from gynaecology outpatient department at GGH. Exclusion criteria included pregnancy, women with known endocrine disorders other than PCOS, women on hormonal or vitamin/mineral supplements. Fasting blood samples were collected for the measurement of fasting blood glucose, c-peptide levels, serum Vitamin D (ng/ml) and Magnesium (mg/dl). Insulin resistance was calculated using the HOMA-IR formula. Results: Descriptive analysis showed a mean serum Vitamin D level of 16.1 ng/ml (SD = 3.35), suggesting widespread Vitamin D insufficiency among participants. The mean Magnesium level was 1.80 mg/dl (SD = 0.23), and the mean insulin resistance (IR) was 11.1 (SD = 7.5), indicating a high prevalence of metabolic disturbance. Correlation analysis revealed a significant negative relationship between serum Vitamin D and insulin resistance (r = -0.45, p < 0.05), indicating that lower Vitamin D levels were associated with higher IR. Magnesium levels, however, showed a weaker and statistically non-significant correlation with IR. In the regression model, Vitamin D emerged as a significant independent predictor of insulin resistance (β = -0.01, p = 0.03), while Magnesium did not demonstrate a significant effect (β = -6.54, p = 0.195). Conclusion: The findings of this study highlight a statistically significant inverse relationship between Vitamin D levels and insulin resistance in women with PCOS. These results underscore the potential importance of Vitamin D in the metabolic management of PCOS. Magnesium, although biologically plausible as a modulator of insulin sensitivity, did not show a significant association in this study, which may be attributed to the limited variability of magnesium levels in the sample or insufficient statistical power. The high prevalence of Vitamin D deficiency and insulin resistance observed in this study and Vitamin D.