Vitamin D Influence on Clinical and Immunological Indicators in Women with Climacteric Syndrome

Aim. To evaluate the cholecalciferol effect on the climacteric manifestations severity and the cytokine status dynamics in women receiving phytoestrogen therapy.

Design. Prospective longitudinal case-control study.

Materials and methods. 302 women aged 48 to 57 years were examined. Of these 229 women had symptoms of climacteric syndrome (CS). At the first stage of the study, clinical signs, 25(OH)D and cytokine levels were assessed in women with CS (n = 229). The control data were the results of similar age women, but without signs of CS (control group, n = 73). At the second stage the dynamics of clinical and immunological parameters in two groups of women with CS were studied. The first group (comparison group, n = 57) consisted of patients who received phytoestrogens therapy for 6 months. The second group (main, n = 57) included women who in addition to a similar 6-month course of phytoestrogens were prescribed cholecalciferol using saturation regimens depending on the initial 25(OH)D serum levels. In the dynamics of treatment, the severity of CS manifestations was assessed, as well as the levels of 25(OH)D, interleukins IL-1â, IL-6, IL-8, and tumor necrosis factor á. After a 6-month course of therapy 55 women from the comparison group and 50 patients from the main group were re-examined.

Results. It was found that climacteric syndrome is characterized by an increased concentrations of IL-6 (p = 0.042) and IL-8 (p = 0.036) and is more often recorded in women with vitamin D deficiency (81.1% versus 68.5%; p = 0.018). The inclusion of cholecalciferol in the treatment led to a significantly more pronounced reduction in the anxiety and panic attacks severity, headaches, somatic symptoms, the overall severity of climacteric syndrome on the Green scale, as well as IL-6 level after 6 months of complex therapy. A significant decrease of IL-8 level was found only when phytoestrogens were taken in combination with cholecalciferol. The combination of phytoestrogens with cholecalciferol also provided a significant increase in 25(OH)D serum content: from 17.77 [13.58; 24.76] ng/ml to 35.47 [31.49; 43.59] ng/ml (p < 0.001).

Conclusion. The results obtained indicate the presence of favorable clinical and immunological effects of vitamin D supplementation in women with climacteric syndrome.

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