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Shahmoradi, A., Aghaei, A., Ghaderi, K., Jafar Rezaei, M., & Azarnezhad, A. (2022). A meta-analysis of the association of ApaI, BsmI, FokI, and TaqI polymorphisms in the vitamin D receptor gene with the risk of polycystic ovary syndrome in the Eastern Mediterranean Regional Office population. International Journal of Reproductive BioMedicine (IJRM), 20(6), 433-446. https://doi.org/10.18502/ijrm.v20i6.11439
https://doi.org/10.18502/ijrm.v20i6.11439
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- Cited by 7 articles
authors
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Arvin Shahmoradi
Arvin Shahmoradi
Department of Laboratory Medicine, Faculty of Paramedical, Kurdistan University of Medical Sciences, Sanandaj, Iran.
-
Abbas Aghaei
Abbas Aghaei
Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
-
Kimya Ghaderi
Kimya Ghaderi
Department of Laboratory Medicine, Faculty of Paramedical, Kurdistan University of Medical Sciences, Sanandaj, Iran.
-
Mohammad Jafar Rezaei
Mohammad Jafar Rezaei
Department of Anatomical Sciences, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
-
Asaad Azarnezhad
Asaad Azarnezhad
Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Published Date
- Jul 6, 2022
A meta-analysis of the association of ApaI, BsmI, FokI, and TaqI polymorphisms in the vitamin D receptor gene with the risk of polycystic ovary syndrome in the Eastern Mediterranean Regional Office population
Abstract
Background: The results of case-control studies on the association between vitamin D receptor gene (VDR) polymorphisms and polycystic ovary syndrome (PCOS) are inconclusive.
Objective: We aimed to more precisely evaluate the correlation between the ApaI, BsmI, FokI, and TaqI VDR gene polymorphisms and PCOS susceptibility.
Materials and Methods: PubMed, Scopus, Science Citation Index, and Google Scholar databases were searched to retrieve related reports released up to the end of 2020. To evaluate the association strength of the VDR gene polymorphisms with PCOS risk, pooled odds ratios (OR) with a 95% confidence interval were determined.
Results: In total, 1,119 subjects (560 PCOS cases and 559 controls) from 7 studies were included which met the inclusion criteria. A statistically significant association between the TaqI polymorphism and PCOS susceptibility was found in the Eastern Mediterranean Regional Office population (T vs. t: OR = 0.715; TT vs. tt: OR = 0.435, p < 0.001; TT vs. Tt+tt: OR = 0.696, p = 0.01; tt vs. TT+Tt: OR = 1.791, p < 0.001). It was found that the ApaI variant was a risk factor in the dominant inheritance model (AA vs. Aa+aa: OR = 1.466, p = 0.01) and the FokI polymorphism was a protective factor in the recessive inheritance model (ff vs. FF+Ff: OR = 0.669, p = 0.04). The VDR BsmI polymorphism did not show association with PCOS susceptibility.
Conclusion: Our meta-analysis revealed that the VDR ApaI in the dominant model, VDR FokI in the recessive model, and VDR TaqI polymorphisms in all genetic models is associated with vulnerability to PCOS. However, further studies with a larger sample size are required.
Key words: Meta-analysis, Polycystic ovary syndrome, Polymorphisms, Vitamin D receptor.
References
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[2] Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A metaanalysis. Iran J Reprod Med 2015; 13: 591–604.
[3] Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004; 89: 2745–2749.
[4] Repaci A, Gambineri A, Pasquali R. The role of low-grade inflammation in the polycystic ovary syndrome. Mol Cell Endocrinol 2011; 335: 30–41.
[5] Ollila MM, West S, Keinänen-Kiukaanniemi S, Jokelainen J, Auvinen J, Puukka K, et al. Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus: A prospective, population-based cohort study. Hum Reprod 2017; 32: 423–431.
[6] Maitra A, Pingle RR, Menon PS, Naik V, Gokral JS, Meherji PK. Dyslipidemia with particular regard to apolipoprotein profile in association with polycystic ovary syndrome: A study among Indian women. Int J Fertil Womens Med 2001; 46: 271–277.
[7] Legro RS, Gnatuk CL, Kunselman AR, Dunaif A. Changes in glucose tolerance over time in women with polycystic ovary syndrome: A controlled study. J Clin Endocrinol Metab 2005; 90: 3236–3242.
[8] Diamanti-Kandarakis E, Kandarakis H, Legro RS. The role of genes and environment in the etiology of PCOS. Endocrine 2006; 30: 19–26.
[9] Sheikhha MH, Kalantar SM, Ghasemi N. Genetics of polycystic ovary syndrome. Iran J Reprod Med 2007; 5: 1–5.
[10] Mehdizadeh A, Kalantar SM, Sheikhha MH, Aali BSh, Ghanei A. Association of SNP rs. 2414096 CYP19 gene with polycystic ovarian syndrome in Iranian women. Int J Reprod BioMed 2017; 15: 491–496.
[11] Wehr E, Möller R, Horejsi R, Giuliani A, Kopera D, Schweighofer N, et al. Subcutaneous adipose tissue topography and metabolic disturbances in polycystic ovary syndrome. Wien Klin Wochenschr 2009; 121: 262– 269.
[12] Thys-Jacobs S, Donovan D, Papadopoulos A, Sarrel P, Bilezikian JP. Vitamin D and calcium dysregulation in the polycystic ovarian syndrome. Steroids 1999; 64: 430–435.
[13] Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes: A systematic review and meta-analysis. J Clin Endocrinol Metab 2007; 92: 2017–2029.
[14] Niu YM, Wang YD, Jiang GB, Bai G, Chai HB, Li XF, et al. Association between vitamin D receptor gene polymorphisms and polycystic ovary syndrome risk: A meta-analysis. Front Physiol 2019; 9: 1902.
[15] Bacopoulou F, Kolias E, Efthymiou V, Antonopoulos CN, Charmandari E. Vitamin D predictors in polycystic ovary syndrome: A meta-analysis. Eur J Clin Invest 2017; 47: 746– 755.
[16] Gyorffy B, Vásárhelyi B, Krikovszky D, Madácsy L, Tordai A, Tulassay T, et al. Gender-specific association of vitamin D receptor polymorphism combinations with type 1 diabetes mellitus. Eur J Endocrinol 2002; 147: 803–808.
[17] Bid HK, Konwar R, Aggarwal C, Gautam S, Saxena M, Nayak VL, et al. Vitamin D receptor (FokI, BsmI and TaqI) gene polymorphisms and type 2 diabetes mellitus: A North Indian study. Indian J Med Sci 2009; 63: 187–194.
[18] Haussler MR, Jurutka PW, Mizwicki M, Norman AW. Vitamin D receptor (VDR)-mediated actions of 1α, 25 (OH) 2vitamin D3: Genomic and non-genomic mechanisms. Best Pract Res Clin Endocrinol Metab 2011; 25: 543–559.
[19] Shahmoradi A, Ghaderi K, Aghaei A, Azarnezhad A. Associations of vitamin D receptor rs1544410 polymorphism with type 1 diabetes mellitus risk: Systematic review and meta-analysis. Meta Gene 2021; 30: 100973.
[20] Baker AR, McDonnell DP, Hughes M, Crisp TM, Mangelsdorf DJ, Haussler MR, et al. Cloning and expression of full-length cDNA encoding human vitamin D receptor. Proc Natl Acad Sci 1988; 85: 3294–3298.
[21] Abdollahzadeh R, Sobhani Fard M, Rahmani F, Moloudi K, Sadeghi Kalani B, Azarnezhad A. Predisposing role of vitamin D receptor (VDR) polymorphisms in the development of multiple sclerosis: A case-control study. J Neurol Sci 2016; 367: 148–151.
[22] Shi XY, Huang AP, Xie DW, Yu XL. Association of vitamin D receptor gene variants with polycystic ovary syndrome: A meta-analysis. BMC Med Genet 2019; 20: 32.
[23] Humadi EH, Showman HA, Al-azzawie HF. Association of vitamin-D receptor gene polymorphisms (FokI and ApaI) and vitamin D serum levels in a sample of Iraqi women with polycystic ovary syndrome. Indian J Public Health Res Dev 2018; 9: 401–408.
[24] Abdul-Hassan IA, Badr AH, Kadhim SJ. Association of vitamin d receptor gene polymorphism at three SNPs and their haplotypes with polycystic ovary syndrome risk in Iraqi women. Pak J Biotechnol 2017; 14: 615–622.
[25] Hamdi RA, Abdul-Qahar ZH, Ahmed SJ, Tawfeeq RK. Assessment of vitamin D receptor gene polymorphism in Iraqi women with polycystic ovary syndrome. J Clin Diagn Res 2018; 12: BC27–BC30.
[26] Ramezani N, Ostadsharif M, Nayeri H. Association of BsmI variant of vitamin D receptor gene with polycystic ovary syndrome: A case-control study. Int J Reprod BioMed 2020; 18: 877–884.
[27] Zadeh-Vakili A, Ramezani Tehrani F, Daneshpour MS, Zarkesh M, Saadat N, Azizi F. Genetic polymorphism of vitamin D receptor gene affects the phenotype of PCOS. Gene 2013; 515: 193–196.
[28] Bagheri M, Rad IA, Jazani NH, Nanbakhsh F. Vitamin D receptor TaqI gene variant in exon 9 and polycystic ovary syndrome risk. Int J Fertil Steril 2013; 7: 116–121.
[29] Mahmoudi T. Genetic variation in the vitamin D receptor and polycystic ovary syndrome risk. Fertil Steril 2009; 92: 1381–1383.
[30] Mahmoudi T, Majidzadeh-A K, Farahani H, Mirakhorli M, Dabiri R, Nobakht H, et al. Association of vitamin D receptor gene variants with polycystic ovary syndrome: A case control study. Int J Reprod BioMed 2015; 13: 793– 800.
[31] Bagheri M, Abdi Rad I, Hosseini Jazani N, Nanbakhsh F. Lack of association of vitamin D receptor FokI (rs10735810)(C/T) and BsmI (rs1544410)(A/G) genetic variations with polycystic ovary syndrome risk: A casecontrol study from Iranian Azeri Turkish women. Maedica 2012; 7: 303–308.
[32] El-shal AS, Shalaby SM, Aly NM, Rashad NM, Abdelaziz AM. Genetic variation in the vitamin D receptor gene and vitamin D serum levels in Egyptian women with polycystic ovary syndrome. Mol Biol Rep 2013; 40: 6063–6073.
[33] Al Thomali A, Daghestani MH, Daghestani MH, Kaya N, Warsy A. Polymorphic variations in VDR gene in Saudi women with and without polycystic ovary syndrome (PCOS) and significant influence of seven polymorphic sites on anthropometric and hormonal parameters. J Med Biochem 2018; 37: 415–425.
[34] Afzal M. Health research in the Word Health Organization Regional Office for the Eastern Mediterranean. East Mediterr Health J 2008; 14 (Suppl.): 67–73.
[35] Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Int J Surg 2010; 8: 336–341.
[36] Asemi Z, Foroozanfard F, Hashemi T, Bahmani F, Jamilian M, Esmaillzadeh A. Calcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome. Clin Nutr 2015; 34: 586–592.
[37] Foroozanfard F, Talebi M, Samimi M, Mehrabi S, Badehnoosh B, Jamilian M, et al. Effect of two different doses of vitamin D supplementation on metabolic profiles of insulin-resistant patients with polycystic ovary syndrome: A randomized, double-blind, placebocontrolled trial. Horm Metab Res 2017; 49: 612–617.
[38] Nandi A, Sinha N, Ong E, Sonmez H, Poretsky L. Is there a role for vitamin D in human reproduction? Horm Mol Biol Clin Investig 2016; 25: 15–28.
[39] Shahrokhi SZ, Ghaffari F, Kazerouni F. Role of vitamin D in female reproduction. Clin Chim Acta 2016; 455: 33–38.
[40] Uitterlinden AG, Fang Y, Van Meurs JB, Pols HA, Van Leeuwen JP. Genetics and biology of vitamin D receptor polymorphisms. Gene 2004; 338: 143–156.
[41] Abdollahzadeh R, Moradi Pordanjani P, Rahmani F, Mashayekhi F, Azarnezhad A, Mansoori Y. Association of VDR gene polymorphisms with risk of relapsing-remitting multiple sclerosis in an Iranian Kurdish population. Int J Neurosci 2018; 128: 505–511.
[42] Goulart LR, Ferreira FR, Goulart IMB. Interaction of Taq I polymorphism at exon 9 of the vitamin D receptor gene with the negative lepromin response may favor the occurrence of leprosy. FEMS Immunol Med Microbiol 2006; 48: 91–98.
[43] Han FF, Lv Yl, Gong Ll, Liu H, Wan ZR, Liu LH. VDR gene variation and insulin resistance related diseases. Lipids Health Dis 2017; 16: 157.
[44] Dasgupta S, Dutta J, Annamaneni S, Kudugunti N, Battini MR. Association of vitamin D receptor gene polymorphisms with polycystic ovary syndrome among Indian women. Indian J Med Res 2015; 142: 276–285.
[45] Wehr E, Trummer O, Giuliani A, Gruber HJ, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol 2011; 164: 741–749.
[46] Liang F, Ren N, Zhang H, Zhang J, Wu Q, Song R, et al. A meta-analysis of the relationship between vitamin D receptor gene ApaI polymorphisms and polycystic ovary syndrome. Adv Clin Exp Med 2019; 28: 255–262.
[47] Jurutka PW, Remus LS, Whitfield GK, Thompson PD, Hsieh JC, Zitzer H, et al. The polymorphic N terminus in human vitamin D receptor isoforms influences transcriptional activity by modulating interaction with transcription factor IIB. Mol Endocrinol 2000; 14: 401–420.
[48] Ahmadi S, Mirzaei K, Hossein-Nezhad A, Shariati G. Vitamin D receptor FokI genotype may modify the susceptibility to schizophrenia and bipolar mood disorder by regulation of dopamine D1 receptor gene expression. Minerva Med 2012; 103: 383–391.
[2] Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A metaanalysis. Iran J Reprod Med 2015; 13: 591–604.
[3] Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004; 89: 2745–2749.
[4] Repaci A, Gambineri A, Pasquali R. The role of low-grade inflammation in the polycystic ovary syndrome. Mol Cell Endocrinol 2011; 335: 30–41.
[5] Ollila MM, West S, Keinänen-Kiukaanniemi S, Jokelainen J, Auvinen J, Puukka K, et al. Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus: A prospective, population-based cohort study. Hum Reprod 2017; 32: 423–431.
[6] Maitra A, Pingle RR, Menon PS, Naik V, Gokral JS, Meherji PK. Dyslipidemia with particular regard to apolipoprotein profile in association with polycystic ovary syndrome: A study among Indian women. Int J Fertil Womens Med 2001; 46: 271–277.
[7] Legro RS, Gnatuk CL, Kunselman AR, Dunaif A. Changes in glucose tolerance over time in women with polycystic ovary syndrome: A controlled study. J Clin Endocrinol Metab 2005; 90: 3236–3242.
[8] Diamanti-Kandarakis E, Kandarakis H, Legro RS. The role of genes and environment in the etiology of PCOS. Endocrine 2006; 30: 19–26.
[9] Sheikhha MH, Kalantar SM, Ghasemi N. Genetics of polycystic ovary syndrome. Iran J Reprod Med 2007; 5: 1–5.
[10] Mehdizadeh A, Kalantar SM, Sheikhha MH, Aali BSh, Ghanei A. Association of SNP rs. 2414096 CYP19 gene with polycystic ovarian syndrome in Iranian women. Int J Reprod BioMed 2017; 15: 491–496.
[11] Wehr E, Möller R, Horejsi R, Giuliani A, Kopera D, Schweighofer N, et al. Subcutaneous adipose tissue topography and metabolic disturbances in polycystic ovary syndrome. Wien Klin Wochenschr 2009; 121: 262– 269.
[12] Thys-Jacobs S, Donovan D, Papadopoulos A, Sarrel P, Bilezikian JP. Vitamin D and calcium dysregulation in the polycystic ovarian syndrome. Steroids 1999; 64: 430–435.
[13] Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diabetes: A systematic review and meta-analysis. J Clin Endocrinol Metab 2007; 92: 2017–2029.
[14] Niu YM, Wang YD, Jiang GB, Bai G, Chai HB, Li XF, et al. Association between vitamin D receptor gene polymorphisms and polycystic ovary syndrome risk: A meta-analysis. Front Physiol 2019; 9: 1902.
[15] Bacopoulou F, Kolias E, Efthymiou V, Antonopoulos CN, Charmandari E. Vitamin D predictors in polycystic ovary syndrome: A meta-analysis. Eur J Clin Invest 2017; 47: 746– 755.
[16] Gyorffy B, Vásárhelyi B, Krikovszky D, Madácsy L, Tordai A, Tulassay T, et al. Gender-specific association of vitamin D receptor polymorphism combinations with type 1 diabetes mellitus. Eur J Endocrinol 2002; 147: 803–808.
[17] Bid HK, Konwar R, Aggarwal C, Gautam S, Saxena M, Nayak VL, et al. Vitamin D receptor (FokI, BsmI and TaqI) gene polymorphisms and type 2 diabetes mellitus: A North Indian study. Indian J Med Sci 2009; 63: 187–194.
[18] Haussler MR, Jurutka PW, Mizwicki M, Norman AW. Vitamin D receptor (VDR)-mediated actions of 1α, 25 (OH) 2vitamin D3: Genomic and non-genomic mechanisms. Best Pract Res Clin Endocrinol Metab 2011; 25: 543–559.
[19] Shahmoradi A, Ghaderi K, Aghaei A, Azarnezhad A. Associations of vitamin D receptor rs1544410 polymorphism with type 1 diabetes mellitus risk: Systematic review and meta-analysis. Meta Gene 2021; 30: 100973.
[20] Baker AR, McDonnell DP, Hughes M, Crisp TM, Mangelsdorf DJ, Haussler MR, et al. Cloning and expression of full-length cDNA encoding human vitamin D receptor. Proc Natl Acad Sci 1988; 85: 3294–3298.
[21] Abdollahzadeh R, Sobhani Fard M, Rahmani F, Moloudi K, Sadeghi Kalani B, Azarnezhad A. Predisposing role of vitamin D receptor (VDR) polymorphisms in the development of multiple sclerosis: A case-control study. J Neurol Sci 2016; 367: 148–151.
[22] Shi XY, Huang AP, Xie DW, Yu XL. Association of vitamin D receptor gene variants with polycystic ovary syndrome: A meta-analysis. BMC Med Genet 2019; 20: 32.
[23] Humadi EH, Showman HA, Al-azzawie HF. Association of vitamin-D receptor gene polymorphisms (FokI and ApaI) and vitamin D serum levels in a sample of Iraqi women with polycystic ovary syndrome. Indian J Public Health Res Dev 2018; 9: 401–408.
[24] Abdul-Hassan IA, Badr AH, Kadhim SJ. Association of vitamin d receptor gene polymorphism at three SNPs and their haplotypes with polycystic ovary syndrome risk in Iraqi women. Pak J Biotechnol 2017; 14: 615–622.
[25] Hamdi RA, Abdul-Qahar ZH, Ahmed SJ, Tawfeeq RK. Assessment of vitamin D receptor gene polymorphism in Iraqi women with polycystic ovary syndrome. J Clin Diagn Res 2018; 12: BC27–BC30.
[26] Ramezani N, Ostadsharif M, Nayeri H. Association of BsmI variant of vitamin D receptor gene with polycystic ovary syndrome: A case-control study. Int J Reprod BioMed 2020; 18: 877–884.
[27] Zadeh-Vakili A, Ramezani Tehrani F, Daneshpour MS, Zarkesh M, Saadat N, Azizi F. Genetic polymorphism of vitamin D receptor gene affects the phenotype of PCOS. Gene 2013; 515: 193–196.
[28] Bagheri M, Rad IA, Jazani NH, Nanbakhsh F. Vitamin D receptor TaqI gene variant in exon 9 and polycystic ovary syndrome risk. Int J Fertil Steril 2013; 7: 116–121.
[29] Mahmoudi T. Genetic variation in the vitamin D receptor and polycystic ovary syndrome risk. Fertil Steril 2009; 92: 1381–1383.
[30] Mahmoudi T, Majidzadeh-A K, Farahani H, Mirakhorli M, Dabiri R, Nobakht H, et al. Association of vitamin D receptor gene variants with polycystic ovary syndrome: A case control study. Int J Reprod BioMed 2015; 13: 793– 800.
[31] Bagheri M, Abdi Rad I, Hosseini Jazani N, Nanbakhsh F. Lack of association of vitamin D receptor FokI (rs10735810)(C/T) and BsmI (rs1544410)(A/G) genetic variations with polycystic ovary syndrome risk: A casecontrol study from Iranian Azeri Turkish women. Maedica 2012; 7: 303–308.
[32] El-shal AS, Shalaby SM, Aly NM, Rashad NM, Abdelaziz AM. Genetic variation in the vitamin D receptor gene and vitamin D serum levels in Egyptian women with polycystic ovary syndrome. Mol Biol Rep 2013; 40: 6063–6073.
[33] Al Thomali A, Daghestani MH, Daghestani MH, Kaya N, Warsy A. Polymorphic variations in VDR gene in Saudi women with and without polycystic ovary syndrome (PCOS) and significant influence of seven polymorphic sites on anthropometric and hormonal parameters. J Med Biochem 2018; 37: 415–425.
[34] Afzal M. Health research in the Word Health Organization Regional Office for the Eastern Mediterranean. East Mediterr Health J 2008; 14 (Suppl.): 67–73.
[35] Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Int J Surg 2010; 8: 336–341.
[36] Asemi Z, Foroozanfard F, Hashemi T, Bahmani F, Jamilian M, Esmaillzadeh A. Calcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome. Clin Nutr 2015; 34: 586–592.
[37] Foroozanfard F, Talebi M, Samimi M, Mehrabi S, Badehnoosh B, Jamilian M, et al. Effect of two different doses of vitamin D supplementation on metabolic profiles of insulin-resistant patients with polycystic ovary syndrome: A randomized, double-blind, placebocontrolled trial. Horm Metab Res 2017; 49: 612–617.
[38] Nandi A, Sinha N, Ong E, Sonmez H, Poretsky L. Is there a role for vitamin D in human reproduction? Horm Mol Biol Clin Investig 2016; 25: 15–28.
[39] Shahrokhi SZ, Ghaffari F, Kazerouni F. Role of vitamin D in female reproduction. Clin Chim Acta 2016; 455: 33–38.
[40] Uitterlinden AG, Fang Y, Van Meurs JB, Pols HA, Van Leeuwen JP. Genetics and biology of vitamin D receptor polymorphisms. Gene 2004; 338: 143–156.
[41] Abdollahzadeh R, Moradi Pordanjani P, Rahmani F, Mashayekhi F, Azarnezhad A, Mansoori Y. Association of VDR gene polymorphisms with risk of relapsing-remitting multiple sclerosis in an Iranian Kurdish population. Int J Neurosci 2018; 128: 505–511.
[42] Goulart LR, Ferreira FR, Goulart IMB. Interaction of Taq I polymorphism at exon 9 of the vitamin D receptor gene with the negative lepromin response may favor the occurrence of leprosy. FEMS Immunol Med Microbiol 2006; 48: 91–98.
[43] Han FF, Lv Yl, Gong Ll, Liu H, Wan ZR, Liu LH. VDR gene variation and insulin resistance related diseases. Lipids Health Dis 2017; 16: 157.
[44] Dasgupta S, Dutta J, Annamaneni S, Kudugunti N, Battini MR. Association of vitamin D receptor gene polymorphisms with polycystic ovary syndrome among Indian women. Indian J Med Res 2015; 142: 276–285.
[45] Wehr E, Trummer O, Giuliani A, Gruber HJ, Pieber TR, Obermayer-Pietsch B. Vitamin D-associated polymorphisms are related to insulin resistance and vitamin D deficiency in polycystic ovary syndrome. Eur J Endocrinol 2011; 164: 741–749.
[46] Liang F, Ren N, Zhang H, Zhang J, Wu Q, Song R, et al. A meta-analysis of the relationship between vitamin D receptor gene ApaI polymorphisms and polycystic ovary syndrome. Adv Clin Exp Med 2019; 28: 255–262.
[47] Jurutka PW, Remus LS, Whitfield GK, Thompson PD, Hsieh JC, Zitzer H, et al. The polymorphic N terminus in human vitamin D receptor isoforms influences transcriptional activity by modulating interaction with transcription factor IIB. Mol Endocrinol 2000; 14: 401–420.
[48] Ahmadi S, Mirzaei K, Hossein-Nezhad A, Shariati G. Vitamin D receptor FokI genotype may modify the susceptibility to schizophrenia and bipolar mood disorder by regulation of dopamine D1 receptor gene expression. Minerva Med 2012; 103: 383–391.