Association of Trace Elements with Polycystic Ovary Syndrome in Women-A Case-Control Study

Abstract

Objectives: There are still limited or lacking data on the association of trace elements (TEs) with polycystic ovary syndrome (PCOS). This case-control study aimed to determine levels of essential TEs (manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), molybdenum (Mo)) and non-essential TEs (arsenic (As), cadmium (Cd), mercury (Hg), lead (Pb)) in urine, whole blood, and serum to investigate a possible association with kidney and liver function, endocrine and metabolic parameters, and environmental and lifestyle sources of potential exposure and provide possible recommendations. Methods: In our case-control study, women with PCOS (n = 35) and healthy controls (n = 35) underwent clinical and ultrasonographic examination, filled in questionnaires targeting general, lifestyle, and environmental information, and provided fasting venous blood samples and first morning urine for biochemical, hormonal, and TE analysis. Multiple linear regression models were used to evaluate the association between TE levels and data obtained through questionnaires. Results: In women with PCOS, lower Mo levels in whole blood (p = 0.024) and serum (p = 0.011) and higher serum Cu levels (p = 0.026) were detected when compared to healthy controls. Results of this study show that amendments in Cu and Mo levels might be related to altered kidney and liver function and disrupted hormonal balance in PCOS women. Cu levels positively correlated with leukocyte count. There was a negative correlation of Mo levels with proteinuria and luteinizing hormone levels. Regarding liver function, Mo negatively correlated with urinary bilirubin levels, and there was a positive association with alanine and aspartate aminotransferase, respectively. Dietary supplement consumption and certain diet habits appeared to be important predictors of exposure to Cu (beef consumption) or Mo (cereal and boiled vegetable consumption) and modify Mo and Cu levels in women. Conclusions: Concentrations of the chemical elements Mo and Cu in biological samples of women appear to be related to PCOS and nutrition. To our knowledge, this is a novel finding for Mo. Additional research is needed to provide more insights into the causality of the PCOS relationship with Mo and Cu in humans.

Keywords: PCOS; diet; endocrine disruptors; essential and non-essential elements; habits; hepatic damage; oxidative stress; renal toxicity.

Figure 1

The correlations of Mo and Cu levels with nutritional patterns in women with PCOS (n = 35). Legend: Cu—copper; Mo—molybdenum. r—Spearman correlation coefficient; statistical significance: p < 0.05.

Figure 2

The correlations of Mo and Cu levels with nutritional patterns in the control group of women (n = 35). Legend: DS—other dietary supplements; Cu—copper; Mo—molybdenum. r—Spearman correlation coefficient; statistical significance: p < 0.05.

Figure 3

Summary of the main findings regarding associations of Cu and Mo levels with PCOS (statistical significance: p < 0.05). Legend: ALT—alanine aminotransferase; AST—aspartate aminotransferase; Cu—copper; DS—dietary supplement; LH—luteinizing hormone; Mo—molybdenum; PCOS—polycystic ovary syndrome.