Особливості діагностики та лікування жінок з синдромом полікістозних яєчників в умовах підвищеного рівня експонування нікелем

Abstract

Abstract. Polycystic ovary syndrome (PCOS) refers to endocrinopathies that women of reproductive age could have. These disorders can be caused by both endogenous (endocrine disorders, chronic infections, stress, etc.) and exogenous factors (environmental, smoking, etc.). Aim. Determination of serum nickel values in women with polycystic ovary syndrome and investigation of the mechanisms underlying the toxic effects of nickel on the reproductive system. Explore potential sources of nickel exposure and develop recommendations for the prevention and treatment of PCOS caused by increased levels of nickel exposure. Materials and Methods. The research was conducted on the bases of State Institution “O.M. Lukianova Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine” 52 women who were diagnosed with PCOS were selected for the study. The control group consisted of 38 women of reproductive age without reproductive system pathology. Determination of serum nickel values in women with PCOS was performed using a Bruker MS 820 inductively coupled plasma mass spectrometer (Australia) using special ICP-MS Expert software. The study of indicators of environmental pollution with nickel was carried out by processing data published in open sources of information. Results. Women with PCOS showed elevated serum nickel values (median ‒ 0.036 mg/l, 95-percentile ‒ 0.194 mg/l), which significantly exceeded the control group (median ‒ 0.001 mg/l, 95-percentile ‒ 0.097 mg/l, p=0.0012). The study of exposure possible sources showed that elevated levels of nickel were found in drinking water from surface water sources. Contamination of surface waters and soils used in agriculture was also detected. The authors propose a set of measures for the prevention and treatment of complications caused by nickel exposure. Conclusions. Nickel exposure occurs mainly by alimentary and inhalation. When exposed to nickel, there is a violation of the function of the endocrine system, activation of inflammatory processes and oxidative stress. In women with PCOS with an increased level of nickel exposure, it is necessary to carry out a set of measures aimed at reducing the level of exposure, accelerating nickel excretion and treating complications that have occurred. Keywords: polycystic ovary syndrome, nickel, exposure, principles of prevention and treatment.