Abstract
Polycystic ovary syndrome (PCOS) is a global health concern for women of reproductive age, as 6.5% of women worldwide are affected by this syndrome. PCOS is marked by hyperandrogenism, anovulation, menstrual abnormalities, and polycystic ovaries. Metals such as arsenic, cadmium, lead and mercury are considered to be systemic toxicants/human carcinogens and seem to have devastating effects on humans, even at minimal exposures. One of the probable aetiological factors for PCOS has been identified as oxidative stress. In view of the probable associations among oxidative stress, metal toxicity and PCOS, the present study examined the role of heavy metals in the generation of oxidative stress among females. This prospective study included 106 women (56 women diagnosed with PCOS and 50 women who were not diagnosed with PCOS as control women). There were no significant differences in the sociodemographic characteristics between the two groups except for the irregularity of menses and the presence of acne. The serum As, Cd, Pb, and Hg levels increased and the serum glutathione (GSH) and superoxide dismutase (SOD) levels diminished significantly in the PCOS group compared to the control group at P < 0.001. The SOD levels were negatively correlated with the As and Pb levels at P < 0.05. Additionally, the PCOS group exhibited a strong negative correlation between the GSH and As levels (P < 0.01), GSH and Pb levels (P < 0.05) and GSH and Hg levels (P < 0.01). Furthermore, the As levels were positively correlated with increased levels of Cd, Pb and Hg among PCOS women. Significant positive correlations were observed between Pb and Cd and between Cd and Hg at P < 0.001. The outcome of the study provides clear insight into the role of metal-induced oxidative stress, which plays a vital role in the pathophysiology underlying PCOS and suggests the use of these markers as prognostic tools to reduce the consequences of high-risk exposure to these metals among females.
Highlights
Polycystic ovary syndrome (PCOS) is a global health concern for women of reproductive age, as 6.5% of women worldwide are affected by this syndrome
Some of the heavy metals in this category are harmful at high doses[4].The environment is constantly being polluted by heavy metals from industries, and exposure to these metals is a major area of public health concern, especially for women of childbearing age, as it can cause reproductive dysfunction in women[5,6]
By further exploring the interelement relationships among the heavy metals, the present study demonstrated significant positive correlations among the heavy metals (e.g., As, Cd, Pb and Hg), which indicated that the pathophysiology that develops in PCOS is probably due to the enhanced levels of these heavy metals that work in concert and lead to oxidative stress (OS)
Summary
The current report evaluated the sociodemographic data, oxidative stress biomarkers, and heavy metal (e.g., As, Cd, Pb and Hg) levels between the PCOS and control groups. The serum fasting blood sugar (FBS) and HbA1c levels were found to increase in the PCOS group compared to the control group. The mean serum SOD values decreased significantly in the PCOS group (9.30 ± 3.2 IU/ml) compared to the control (17.39 ± 3.35 IU/ml). In contrast to the investigated antioxidant markers, the PCOS patients exhibited marked increases in their heavy metal levels compared to the controls. A strong significant negative correlation between increased HbA1c and decreased antioxidant (SOD) at P < 0.001 was obtained. The correlations among the heavy metals and antioxidant markers are represented in the form of multiple regression plots (Figs. 2 and 3)
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