Changes in serum heavy metals in polycystic ovary syndrome and their association with endocrine, lipid-metabolism, inflammatory characteristics and pregnancy outcomes

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. Heavy metals, a nonnegligible pollutant, have significant effects on human health, and they are related to reproductive dysfunction. This study aimed to investigate whether serum heavy metal levels were related to PCOS and the association of increased heavy metals with endocrine, lipid-metabolism and inflammatory characteristics and pregnancy outcomes. 80 subjects (40 with PCOS and 40 for control) were selected to analyze their clinical characteristics and serum heavy metal concentrations. Serum chromium (Cr), mercury (Hg) and copper (Cu) were significantly higher in PCOS patients. Cr was positively correlated with luteinizing hormone (LH) (ρ = 0.240 and P = 0.033) and negatively correlated with prolactin (PRL) (ρ = −0.248 and P = 0.032), Hg was positively correlated with LH (ρ = 0.446 and P < 0.001), testosterone (T) (ρ = 0.300 and P = 0.008), androstenedione (A) (ρ = 0.316 and P = 0.006), interleukin-6 (IL-6) (ρ = 0.344 and P = 0.002), and tumour necrosis factor-α (TNF-α) (ρ = 0.248 and P = 0.026), and Cu was found to be positively correlated with low-density lipids (LDL) (ρ = 0.264 and P = 0.021), IL-6 (ρ = 0.295 and P = 0.008), TNF-α (ρ = 0.336 and P = 0.002) and white blood cells (WBC) count (ρ = 0.300 and P = 0.008). Cu levels were significantly higher in nonpregnant patients than in pregnant patients who received in vitro fertilization and embryo transfer treatments. In conclusion, the present study shows that PCOS patients exhibited increased serum Cr, Hg and Cu levels, which were related to some sex hormones and lipid-metabolism disturbances and inflammatory cytokines releases, and elevated Cu levels were related to pregnancy failure, suggesting that these heavy metals may provide valuable information to predict PCOS.