Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndro
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Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome? Demet Aydogan Kirmizi 1 Ayse Yesim Gocmen 4
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Emre Baser 1
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Vugar Ali Turksoy 2
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Mustafa Kara 3
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Ethem Serdar Yalvac 1
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Received: 9 April 2020 / Accepted: 25 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities. Keywords Polycystic ovary syndrome . Heavy metal . Antimony . Cadmium . Insulin resistance . Zinc
Introduction PCOS is a common and important endocrinological disease of which its metabolic effects can be progressive. International prevalence rate ranges from 5 to 21% [1, 2]. In a study conducted in Turkey, the prevalence has been reported as 19.9% [3]. It is characterized by insulin resistance (IR), irregular and
anovulatory menstrual cycles, and clinical and/or biochemical hyperandrogenism. Insulin resistance is of importance regarding the development and persistence of this disease [4]. The cause of hyperinsulinemia, hyperandrogenemia, obesity, and the changing hormonal course in PCOS is still unknown. This metabolic course is associated with chronic low-dose infl
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