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

What was studied?

This case–control study investigated the association between trace element levels and polycystic ovary syndrome (PCOS) in reproductive-aged women. Researchers measured concentrations of both essential trace elements including manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), and molybdenum (Mo), and non-essential trace elements, arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) in urine, serum, and whole blood. The study sought to examine how these elements might influence kidney and liver function, metabolic and endocrine parameters, and potential environmental or dietary exposure.

Who was studied?

The study population included 70 women, divided evenly between 35 diagnosed PCOS patients and 35 healthy controls. Participants were aged 20–39 years and selected based on strict criteria to exclude comorbidities such as diabetes, cardiovascular or autoimmune diseases, and recent hormonal treatments. All participants underwent clinical assessments, including anthropometrics, ultrasonography, and hormonal profiling. Dietary, environmental, and lifestyle exposures were gathered using detailed questionnaires, while biological samples were analyzed using high-precision inductively coupled plasma mass spectrometry.

What were the most important findings?

The most significant findings showed that women with PCOS had elevated serum copper (Cu) and reduced whole blood and serum molybdenum (Mo) levels compared to controls. Although these differences lost statistical significance after adjusting for BMI, age, and hematocrit, other associations remained clinically relevant. Cu levels positively correlated with leukocyte count, suggesting an inflammatory link. Conversely, Mo levels negatively correlated with luteinizing hormone (LH), urinary bilirubin, and markers of kidney function such as proteinuria.

From a microbiome perspective, altered copper and molybdenum levels are particularly important. Elevated Cu can promote oxidative stress, disrupt mucosal immunity, and reduce microbial diversity, especially suppressing beneficial bacteria such as Faecalibacterium prausnitzii. Meanwhile, low Mo levels can impair molybdoenzyme function necessary for detoxification and redox regulation, which may result in the accumulation of inflammatory metabolites that disturb the gut barrier. These changes may exacerbate the chronic low-grade inflammation and hormonal dysregulation characteristic of PCOS. The study also identified that beef consumption correlated positively with Cu levels, and cereal and boiled vegetable consumption correlated positively with Mo levels, linking dietary sources directly to trace element concentrations.

What are the greatest implications of this study?

This study provides new insight into the potential role of Mo as well as supporting existing findings on Cu. It suggests that nutritional and environmental factors significantly influence the body’s trace element status, which in turn may modulate inflammation, liver and kidney function, and reproductive hormone levels in women with PCOS. Clinically, these findings support incorporating dietary assessments and trace element screening in the management of PCOS. More importantly, this study underscores a microbiome-relevant pathway: alterations in Cu and Mo not only influence host metabolism but likely affect gut microbial balance, further perpetuating systemic metabolic dysfunction. This integrative perspective could pave the way for dietary or supplemental interventions targeting TE imbalances to improve reproductive and metabolic outcomes in PCOS.