{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:59:51Z","timestamp":1780898391722,"version":"3.54.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persistent organic pollutants (POPs), including organochlorine pesticides (OCPs) and per- and polyfluoroalkyl substances (PFAS), are endocrine-disrupting chemicals potentially linked to polycystic ovary syndrome (PCOS). However, evidence on their combined effects and underlying mechanisms remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a case\u2013control study including 146 women with PCOS and 241 controls recruited from the Affiliated Hospital of Hebei University, China (2023\u20132025). Serum concentrations of 15 POPs (6 OCPs and 9 PFAS) were measured using GC\u2013MS\/MS and UPLC-MS\/MS. Associations with PCOS were evaluated using multivariable logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). Mediation analysis examined whether sex hormones mediated these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In single-pollutant analyses, PFOS (OR\u202f=\u202f2.63, 95% CI: 1.78\u20133.88), p,p\u2019-DDE (OR\u202f=\u202f2.25, 95% CI: 1.54\u20133.28), heptachlor (OR\u202f=\u202f1.99, 95% CI: 1.26\u20133.14), and PFHxS (OR\u202f=\u202f1.74, 95% CI: 1.15\u20132.62) were significantly associated with increased PCOS risk. Mixture analyses revealed strong positive associations between the overall POPs mixture and PCOS (WQS OR\u202f=\u202f9.29, 95% CI: 3.38\u201325.50; qgcomp OR\u202f=\u202f7.04, 95% CI: 2.79\u201317.80), with PFOS and p,p\u2019-DDE identified as predominant contributors. BKMR confirmed PFOS (PIP\u202f=\u202f1.000) and p,p\u2019-DDE (PIP\u202f=\u202f0.998) as the most important contributors. Mediation analysis indicated that testosterone mediated 49.3% of the PFOS\u2013PCOS association, while progesterone mediated 20.9% of the PFOS\u2013PCOS and 24.8% of the p,p\u2019-DDE\u2013PCOS associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exposure to POPs, particularly PFOS and p,p\u2019-DDE, was associated with elevated PCOS risk among Chinese women. Sex hormones, especially testosterone and progesterone, partially mediated these associations, suggesting hormonal disruption as a potential mechanism linking POPs exposure to PCOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1807105","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:33:58Z","timestamp":1780896838000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between serum persistent organic pollutants and polycystic ovary syndrome risk: a case\u2013control study with mediation analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Zekun","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, The University of Hong Kong","place":["Hong Kong, Hong Kong SAR, 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