{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T23:53:27Z","timestamp":1778025207588,"version":"3.51.4"},"reference-count":57,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,16]],"date-time":"2022-01-16T00:00:00Z","timestamp":1642291200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Polycystic ovary syndrome (PCOS) is one of the most commonly recognized endocrinopathies in women. The literature lacks clear data that allow any meaningful conclusions to be drawn about the influence of trace elements in erythrocytes on the biochemical parameters of PCOS. Materials and methods: This study was conducted among 47 women meeting the Rotterdam criteria for the diagnosis of polycystic ovary syndrome. The research groups included women with PCOS with different BMI values (body mass index): obese women with PCOS (PCOS with BMI \u2265 30, mean BMI index 35.4 \u00b1 4.4 kg\/m2), nonobese PCOS women (PCOS with BMI &lt; 30, mean BMI index 25.2 \u00b1 2.8 kg\/m2), and healthy control group (CG) with a mean BMI of 23.57 \u00b1 0.9 kg\/m2. The contents of trace elements in erythrocytes were determined with an inductively coupled plasma atomic emission spectrometer. Results: The only trace element showing significant differences in concentration between the studied groups was nickel (Ni). The level of nickel in the obese women with PCOS (BMI \u2265 30) was significantly higher than in nonobese women (BMI &lt; 30). The content of other trace elements in erythrocytes did not differ significantly between the studied groups. Several significant correlations were found within each of the studied PCOS groups: in the group of obese women, the content of zinc (Zn) in erythrocytes positively correlated with prolactin, the content of magnesium (Mg) positively correlated with testosterone, and the content of manganese (Mn) negatively correlated with thyroid-stimulating hormone. In the group of nonobese women, Zn content correlated positively with testosterone, Ni with luteinizing hormone (LH) and estradiol, and Mg negatively correlated with estradiol. Conclusions: The relationship between the level of trace elements and the level of hormones suggests that, in obese women with PCOS, nickel may play a role in inhibiting the processes of folliculogenesis and ovulation. Research on trace elements and their relationship to ovulatory cycles and the development of PCOS may contribute to reducing the consequences of PCOS and, therefore, should be extended.<\/jats:p>","DOI":"10.3390\/ijerph19020976","type":"journal-article","created":{"date-parts":[[2022,1,16]],"date-time":"2022-01-16T20:44:00Z","timestamp":1642365840000},"page":"976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4835-8517","authenticated-orcid":false,"given":"Kamila","family":"Pokorska-Niewiada","sequence":"first","affiliation":[{"name":"Department of Toxicology, Dairy Technology and Food Storage, West Pomeranian University of Technology in Szczecin, 71-374 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnieszka","family":"Brodowska","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6853-9155","authenticated-orcid":false,"given":"Jacek","family":"Brodowski","sequence":"additional","affiliation":[{"name":"Primary Care Department, Pomeranian Medical University in Szczecin, \u017bo\u0142nierska 48, 71-210 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9808-0624","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Szczuko","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1093\/humrep\/dew218","article-title":"The prevalence and phenotypic features of polycystic ovary syndrome: A systematic review and meta-analysis","volume":"31","author":"Bozdag","year":"2016","journal-title":"Hum. Reprod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/nrendo.2018.24","article-title":"Polycystic ovary syndrome: Definition, aetiology, diagnosis and treatment","volume":"14","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1467-789X.2012.01053.x","article-title":"The effect of obesity on polycystic ovary syndrome: A systematic review and meta-analysis","volume":"14","author":"Lim","year":"2012","journal-title":"Obes. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/BF03345554","article-title":"The metabolic syndrome in polycystic ovary syndrome","volume":"29","author":"Essah","year":"2006","journal-title":"J. Endocrinol. Investig."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.4103\/ijem.IJEM_637_18","article-title":"Obese and non-obese polycystic ovarian syndrome: Comparison of clinical, metabolic, hormonal parameters, and their differential response to clomiphene","volume":"23","author":"Sachdeva","year":"2019","journal-title":"Indian J. Endocr. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1056\/NEJMra041536","article-title":"Polycystic ovary syndrome","volume":"352","author":"Ehrmann","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_7","first-page":"22","article-title":"The role of macro- and microelements in the pathogenesis of polycystosis of the ovaries","volume":"4","author":"Prodarchuk","year":"2019","journal-title":"HERO"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"98","DOI":"10.17140\/OROJ-2-115","article-title":"Obesity and Trace Elements","volume":"2","author":"Demerdash","year":"2015","journal-title":"Obes. Res. Open J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2695","DOI":"10.1210\/clinem\/dgaa285","article-title":"Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists","volume":"105","author":"Cena","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"289","DOI":"10.5455\/medarh.2020.74.289-293","article-title":"Follicle Stimulating Hormone (LH: FSH) Ratio in Polycystic Ovary Syndrome (PCOS)\u2014Obese vs. Non- Obese Women","volume":"74","author":"Saadia","year":"2020","journal-title":"Med. Arch."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Polak, A.M., Krentowska, A., \u0141ebkowska, A., Buczy\u0144ska, A., Adamski, M., Adamska-Patruno, E., Fiedorczuk, J., Kr\u0119towski, A.J., Kowalska, I., and Adamska, A. (2020). The Association of Serum Levels of Leptin and Ghrelin with the Dietary Fat Content in Non-Obese Women with Polycystic Ovary Syndrome. Nutrients, 12.","DOI":"10.3390\/nu12092753"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1177\/0960327111424299","article-title":"Serum trace elements and heavy metals in polycystic ovary syndrome","volume":"31","author":"Kurdoglu","year":"2011","journal-title":"Hum. Exp. Toxicol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1017\/S0007114518000818","article-title":"Dietary minerals, reproductive hormone levels and sporadic anovulation: Associations in healthy women with regular menstrual cycles","volume":"120","author":"Kim","year":"2018","journal-title":"Br. J. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.3390\/ijerph7093332","article-title":"An examination of the association of selected toxic metals with total and central obesity indices","volume":"7","author":"Padilla","year":"2010","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.2174\/0929867053764635","article-title":"Metals, toxicity and oxidative stress","volume":"12","author":"Valko","year":"2005","journal-title":"Curr. Med. Chem."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1111\/j.1365-2605.2009.01035.x","article-title":"Association of endocrine disruptors and obesity: Perspectives from epidemiological studies","volume":"33","author":"Hatch","year":"2010","journal-title":"Int. J. Androl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s12011-020-02220-w","article-title":"Are heavy metal exposure and trace element levels related to metabolic and endocrine problems in polycystic ovary syndrome?","volume":"198","author":"Kirmizi","year":"2020","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s40618-015-0372-x","article-title":"Hyperinsulinism and polycystic ovary syndrome (PCOS): Role of insulin clearance","volume":"38","author":"Amato","year":"2015","journal-title":"J. Endocrinol. Investig."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Rotterdam ESHRE\/ASRM-sponsored PCOS Consensus Workshop Group (2004). Revised 2003 consensus on diagnostic criteria and logterm health risks related to polycystic ovary syndrome (PCOS). Hum. Reprod., 19, 41\u201347.","DOI":"10.1093\/humrep\/deh098"},{"key":"ref_20","unstructured":"WHO (2000). Obesity. Preventing and Managing the Global Epidemic. Report of a WHO Consultation, World Health Organization Technical Report Series 894."},{"key":"ref_21","unstructured":"Fraser, M., and Farrokh, S. (2014). Free Androgen Index, University of Rochester Medical Center."},{"key":"ref_22","unstructured":"WHO (2011). Use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus, World Health Organization."},{"key":"ref_23","unstructured":"WHO (2006). Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycaemia, World Health Organization."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and o-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1210\/jcem-21-11-1440","article-title":"Clinical assessment of body hair growth in women","volume":"21","author":"Ferriman","year":"1961","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0003-2670(99)00104-X","article-title":"Nomenclature in evaluation of analytical methods including detection and quantification capabilities (IUPAC Recommendations 1995)","volume":"391","author":"Currie","year":"1999","journal-title":"Anal. Chim. Acta"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"317241","DOI":"10.1155\/2012\/317241","article-title":"Obesity differentially affects phenotypes of polycystic ovary syndrome","volume":"2012","author":"Moran","year":"2012","journal-title":"Int. J. Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00404-016-4096-8","article-title":"Are progranulin levels associated with polycystic ovary syndrome and its possible metabolic effects in adolescents and young women?","volume":"294","author":"Ersoy","year":"2016","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_29","first-page":"24","article-title":"Dehydroepiandrosterone-Sulfate, Insulin Resistance and Ovarian Volume Estimation in Patients With Polycystic Ovarian Syndrome","volume":"11","author":"Christodoulaki","year":"2017","journal-title":"J. Fam. Reprod. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1210\/jcem-66-1-131","article-title":"The impact of obesity andchronic hyperinsulinemia on gonadotropin release and gonadal steroidsecretion in the polycystic ovary syndrome","volume":"66","author":"Dunaif","year":"1988","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lerchbaum, E., Schwetz, V., Rabe, T., Giuliani, A., and Obermayer-Pietsch, B. (2014). Hyperandrogenemia in Polycystic Ovary Syndrome: Exploration of the Role of Free Testosterone and Androstenedione in Metabolic Phenotype. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0108263"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12958-017-0230-0","article-title":"The effect of estradiol on granulosa cell responses to FSH in women with polycystic ovary syndrome","volume":"15","author":"Homer","year":"2017","journal-title":"Reprod. Biol. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Xu, X.-L., Deng, S.-L., Lian, Z.-X., and Yu, K. (2021). Estrogen Receptors in Polycystic Ovary Syndrome. Cells, 10.","DOI":"10.3390\/cells10020459"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.metabol.2018.11.002","article-title":"Characteristics of obesity in polycystic ovary syndrome: Etiology, treatment, and genetics","volume":"92","author":"Glueck","year":"2019","journal-title":"Metabolism"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1152\/physrev.2000.80.4.1523","article-title":"Prolactin: Structure, function, and regulation of secretion","volume":"80","author":"Freeman","year":"2000","journal-title":"Physiol. Rev."},{"key":"ref_36","first-page":"232","article-title":"Prolactin and alteration of fertility","volume":"83","year":"2018","journal-title":"Ceska. Gynekol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s12011-014-9941-7","article-title":"Zinc and Homocysteine Levels in Polycystic Ovarian Syndrome Patients with Insulin Resistance","volume":"158","author":"Guler","year":"2014","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12011-015-0294-7","article-title":"Association of Serum Heavy Metals and Trace Element Concentrations with Reproductive Hormone Levels and Polycystic Ovary Syndrome in a Chinese Population","volume":"167","author":"Zheng","year":"2015","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s12011-012-9592-5","article-title":"Altered Trace Mineral Milieu Might Play An Aetiological Role in the Pathogenesis of Polycystic Ovary Syndrome","volume":"152","author":"ChaChakraborty","year":"2013","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"26","DOI":"10.18370\/2309-4117.2016.27.26-29","article-title":"Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory disease","volume":"1","author":"Tatarchuk","year":"2016","journal-title":"Reprod. Endocrinol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Nasiadek, M., Stragierowicz, J., Klimczak, M., and Kilanowicz, A. (2020). The role of zinc in selected female reproductive system disorders. Nutrients, 12.","DOI":"10.3390\/nu12082464"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"263","DOI":"10.3389\/fendo.2020.00263","article-title":"The association between prolactin and metabolic parameters in pcos women: A retrospective analysis","volume":"11","author":"Yang","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1177\/0269216307087148","article-title":"Prolactin and dopamine: What is the connection? A review article","volume":"22","author":"Fitzgerald","year":"2008","journal-title":"J. Psychopharmacol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1038\/tp.2016.50","article-title":"Dopamine\u2013prolactin pathway potentially contributes to the schizophrenia and type 2 diabetes comorbidity","volume":"6","author":"Gragnoli","year":"2016","journal-title":"Transl. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s12011-016-0774-4","article-title":"Blood trace element concentrations in polycystic ovary syndrome: Systematic review and meta-analysis","volume":"175","author":"Spritzer","year":"2017","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1080\/10934529.2012.672114","article-title":"Reproductive toxicology of nicke\u2014Review","volume":"47","author":"Forgacs","year":"2012","journal-title":"J. Environ. Sci. Health A Tox Hazard. Subst. Environ. Eng."},{"key":"ref_47","first-page":"21","article-title":"Effect of manganese and nickel on prolactin levels in women with polycystic ovary syndrome","volume":"289","author":"Gunkov","year":"2019","journal-title":"Georgian Med. News"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"375","DOI":"10.26453\/otjhs.571510","article-title":"The relationship between insulin resistance and trace elements in patients with polycystic ovary syndrome","volume":"5","author":"Balahoroglu","year":"2020","journal-title":"Online T\u00fcrk Sa\u011fl\u0131k Bilimleri Derg."},{"key":"ref_49","first-page":"3036","article-title":"Zinc and copper levels and their correlation with polycystic ovary syndrome biochemical changes","volume":"9","author":"Khalaf","year":"2018","journal-title":"Int. J. Pharm. Sci. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/00003081-200306000-00011","article-title":"Insulin sensitizers for polycystic ovary syndrome","volume":"46","author":"Baillargeon","year":"2003","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"86","DOI":"10.4103\/ijpvm.IJPVM_576_17","article-title":"Oxidative stress and polycystic ovary syndrome: A brief review","volume":"10","author":"Mohammadi","year":"2019","journal-title":"Int. J. Prev. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.2337\/diacare.28.5.1175","article-title":"Magnesium deficiency is associated with insulin resistance in obese children","volume":"28","author":"Huerta","year":"2005","journal-title":"Diabetes Care"},{"key":"ref_53","first-page":"258","article-title":"Induced magnesium deficiency can be treated by vitamin D supplementation","volume":"59","author":"Farhanghi","year":"2009","journal-title":"JPMA"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1089\/met.2010.0039","article-title":"Polycystic ovary syndrome in the pediatric population","volume":"8","author":"Bremer","year":"2010","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3109\/09513590.2011.579663","article-title":"Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance","volume":"28","author":"Sharifi","year":"2012","journal-title":"Gynecol. Endocrinol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.nut.2017.01.009","article-title":"Effect of magnesium supplementation on insulin resistance in humans: A systematic review","volume":"38","author":"Morais","year":"2017","journal-title":"Nutrition"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1007\/s12011-020-02275-9","article-title":"Associations between serum magnesium concentrations and polycystic ovary syndrome status: A systematic review and meta-analysis","volume":"199","author":"Babapour","year":"2020","journal-title":"Biol. Trace Elem. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/2\/976\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:15:09Z","timestamp":1760364909000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/2\/976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,16]]},"references-count":57,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["ijerph19020976"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19020976","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,16]]}}}