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Status of Serum Copper, Magnesium, and Total Antioxidant Capacity in Patients with Polycystic Ovary Syndrome


This study evaluates serum copper and magnesium and total antioxidant capacity levels in PCOS patients. In this regard, the probable association of copper and magnesium with total antioxidant capacity (TAC) was investigated. In total, 150 women (60 PCOS patients and 90 healthy subjects) participated in this case–control study. PCOS was diagnosed according to the Rotterdam criteria (2003). Serum Cu, Mg, Ca, TAC, insulin levels, and insulin resistance indices were determined. Insulin was measured using ELISA methods. Serum Cu and Mg levels were measured by an atomic absorption spectrophotometer and the Xylidyl Blue method respectively. The correlations between the parameters were analyzed using the Spearman correlation test. Serum Cu level was significantly higher while TAC was significantly lower in the PCOS patients than those in the controls (p = 0.019 and p = 0.002 respectively). No significant difference was detected between the two groups in terms of serum Mg and Ca levels and Ca/Mg ratio. In insulin-resistant PCOS subjects, there was a negative correlation between Mg levels and homeostatic model assessment for insulin resistance (r = − 0.449, p = 0.006) but a positive correlation between Mg levels and quantitative insulin sensitivity check index (r = 0.480, p = 0.003). A negative correlation also existed between Mg levels and TAC in non-insulin-resistant PCOS patients (r = − 0.407, p = 0.04). According to the results, copper and magnesium seem to contribute to oxidative stress and insulin resistance in PCOS patients. Therefore, to prevent long-term metabolic complications in PCOS women, it is recommended that these elements be routinely monitored. Also, significantly lower levels of serum TAC in PCOS patients than in normal women may suggest increased oxidative stress in such patients.

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Polycystic ovary syndrome


Total antioxidant capacity







Ca/Mg ratio:

Calcium/magnesium ratio

G/I ratio:

Glucose/insulin ratio


Body mass index


Fasting blood sugar


Insulin resistance


Non-insulin resistance


Homeostatic model assessment for insulin resistance


Quantitative insulin sensitivity check index


  1. Norman RJ, Dewailly D, Legro RS, Hickey TE (2007) Polycystic ovary syndrome. Lancet 370:685–697

    CAS  Article  Google Scholar 

  2. Rahsepar M, Mahjoub S, Esmaeilzadeh S, Kanafchian M, Ghasemi M (2017) Evaluation of vitamin D status and its correlation with oxidative stress markers in women with polycystic ovary syndrome. Int J Reprod Biomed 15:345–350

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Vincent HK, Taylor AG (2005) Biomarkers and potential mechanisms of obesity-induced oxidant stress in humans. Int J Obes 30:400–418

    Article  Google Scholar 

  4. Liu S, Navarro G, Mauvais-Jarvis F (2010) Androgen excess produces systemic oxidative stress and predisposes to beta-cell failure in female mice. PLoS One 5:e11302

    Article  Google Scholar 

  5. Murri M, Luque-Ramírez M, Insenser M, Ojeda-Ojeda M, Escobar-Morreale HF (2013) Circulating markers of oxidative stress and polycystic ovary syndrome (PCOS): a systematic review and meta-analysis. Hum Reprod Update 19:268–288

    CAS  Article  Google Scholar 

  6. Kazi TG, Afridi H, Kazi N, Jamali MK, Arain MB, Jalbani N, Kandhro GA (2008) Copper, chromium, manganese, iron, nickel, and zinc levels in biological samples of diabetes mellitus patients. Biol Trace Elem Res 122:1–18

    CAS  Article  Google Scholar 

  7. Kanafchian M, Mahjoub S, Esmaeilzadeh S, Rahsepar M, Mosapour A (2018) Status of serum selenium and zinc in patients with the polycystic ovary syndrome with and without insulin resistance. Middle East Fertil Soc J 23:241–245

    Article  Google Scholar 

  8. Valko M, Morris H, Cronin MT (2005) Metals, toxicity and oxidative stress. Curr Med Chem 12:1161–1208

    CAS  Article  Google Scholar 

  9. Uriu-Adams JY, Keen CL (2005) Copper, oxidative stress, and human health. Mol Asp Med 26:268–298

    CAS  Article  Google Scholar 

  10. Kauffman RP, Tullar PE, Nipp RD, Castracane VD (2011) Serum magnesium concentrations and metabolic variables in polycystic ovary syndrome. Acta Obstet Gynecol Scand 90:452–458

    CAS  Article  Google Scholar 

  11. Swetha N, Vyshnavi R, Modagan P, Rajagopalan B (2013) A correlative study of biochemical parameters in polycystic ovarian syndrome. Int J Biol Med Res 4:3148–3154

    Google Scholar 

  12. Maleedhu P, Vijayabhaskar M, Rao P, Kodumuri P (2014) Antioxidant status in women with polycystic ovary syndrome. Int J Med Health Sci 3:91–96

    Google Scholar 

  13. Guler I, Himmetoglu O, Turp A, Erdem A, Erdem M, Onan MA, Taskiran C, Taslipinar MY, Guner H (2014) Zinc and homocysteine levels in polycystic ovarian syndrome patients with insulinresistance. Biol Trace Elem Res 158:297–304

    CAS  Article  Google Scholar 

  14. Azziz R (2006) Diagnosis of polycystic ovarian syndrome: the Rotterdam criteria arepremature. J Clin Endocrinol Metab 91:781–785

    CAS  Article  Google Scholar 

  15. Ott J, Wattar L, Kurz C, Seemann R, Huber JC, Mayerhofer K, Vytiska-Binstorfer E (2012) Parameters for calcium metabolism in women with polycystic ovary syndrome who undergo clomiphene citrate stimulation: a prospective cohort study. Eur J Endocrinol 166:897–902

    CAS  Article  Google Scholar 

  16. Muniyappa R, Lee S, Chen H, Quon MJ (2008) Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J PhysiolEndocrinol Metab 294:15–26

    Article  Google Scholar 

  17. Benzie IF, Strain J (1996) The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem 239:70–76

    CAS  Article  Google Scholar 

  18. Kurdoglu Z, Kurdoglu M, Demir H, Sahin HG (2012) Serum trace elements andheavy metals in polycystic ovary syndrome. Hum Exp Toxicol 31:452–456

    CAS  Article  Google Scholar 

  19. Chakraborty P, Ghosh S, Goswami S, Kabir SN, Chakravarty B, Jana K (2013) Altered trace mineral milieu might play an aetiological role in the pathogenesis of polycystic ovary syndrome. Biol Trace Elem Res 152:9–15

    CAS  Article  Google Scholar 

  20. Zheng G, Wang L, Guo Z, Sun L, Wang L, Wang C, Zuo Z, Qiu H (2015) Association of serum heavy metals and trace element concentrations with reproductive hormonelevels and polycystic ovary syndrome in a Chinese population. Biol Trace Elem Res 167:1–10

    CAS  Article  Google Scholar 

  21. Celik C, Bastu E, Abali R, Alpsoy S, Guzel EC, Aydemir B, Yeh J (2013) The relationship between copper, homocysteine and early vascular diseasein lean women with polycystic ovary syndrome. Gynecol Endocrinol 29:488–491

    CAS  Article  Google Scholar 

  22. Kurdoglu Z, Ozkol H, Tuluce Y, Koyuncu I (2012) Oxidative status and its relation with insulin resistance in young nonobese women with polycystic ovary syndrome. J Endocrinol Investig 35:317–321

    CAS  Google Scholar 

  23. Fenkci V, Fenkci S, Yilmazer M, Serteser M (2003) Decreased total antioxidant status and increased oxidative stress in women with polycystic ovary syndrome may contribute to the risk of cardiovascular disease. Fertil Steril 80:123–127

    Article  Google Scholar 

  24. Gaetke LM, Chow CK (2003) Copper toxicity, oxidative stress, and antioxidant nutrients. Toxicology 189:147–163

    CAS  Article  Google Scholar 

  25. Mahjoub S, Masrour-Roudsari J (2012) Role of oxidative stress in pathogenesis of metabolic syndrome. Caspian J Intern Med 3:386–396

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Rajeswari G, Gopal PS, Veerabhadrudu B, Suresh E (2016) Study of magnesium levels in polycystic ovarian syndrome. Int J Adv Sci Res 2:054–058

    Article  Google Scholar 

  27. Usharani M, Santhanalakshmi L (2015) Study of magnesium level in polycystic ovarian syndrome. Int J Adv Res 3:1456–1461

    CAS  Google Scholar 

  28. Sharifi F, Mazloomi S, Hajihosseini R, Mazloomzadeh S (2012) Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance. Gynecol Endocrinol 28:7–11

    CAS  Article  Google Scholar 

  29. Yeon Lee J, Baw CK, Gupta S, Aziz N, Agarwal A (2010) Role of oxidative stress in polycystic ovary syndrome. Curr Womens Health Rep 6:96–107

    Article  Google Scholar 

  30. Mohamadin AM, Habib FA, Elahi TF (2010) Serum paraoxonase 1 activity and oxidant/antioxidant status in Saudi women with polycystic ovary syndrome. Pathophys 17:189–196

    CAS  Article  Google Scholar 

  31. Moti M, Amini L, Mirhoseini Ardakani SS, Kamalzadeh S, Masoomikarimi M, Jafarisani M (2015) Oxidative stress and anti-oxidant defense system in Iranian women with polycystic ovary syndrome. Iran J Reprod Med 13:373–378

    PubMed  PubMed Central  Google Scholar 

  32. Kandasamy S, Inmozhi Sivagamasundari R, Bupathy A, Sethubathy S, Gobal V (2010) Evaluation of insulin resistance and oxidative stress in obese patients with polycystic ovary syndrome. Int J Appl Biol Pharm Technol 1:391–398

    Google Scholar 

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We would like to thank the participating patients as well as the staff of Fatemeh Zahra Infertility and Reproductive Health Research Center for their valuable cooperation with this project.


We are grateful for the financial support granted by Babol University of Medical Sciences, Iran.

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Correspondence to Soleiman Mahjoub.

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Approval was obtained from the ethics committee of Babol University of Medical Sciences (MUBABOL.REC.1394.65). All the participants were informed of the aims of the study, and informed consents were obtained from them. The biochemical tests had no cost for the participants, and the results of these tests were reported to them.

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Kanafchian, M., Esmaeilzadeh, S., Mahjoub, S. et al. Status of Serum Copper, Magnesium, and Total Antioxidant Capacity in Patients with Polycystic Ovary Syndrome. Biol Trace Elem Res 193, 111–117 (2020).

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  • Polycystic ovary syndrome
  • Insulin resistance
  • Copper
  • Magnesium
  • Total antioxidant capacity