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Assessment of Serum Elements Concentration and Polycystic Ovary Syndrome (PCOS): Systematic Review and Meta-analysis

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Abstract

Change in the levels of trace elements has been linked with PCOS pathogenesis by various studies, whereas some had reported no such association. Therefore, in order to evaluate association of eleven trace element (Cu, Zn, Cr, Cd, Se, Mn, Fe, Mg, Co, Ni and Pb) serum concentration with PCOS pathogenesis, current systematic review and meta-analysis has been carried out. Literature search was conducted using PubMed, Central Cochrane Library, Google Scholar and Science Direct databases with appropriate keywords. Studies published upto 3rd of September were evaluated for eligibility with suitable inclusion and exclusion criteria. Only case–control studies examining the association of serum trace element concentrations between PCOS cases and controls were selected. Present meta-analysis identified 32 articles with 2317 PCOS and 1898 controls. The serum Cu (MD = 15.40; 95% CI = 4.32 to 26.48; p = 0.006), Co (MD = 0.01; 95% CI = 0.01 to 0.02; p = 0.000), Cr (MD = 0.04; 95% CI = 0.00 to 0.07; p = 0.03) and Fe (MD = 12.98; 95% CI = 5.87–20.09; p = 0.0003) concentration is significantly higher, while lower concentration has been observed for Se (MD =  − 0.99; 95% CI =  − 1.31 to − 0.67; p = 0.000) and Mg (MD =  − 223.41; 95% CI =  − 391.60 to − 55.23; p = 0.009) among women with PCOS in comparison with the healthy group. Concentration of other elements which were analysed is not significantly related to PCOS. In short, PCOS women has higher serum concentrations of Cu, Co, Cr and Fe and lower concentrations of Se and Mg. Studies with sub-population of obese, non-obese and with and without insulin resistance are important to understand the pathomechanism of these elements in the syndrome.

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Data Availability

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Acknowledgements

The authors would like to thank the financial support for this work by ICMR New Delhi [54/08/2019/HUM-BMS, Project id 2019-1384]. DST-FIST support (SR/FST/LS-I/2017/49-C) to the Department of Human Genetics & Molecular Medicine is acknowledged.

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  1. Laboratory for Reproductive and Developmental Disorders, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, 151401, India

    Priya Sharma & Preeti Khetarpal

  2. Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda, 151401, India

    Vartika Gupta & Kush Kumar

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Priya Sharma: Conceptualization, methodology, formal analysis, data curation and writing—original draft.

Vartika Gupta: Methodology, data curation and formal analysis.

Kush Kumar: Methodology, data curation and formal analysis.

Preeti Khetarpal: Conceptualization, validation, supervision, writing (review and editing) and funding acquisition.

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Correspondence to Preeti Khetarpal.

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Supplementary Information

Below is the link to the electronic supplementary material.

12011_2021_3058_MOESM1_ESM.pdf

Supplementary file1 a) The funnel plot for the association between serum Cu concentration and PCOS; b) The sensitivity analysis test for association between Cu concentration and PCOS risk. (PDF 242 KB)

12011_2021_3058_MOESM2_ESM.pdf

Supplementary file2 a) The funnel plot for the association between serum Zn concentration and PCOS; b) The sensitivity analysis test for association between Zn concentration and PCOS risk. (PDF 275 KB)

12011_2021_3058_MOESM3_ESM.pdf

Supplementary file3 The sensitivity analysis by excluding largest size effect study. (a-g) representing the sensitivity analysis test for association between PCOS risk and the serum trace elements concentration of Cd, Se, Mn, Fe, and Pb respectively. (PDF 592 KB)

12011_2021_3058_MOESM4_ESM.pdf

Supplementary file4 a) The funnel plot for the association between serum Mg concentration and PCOS; b) The sensitivity analysis test for association between Mg concentration and PCOS risk. (PDF 264 KB)

12011_2021_3058_MOESM5_ESM.docx

Supplementary file5 The Newcastle-Ottawa Scale (NOS) used for the quality assessment of the thirty-two relevant studies included in the metanalysis. (DOCX 15 KB)

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Sharma, P., Gupta, V., Kumar, K. et al. Assessment of Serum Elements Concentration and Polycystic Ovary Syndrome (PCOS): Systematic Review and Meta-analysis. Biol Trace Elem Res 200, 4582–4593 (2022). https://doi.org/10.1007/s12011-021-03058-6

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  • DOI: https://doi.org/10.1007/s12011-021-03058-6

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