Peoples' Friendship University of Russia (RUDN University), Moscow, 117198, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119146, Russia.
Peoples' Friendship University of Russia (RUDN University), Moscow, 117198, Russia; IM Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119146, Russia; Yaroslavl State University, Yaroslavl, 150003, Russia.
J Trace Elem Med Biol. 2019 Dec;56:124-130. doi: 10.1016/j.jtemb.2019.08.009. Epub 2019 Aug 20.
Iron (Fe), copper (Cu), and manganese (Mn) play a significant role in female reproduction and fetal development. At the same time, high levels of metals may exert toxic effects. Correspondingly, both excess and deficiency of essential trace elements were shown to be associated with female infertility and adverse pregnancy outcome, although the existing data are rather contradictory. Therefore, the objective of the present study was to reveal the potential role of altered iron, copper, and manganese status in female reproductive health problems through assessment of serum metal levels in healthy non-pregnant and pregnant women, as well as patients with miscarriage and primary infertility.
A total of 150 healthy controls, 169 pregnant women (II trimester of pregnancy), 75 women with miscarriage, and 91 patients with primary infertility were enrolled. Serum metal levels were assessed using ICP-MS.
Pregnant women are characterized by a significant increase in serum Cu an Mn levels by 40% (p < 0.001) and 16% (p = 0.043) as compared to the controls, respectively. Serum Cu levels in women with miscarriage and infertility were 30% and 35% lower than those in pregnant women (p < 0.001). No significant difference in serum iron levels were observed between the control and pregnant women. Women who had miscarriage were characterized by 13% (p = 0.042) higher serum Fe levels as compared to the pregnant ones. Multiple regression analysis demonstrated that serum copper levels was significantly associated both with pregnancy (β = 0.436; p < 0.001) and reproductive health problems in women (β = -0.272; p < 0.001). The latter was improved significant after adjustment for serum Fe and Mn levels, age, and BMI (β = -0.431; p < 0.001). The model incorporating serum Cu, Fe, Mn, and anthropometric parameters accounted for 23% of variability in reproductive status (p < 0.001).
It is proposed that the lack of pregnancy-associated increase in metal levels in miscarriage and infertility may be indicative of at least partial role of metal insufficiency in impaired pregnancy and reproductive function in general. However, detailed clinical studies as well as experimental investigations are required for assessment of the potential causes and mechanisms of the observed associations.
铁（Fe）、铜（Cu）和锰（Mn）在女性生殖和胎儿发育中起着重要作用。与此同时，金属含量过高可能会产生毒性作用。相应地，尽管现有数据存在矛盾，但必需微量元素的过量和缺乏都与女性不孕和不良妊娠结局有关。因此，本研究的目的是通过评估健康未怀孕和怀孕妇女、流产和原发性不孕妇女的血清金属水平，揭示改变的铁、铜和锰状态在女性生殖健康问题中的潜在作用。
共纳入 150 名健康对照者、169 名孕妇（妊娠中期）、75 名流产妇女和 91 名原发性不孕患者。使用 ICP-MS 评估血清金属水平。
与对照组相比，孕妇血清 Cu 和 Mn 水平分别显著增加 40%（p<0.001）和 16%（p=0.043）。流产和不孕妇女的血清 Cu 水平比孕妇低 30%和 35%（p<0.001）。对照组和孕妇的血清铁水平无显著差异。与孕妇相比，流产妇女的血清 Fe 水平高 13%（p=0.042）。多元回归分析表明，血清铜水平与妊娠（β=0.436；p<0.001）和女性生殖健康问题均显著相关（β=-0.272；p<0.001）。调整血清 Fe 和 Mn 水平、年龄和 BMI 后，后者显著改善（β=-0.431；p<0.001）。纳入血清 Cu、Fe、Mn 和人体测量参数的模型解释了生殖状况 23%的变异性（p<0.001）。
提出在流产和不孕中缺乏与妊娠相关的金属水平增加，至少表明金属不足在一定程度上与妊娠和生殖功能受损有关。然而，需要详细的临床研究和实验研究来评估观察到的关联的潜在原因和机制。
