Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China.
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China; Department of Maternal and Child Health, School of Public Health, Peking University, China.
J Hazard Mater. 2024 May 15;470:134206. doi: 10.1016/j.jhazmat.2024.134206. Epub 2024 Apr 3.
The associations between metallic elements and ovarian reserve function have remained uncertain yet. In this case-control study, we involved 149 women with diminished ovarian reserve (DOR) and 151 women with normal ovarian reserve, and assessed the levels of six heavy metallic (Cr, Cd, As, Hg, Pb, and Mn) and seven trace essential (Se, Fe, Zn, Co, Mo, Cu, I) elements in their follicular fluid with inductively coupled plasma mass spectrometry. Associations were examined with logistic regressions and Bayesian kernel machine regression (BKMR). As a result, we found that the medium and the highest tertiles of Pb were significantly associated with an increased likelihood of DOR compared to the lowest tertile, while the medium or/an the highest tertiles of Cu, I, and Fe showed significantly lower likelihoods of DOR compared to the lowest tertiles. Cu and Pb showed significantly non-linear associations with ovarian reserve markers such as follicle-stimulating, anti-mullerian hormone levels, and antral follicle count. With the rising overall concentrations of heavy metals, the likelihood of DOR increased although not significant. There was a trend of a "U-shaped" association across the whole concentration range of trace essential elements and the likelihood of DOR. Our study revealed that avoiding heavy metallic elements and properly supplementing trace essential elements are conducive to ovarian function.
金属元素与卵巢储备功能之间的关系仍不确定。在这项病例对照研究中，我们纳入了 149 名卵巢储备功能减退（DOR）患者和 151 名卵巢储备功能正常的患者，并采用电感耦合等离子体质谱法检测了她们卵泡液中六种重金属（Cr、Cd、As、Hg、Pb 和 Mn）和七种痕量必需元素（Se、Fe、Zn、Co、Mo、Cu、I）的水平。我们采用逻辑回归和贝叶斯核机器回归（BKMR）来评估关联。结果发现，与最低三分位相比，Pb 的中、高三分位与 DOR 的发生风险增加显著相关，而 Cu、I 和 Fe 的中、高三分位与 DOR 的发生风险降低显著相关。Cu 和 Pb 与卵巢储备标志物如卵泡刺激素、抗苗勒管激素水平和窦卵泡计数呈显著非线性关联。随着重金属整体浓度的升高，DOR 的发生风险虽然没有显著增加，但有升高的趋势。痕量必需元素的整个浓度范围内与 DOR 的发生风险呈“U 型”关联趋势。本研究表明，避免重金属元素和适当补充痕量必需元素有利于卵巢功能。
