PMID- 38232522
OWN - NLM
STAT- MEDLINE
DCOM- 20240205
LR  - 20240206
IS  - 1090-2414 (Electronic)
IS  - 0147-6513 (Linking)
VI  - 271
DP  - 2024 Feb
TI  - Elevated levels of Zn, Cu and Co are associated with an increased risk of 
      endometriosis: Results from a casecontrol study.
PG  - 115932
LID - S0147-6513(24)00006-X [pii]
LID - 10.1016/j.ecoenv.2024.115932 [doi]
AB  - BACKGROUND: Endometriosis is a common gynecological disease that affects 
      approximately 5 % approximately 10 % of reproductive-aged women. Zinc (Zn), selenium (Se), 
      copper (Cu), cobalt (Co) and molybdenum (Mo) are essential trace elements and are 
      very important for human health. However, studies on the relationship between 
      mixtures of essential trace elements and the risk of endometriosis are limited 
      and inconsistent. In particular, studies confirming the association via different 
      sample types are limited. OBJECTIVE: This study aimed to investigate the 
      associations between Zn, Se, Cu, Co and Mo concentrations in blood and follicular 
      fluid (FF) and endometriosis risk in a Chinese population. METHODS: A total of 
      609 subjects undergoing in vitro fertilization (IVF) were recruited; 836 samples 
      were analyzed, including 451 blood samples (234 controls and 217 cases) and 385 
      FF samples (203 controls and 182 cases). In addition, 227 subjects provided both 
      blood and FF samples. Zn, Se, Cu, Co and Mo concentrations in blood and FF were 
      quantified via inductively coupled plasma-mass spectrometry (ICP-MS). The 
      associations between the levels of Zn, Se, Cu, Co and Mo and the risk of 
      endometriosis were assessed using single-element models (logistic regression 
      models), and the combined effect of the trace elements on endometriosis risk was 
      assessed using multielement models (Bayesian kernel machine regression (BKMR) and 
      weighted quantile sum (WQS) regression). RESULTS: Based on the single-element 
      models, significant associations of Zn concentrations in blood (high-level vs. 
      low-level group: aOR = 14.17, 95 % CI: 7.31, 27.50) and FF (first tertile vs. 
      second tertile group: aOR = 0.34, 95 % CI: 0.16, 0.71; third tertile vs. second 
      tertile group: aOR = 2.32, 95 % CI: 1.38, 3.91, respectively) and Co 
      concentrations in blood (first tertile vs. second tertile group, aOR = 0.24, 95 % 
      CI: 0.12, 0.48) and FF (third tertile vs. second tertile group: aOR = 3.87, 95 % 
      CI: 2.19, 6.84) with endometriosis risk were found after adjustment for all 
      confounders. In FF, Cu and Mo levels were significantly greater among the cases 
      than among the controls, with a positive association with endometriosis risk (Cu 
      (first tertile vs. second tertile group: aOR = 0.39, 95 % CI: 0.19, 0.81; third 
      tertile vs. second tertile group: aOR = 2.73, 95 % CI: 1.61, 4.66, respectively) 
      and Mo (high-level vs. low-level group: aOR = 14.93, 95 % CI: 7.16, 31.12)). 
      However, similar associations between blood Cu and Mo levels and endometriosis 
      risk were not found. In addition, the levels of these five essential trace 
      element mixtures in blood and in FF were significantly and positively associated 
      with endometriosis risk according to the BKMR analyses; the levels of Zn and Cu 
      in blood and the levels of Mo in FF were significantly related to the risk of 
      endometriosis, and the posterior inclusion probabilities (PIPs) were 1.00, 0.99 
      and 1.00 for Zn and Cu levels in blood and Mo levels in FF, respectively. 
      Furthermore, Zn and Mo were the highest weighted elements in blood and FF, 
      respectively, according to WQS analyses. CONCLUSION: The risk of endometriosis 
      was associated with elevated levels of several essential trace elements (Zn, Cu 
      and Co). Elevated levels of these elements may be involved in the pathomechanism 
      of endometriosis. However, further studies with larger sample sizes will be 
      necessary to confirm these associations.
CI  - Copyright (c) 2024 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Su, Xun
AU  - Su X
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Yue, Xinyu
AU  - Yue X
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Zhang, Ying
AU  - Zhang Y
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Shen, Lingchao
AU  - Shen L
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Zhang, Huan
AU  - Zhang H
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China.
FAU - Wang, Xin
AU  - Wang X
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Yin, Tao
AU  - Yin T
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Zhang, Hua
AU  - Zhang H
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Peng, Jie
AU  - Peng J
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Wang, Xiaolei
AU  - Wang X
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Zou, Weiwei
AU  - Zou W
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Liang, Dan
AU  - Liang D
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China.
FAU - Du, Yinan
AU  - Du Y
AD  - School of Basic Medical Sciences, Anhui Medical University, No 81 Meishan Road, 
      Hefei 230032, Anhui, China.
FAU - Liu, Yajing
AU  - Liu Y
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China. Electronic address: 13385690561@163.com.
FAU - Cao, Yunxia
AU  - Cao Y
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; NHC Key 
      Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical 
      University), No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of 
      Population Health Across Life Cycle (Anhui Medical University), Ministry of 
      Education of the people's Republic of China, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, 
      No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Engineering 
      Research Center of Biopreservation and Artificial Organs, No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Anhui Provincial Institute of Translational Medicine, 
      No 81 Meishan Road, Hefei 230032, Anhui, China. Electronic address: 
      caoyunxia5972@ahmu.edu.cn.
FAU - Ji, Dongmei
AU  - Ji D
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal 
      Gametes and Reproductive Tract (Anhui Medical University), No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle 
      (Anhui Medical University), Ministry of Education of the people's Republic of 
      China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Province Key 
      Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, Hefei 230032, 
      Anhui, China; Anhui Provincial Engineering Research Center of Biopreservation and 
      Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Provincial Institute of Translational Medicine, No 81 Meishan Road, Hefei 230032, 
      Anhui, China. Electronic address: cahsxjdm@aliyun.com.
FAU - Liang, Chunmei
AU  - Liang C
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui 
      Medical University, No 218 Jixi Road, Hefei 230022, Anhui, China; the First 
      Affiliated Hospital & School of Public Health, Anhui Medical University, No 81 
      Meishan Road, Hefei 230032, Anhui, China; School of Public Health, Anhui Medical 
      University, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of 
      Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No 
      81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health 
      Across Life Cycle (Anhui Medical University), Ministry of Education of the 
      people's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui 
      Province Key Laboratory of Reproductive Health and Genetics, No 81 Meishan Road, 
      Hefei 230032, Anhui, China; Anhui Provincial Engineering Research Center of 
      Biopreservation and Artificial Organs, No 81 Meishan Road, Hefei 230032, Anhui, 
      China; Anhui Provincial Institute of Translational Medicine, No 81 Meishan Road, 
      Hefei 230032, Anhui, China; School of Basic Medical Sciences, Anhui Medical 
      University, No 81 Meishan Road, Hefei 230032, Anhui, China. Electronic address: 
      liang_chun_mei@126.com.
LA  - eng
PT  - Journal Article
DEP - 20240116
PL  - Netherlands
TA  - Ecotoxicol Environ Saf
JT  - Ecotoxicology and environmental safety
JID - 7805381
RN  - 0 (Trace Elements)
RN  - J41CSQ7QDS (Zinc)
RN  - 3G0H8C9362 (Cobalt)
RN  - H6241UJ22B (Selenium)
RN  - 81AH48963U (Molybdenum)
SB  - IM
MH  - Humans
MH  - Female
MH  - Adult
MH  - *Trace Elements/analysis
MH  - Zinc
MH  - Cobalt
MH  - *Endometriosis/epidemiology
MH  - Bayes Theorem
MH  - *Selenium
MH  - Molybdenum
OTO - NOTNLM
OT  - BKMR
OT  - Endometriosis
OT  - Essential trace elements
OT  - WQS
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2024/01/18 00:42
MHDA- 2024/02/05 06:43
CRDT- 2024/01/17 18:06
PHST- 2023/08/22 00:00 [received]
PHST- 2024/01/01 00:00 [revised]
PHST- 2024/01/02 00:00 [accepted]
PHST- 2024/02/05 06:43 [medline]
PHST- 2024/01/18 00:42 [pubmed]
PHST- 2024/01/17 18:06 [entrez]
AID - S0147-6513(24)00006-X [pii]
AID - 10.1016/j.ecoenv.2024.115932 [doi]
PST - ppublish
SO  - Ecotoxicol Environ Saf. 2024 Feb;271:115932. doi: 10.1016/j.ecoenv.2024.115932. 
      Epub 2024 Jan 16.