Multivariate logistic regression analysis on PCOS association with reproductive characteristics, Cp, and Mg levels
Variable
OR
SE
Lower 95% CI for OR
Upper 95% CI for OR
P value
AFC (n)
2.692
0.213
0.770
1.211
0.0001
Menses per year
0.313
0.248
–1.417
–0.903
0.0001
Cp
1.01
0.09
0.001
0.001
0.048
Mg
1.29
0.92
0.257
0.257
0.780
Age and FBS levels were used as continuous variables while rest were used as categorical variables. Coding of categorical variables normal Mg level = 0, hypomagnesemia = 1
The authors declare that they have no conflicts of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the Declaration of Helsinki 1964 and its later amendments or comparable ethical standards. The study was approved by the institutional review committee of the Armed Forces Medical College, Pune reference number IEC/2018/23.
Consent to participate
Informed consent to participate in the study was obtained from all participants.
Consent to publication
Informed consent to publication was obtained from relevant participants.
Availability of data and materials
The data that support the findings of this study will be shared upon reasonable request data policy from the corresponding author.
Barbosa G, de Sá LBPC, Rocha DRTW, Arbex AK. Polycystic ovary syndrome (PCOS) and fertility.Open J Endocr Metab Dis. 2016;6:58–65. [DOI]
Deswal R, Narwal V, Dang A, Pundir CS. The prevalence of polycystic ovary syndrome: a brief systematic review.J Hum Reprod Sci. 2020;13:261–71. [DOI] [PubMed] [PMC]
Eiras MC, Pinheiro DP, Romcy KAM, Ferriani RA, Reis RMD, Furtado CLM. Polycystic ovary syndrome: the epigenetics behind the disease.Reprod Sci. 2022;29:680–94. [DOI] [PubMed]
Kumarapeli VL, Seneviratne RdA, Wijeyaratne CN. Health-related quality of life and psychological distress in polycystic ovary syndrome: a hidden facet in South Asian women.BJOG. 2011;118:319–28. [DOI] [PubMed]
Barbagallo M, Dominguez LJ. Magnesium metabolism in type 2 diabetes mellitus, metabolic syndrome and insulin resistance.Arch Biochem Biophys. 2007;458:40–7. [DOI] [PubMed]
Saris WHM, Astrup A, Prentice AM, Zunft HJF, Formiguera X, Verboeket-van de Venne WPHG, et al. Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study.Int J Obes Relat Metab Disord. 2000;24:1310–8. [DOI] [PubMed]
Larsson SC, Wolk A. Magnesium intake and risk of type 2 diabetes: a meta-analysis.J Intern Med. 2007;262:208–14. [DOI] [PubMed]
Guerrero-Romero F, Rodríguez-Morán M. The effect of lowering blood pressure by magnesium supplementation in diabetic hypertensive adults with low serum magnesium levels: a randomized, double-blind, placebo-controlled clinical trial.J Hum Hypertens. 2009;23:245–51. [DOI] [PubMed]
Nielsen FH. Magnesium deficiency and increased inflammation: current perspectives.J Inflamm Res. 2018;11:25–34. [DOI] [PubMed] [PMC]
Kostov K. Effects of magnesium deficiency on mechanisms of insulin resistance in type 2 diabetes: focusing on the processes of insulin secretion and signaling.Int J Mol Sci. 2019;20:1351. [DOI] [PubMed] [PMC]
Healy J, Tipton K. Ceruloplasmin and what it might do.J Neural Transm (Vienna). 2007;114:777–81. [DOI] [PubMed]
Shukla N, Maher J, Masters J, Angelini GD, Jeremy JY. Does oxidative stress change ceruloplasmin from a protective to a vasculopathic factor?Atherosclerosis. 2006;187:238–50. [DOI] [PubMed]
Gitlin JD. Transcriptional regulation of ceruloplasmin gene expression during inflammation.J Biol Chem. 1988;263:6281–7. [PubMed]
Iwata T, Kantarci A, Yagi M, Jackson T, Hasturk H, Kurihara H, et al. Ceruloplasmin induces polymorphonuclear leukocyte priming in localized aggressive periodontitis.J Periodontol. 2009;80:1300–6. [DOI] [PubMed] [PMC]
Harshavardhana B, Rath SK, Mukherjee M. Evaluation of serum ceruloplasmin in aggressive and chronic periodontitis patients.J Indian Soc Periodontol. 2013;17:333–7. [DOI] [PubMed] [PMC]
Inoue K, Sakano N, Ogino K, Sato Y, Wang DH, Kubo M, et al. Relationship between ceruloplasmin and oxidative biomarkers including ferritin among healthy Japanese.J Clin Biochem Nutr. 2013;52:160–6. [DOI] [PubMed] [PMC]
Fox PL, Mukhopadhyay C, Ehrenwald E. Structure, oxidant activity, and cardiovascular mechanisms of human ceruloplasmin.Life Sci. 1995;56:1749–58. [DOI] [PubMed]
de Groot PCM, Dekkers OM, Romijn JA, Dieben SWM, Helmerhorst FM. PCOS, coronary heart disease, stroke and the influence of obesity: a systematic review and meta-analysis.Hum Reprod Update. 2011;17:495–500. [DOI] [PubMed]
Elci E, Kaya C, Cim N, Yildizhan R, Elci GG. Evaluation of cardiac risk marker levels in obese and non-obese patients with polycystic ovaries.Gynecol Endocrinol. 2017;33:43–7. [DOI] [PubMed]
Kriseman M, Mills C, Kovanci E, Sangi-Haghpeykar H, Gibbons W. Antimullerian hormone levels are inversely associated with body mass index (BMI) in women with polycystic ovary syndrome.J Assist Reprod Genet. 2015;32:1313–6. [DOI] [PubMed] [PMC]
Cengiz H, Ekin M, Dagdeviren H, Yildiz Ş, Kaya C, Kanawati A. Comparison of serum anti-Müllerian hormone levels in normal weight and overweight-obese adolescent patients with polycystic ovary syndrome.Eur J Obstet Gynecol Reprod Biol. 2014;180:46–50. [DOI] [PubMed]
Sathyapalan T, Atkin SL. Mediators of inflammation in polycystic ovary syndrome in relation to adiposity.Mediators Inflamm. 2010;2010:758656. [DOI] [PubMed] [PMC]
Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, et al. Chronic low grade inflammation in pathogenesis of PCOS.Int J Mol Sci. 2021;22:3789. [DOI] [PubMed] [PMC]
Engström G, Hedblad B, Stavenow L, Lind P, Janzon L, Lindgärde F. Inflammation-sensitive plasma proteins are associated with future weight gain.Diabetes. 2003;52:2097–101. [DOI] [PubMed]
Kim OY, Shin MJ, Moon J, Chung JH. Plasma ceruloplasmin as a biomarker for obesity: a proteomic approach.Clin Biochem. 2011;44:351–6. [DOI] [PubMed]
Göçmen AY, Sahin E, Semiz E, Gümuşlü S. Is elevated serum ceruloplasmin level associated with increased risk of coronary artery disease?Can J Cardiol. 2008;24:209–12. [DOI] [PubMed] [PMC]
Iskra M, Majewski W. Oxidase activity of ceruloplasmin and concentrations of copper and zinc in serum in chronic arterial occlusion of the lower limbs.J Trace Elem Med Biol. 1999;13:76–81. [DOI] [PubMed]
Cunningham J, Leffell M, Mearkle P, Harmatz P. Elevated plasma ceruloplasmin in insulin-dependent diabetes mellitus: evidence for increased oxidative stress as a variable complication.Metabolism. 1995;44:996–9. [DOI] [PubMed]
Daimon M, Susa S, Yamatani K, Manaka H, Hama K, Kimura M, et al. Hyperglycemia is a factor for an increase in serum ceruloplasmin in type 2 diabetes.Diabetes Care. 1998;21:1525–8. [DOI] [PubMed]
The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS).Hum Reprod. 2004;19:41–7. [DOI] [PubMed]
Guerrero-Romero F, Tamez-Perez HE, González-González G, Salinas-Martínez AM, Montes-Villarreal J, Treviño-Ortiz JH, et al. Oral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomized trial.Diabetes Metab. 2004;30:253–8. [DOI] [PubMed]
Somani BL, Ambade V. A kinetic method amenable to automation for ceruloplasmin estimation with inexpensive and stable reagents.Clin Biochem. 2007;40:571–4. [DOI] [PubMed]
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus.Diabetes Care. 2003;26:3160–7. [DOI] [PubMed]
Rosolova H, Mayer O Jr, Reaven G. Effect of variations in plasma magnesium concentration on resistance to insulin-mediated glucose disposal in nondiabetic subjects.J Clin Endocrinol Metab. 1997;82:3783–5. [DOI] [PubMed]
Song Y, Manson JE, Buring JE, Liu S. Dietary magnesium intake in relation to plasma insulin levels and risk of type 2 diabetes in women.Diabetes Care. 2004;27:59–65. [DOI] [PubMed]
Kao WH, Folsom AR, Nieto FJ, Mo JP, Watson RL, Brancati FL. Serum and dietary magnesium and the risk for type 2 diabetes mellitus: the Atherosclerosis Risk in Communities Study.Arch Intern Med. 1999;159:2151–9. [DOI] [PubMed]
Hamilton KP, Zelig R, Parker AR, Haggag A. Insulin resistance and serum magnesium concentrations among women with polycystic ovary syndrome.Curr Dev Nutr. 2019;3:nzz108. [DOI] [PubMed] [PMC]
Guerrero-Romero F, Rodríguez-Morán M. Low serum magnesium levels and metabolic syndrome.Acta Diabetol. 2002;39:209–13. [DOI] [PubMed]
Ford KA, LaBarbera AR. Cationic modulation of follicle-stimulating hormone binding to granulosa cell receptor.Biol Reprod. 1987;36:643–50. [DOI] [PubMed]
Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycystic ovary syndrome.J Clin Endocrinol Metab. 2008;93:162–8. [DOI] [PubMed] [PMC]
Abbara A, Eng PC, Phylactou M, Clarke SA, Hunjan T, Roberts R, et al. Anti-Müllerian hormone (AMH) in the diagnosis of menstrual disturbance due to polycystic ovarian syndrome.Front Endocrinol (Lausanne). 2019;10:656. [DOI] [PubMed] [PMC]
Chiu WL, Boyle J, Vincent A, Teede H, Moran LJ. Cardiometabolic risks in polycystic ovary syndrome: non-traditional risk factors and the impact of obesity.Neuroendocrinology. 2017;104:412–24. [DOI] [PubMed]
Harris HR, Titus LJ, Cramer DW, Terry KL. Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population-based case-control study.Int J Cancer. 2017;140:285–91. [DOI] [PubMed] [PMC]
Kim JJ, Hwang KR, Chae SJ, Yoon SH, Choi YM. Impact of the newly recommended antral follicle count cutoff for polycystic ovary in adult women with polycystic ovary syndrome.Hum Reprod. 2020;35:652–9. [DOI] [PubMed]
Franks S, Mason H, Willis D. Follicular dynamics in the polycystic ovary syndrome.Mol Cell Endocrinol. 2000;163:49–52. [DOI] [PubMed]
Wisdom SJ, Wilson R, McKillop JH, Walker JJ. Antioxidant systems in normal pregnancy and in pregnancy-induced hypertension.Am J Obstet Gynecol. 1991;165:1701–4. [DOI] [PubMed]
Osaki S, Johnson DA, Frieden E. The possible significance of the ferrous oxidase activity of ceruloplasmin in normal human serum.J Biol Chem. 1966;241:2746–51. [DOI] [PubMed]
Mehde AA, Resan AK. Study of several biochemical features in sera of patients with polycystic ovaries and compared with the control group.Aust J Basic & Appl Sci. 2014;8:620–7.
Woo I, Tobler K, Khafagy A, Christianson MS, Yates M, Garcia J. Predictive value of elevated LH/FSH ratio for ovulation induction in patients with polycystic ovary syndrome.J Reprod Med. 2015;60:495–500. [PubMed]
Chen J, Shen S, Tan Y, Xia D, Xia Y, Cao Y, et al. The correlation of aromatase activity and obesity in women with or without polycystic ovary syndrome.J Ovarian Res. 2015;8:11. [DOI] [PubMed] [PMC]
Guzick DS. Polycystic ovary syndrome.Obstet Gynecol. 2004;103:181–93. [DOI] [PubMed]
Tsilchorozidou T, Overton C, Conway GS. The pathophysiology of polycystic ovary syndrome.Clin Endocrinol (Oxf). 2004;60:1–17. [DOI] [PubMed]
Schuring AN, Schulte N, Sonntag B, Kiesel L. Androgens and insulin—two key players in polycystic ovary syndrome. Recent concepts in the pathophysiology and genetics of polycystic ovary syndrome.Gynakol Geburtshilfliche Rundsch. 2008;48:9–15. [DOI] [PubMed]
Pasquali R, Stener-Victorin E, Yildiz BO, Duleba AJ, Hoeger K, Mason H, et al. PCOS Forum: research in polycystic ovary syndrome today and tomorrow.Clin Endocrinol (Oxf). 2011;74:424–33. [DOI] [PubMed] [PMC]
Willis EL, Kersey DC, Durrant BS, Kouba AJ. The acute phase protein ceruloplasmin as a non-invasive marker of pseudopregnancy, pregnancy, and pregnancy loss in the giant panda.PLoS One. 2011;6:e21159. [DOI] [PubMed] [PMC]
Serdar Z, Gür E, Develioğlu O. Serum iron and copper status and oxidative stress in severe and mild preeclampsia.Cell Biochem Funct. 2006;24:209–15. [DOI] [PubMed]
Dumitriu L, Bartoc R, Ursu H, Purice M, Ionescu V. Significance of high levels of serum malonyl dialdehyde (MDA) and ceruloplasmin (CP) in hyper- and hypothyroidism.Endocrinologie. 1988;26:35–8. [PubMed]
