The Role of Serum Cadmium Levels in the Etiology of Premature Ovarian Failure: A Case-Control Study

Öz

Premature ovarian failure (POF) is a clinical syndrome known to affect approximately 1% of women of reproductive age. A number of genetic, autoimmune, metabolic, infectious and environmental causes have been identified in the etiology of POF. Cadmium is a toxic metal which can accumulate in ovaries and causes a significant decrease in the binding of gonadotropins that regulate steroidogenic enzyme activity in granulosa cells. We aimed to investigate the role of cadmium in the etiology of POF. Thirty-five patients with POF were enrolled in group 1 which was the study group. Two control groups were formed from healthy participants. Thirty-fiveparticipants who were age-matched young women with regular menstruation were included in group 2.Thirty-fivehealthy postmenopausal women were included in group 3. Patients' demographic data were recorded. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and cadmium levels were measured. There was a statistically significant difference between the groups for gravida, parity and living children (p<0.001), but no difference was found for abortion (p=0.430). While there was a statistically significant difference between the groups for serum FSH, LH and E2 levels (p<0.001), no statistically significant difference was found for T3, T4 and TSH. Serum cadmium levels were found to be statistically significantly decreased in group 1 compared to g roups 2 and 3 (p<0.001). This study revealed that cadmium had no direct effect on the development of POF, but it should be kept in mind that the synergistic and antagonistic effects of metals may affect this result.

Anahtar Kelimeler

• Premature ovarian failure
• cadmium
• heavy metal exposure
• infertility

Prematürovaryan Yetmezlik Etyolojisinde Serum Kadmiyum Düzeyinin Rolü:Vaka kontrol çalışması

Öz

Prematüre over yetmezliği (POF), üreme çağındaki kadınların yaklaşık %1'ini etkilediği bir klinik sendromdur. POF etiyolojisinde bir takım genetik, otoimmün, metabolik, enfeksiyöz ve çevresel nedenler tanımlanmıştır. Kadmiyum, yumurtalıklarda birikebilen ve granüloza hücrelerinde steroidojenik enzim aktivitesini düzenleyen gonadotropinlerin bağlanmasında önemli bir azalmaya neden olabilen toksik bir metaldir. POF etiyolojisinde kadmiyumun rolünü araştırmayı amaçladık. Çalışma grubu olan grup 1'e POF'lu 35 hasta alındı. Katılımcılarla iki sağlıklı kontrol grubu oluşturuldu. Grup 2'ye, kendi yaşlarında düzenli adet gören genç kadınlardan oluşan otuz beş katılımcı, grup 3'e menopoz sonrası sağlıklı otuz beş kadın dahil edildi. Hastaların demografik verileri kaydedildi. Serum folikül uyarıcı hormon (FSH), luteinize edici hormon (LH), östradiol (E2), tiroid uyarıcı hormon (TSH), triiyodotironin (T3), tiroksin (T4) ve kadmiyum düzeyleri ölçüldü. Gruplar arasında gravida, parite ve yaşayan çocuklar açısından istatistiksel olarak anlamlı fark varken (p<0,001) abortus için fark bulunmadı (p=0,430). Serum FSH, LH ve E2 düzeyleri açısından gruplar arasında istatistiksel olarak anlamlı fark varken (p<0,001), T3, T4 ve TSH için istatistiksel olarak anlamlı fark bulunmadı. Serum kadmiyum düzeyleri grup 1'de grup 2 ve 3'e göre istatistiksel olarak anlamlı düzeyde azalmıştı (p<0,001). Bu çalışma kadmiyum düzeyinin POF gelişimi üzerinde direkt etkisi olmadığını ortaya koymuştur ancak metallerin sinerjistik ve antagonistik etkilerinin bu sonucu etkileyebileceği de akılda tutulmalıdır.

Anahtar Kelimeler

• Kadmiyum
• Ağır metal maruziyeti
• İnfertilite
• Prematür ovaryan yetmezlik

Kaynakça

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