Recommendations for medical support of women with polycystic ovary syndrome in the conditions of elevated manganese exposure

A substantial body of research has demonstrated that environmental factors play a distinctive role in the aetiology of polycystic ovary syndrome, ranking among the numerous underlying causes of this condition. Aim. To determine the manganese content in the blood of women of fertile age living in an urbanized region, and secondly, to optimise approaches to the care of women with polycystic ovary syndrome in conditions of manganese exposure. Materials and methods. Analysis of the data from the state monitoring of chemical pollution of environmental objects in Kyiv and Kyiv region. The determination of manganese in blood serum of women was carried out by the method of inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis: the sample characteristics were determined by the median and 95th percentile indicators; analysis of the relationship between the data in groups of women (levels of manganese and prolactin in the blood) was performed using the Spearman rank correlation method. Results. According to state monitoring data, it was established that the permissible levels of manganese have been surpassed in surface waters (from 3.2 to 28 times) and in the air of Kyiv (more than 10 times). According to the results of blood tests of women with polycystic ovary syndrome (study group, n=52), increased levels of manganese in blood serum were detected (median — 0.0095 mg/l, 95th percentile — 0.13 mg/l) compared to the control group (healthy women, n=38), median — 0.0035 mg/l, 95th percentile — 0.014 mg/l, p= 0.0012; Spearman’s rank correlation coefficient — rс=0.38, p<0.05. In women from the study group, a positive correlation between elevated manganese levels and blood prolactin levels — r=0.4137, p=0.0134 was found. Conclusions. In an urbanised region, there are numerous potential sources of manganese exposure that increase the risk of polycystic ovary syndrome. Blood prolactin levels can be considered a biomarker. The medical care of women suffering from polycystic ovary syndrome who have been exposed to manganese necessitates the stimulation of the body’s detoxification systems, the prevention of oxidative stress, and organoprotective therapy.