Dysprosium, cerium, indium, yttrium, and lutetium as emerging contributors to oxidative stress in polycystic ovary syndrome

To investigate the role of Dysprosium (Dy), Cerium (Ce), Indium (In), Yttrium (Y), and Lutetium (Lu) in relation to oxidative stress (OS) and their potential alterations in polycystic ovary syndrome (PCOS) females. This case-control study included two groups: Healthy controls (50) and PCOS cases (56). Serum levels of Dy, Ce, In, Y, and Lu were quantified using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). OS was evaluated by measuring serum levels of malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD). Furthermore, Pearson's correlation was performed to investigate the correlation between rare earth elements (REEs) and OS markers and differences in correlation strength between the PCOS and control groups were assessed using Fisher's z-test. PCOS subjects exhibited markedly higher concentrations of Dy, Ce, In, and Y than those in the control group (P < 0.05). The analysis of OS biomarkers revealed elevated MDA levels in the PCOS group, indicating enhanced lipid peroxidation, alongside significantly reduced antioxidant capacity (GSH and SOD) (P < 0.001). Pearson's correlation demonstrated significant positive associations between higher Dy, Ce, and Y levels and increased MDA levels (P < 0.05). Additionally, a significant negative correlation was observed between In and Y and the antioxidant markers GSH and SOD (P < 0.05), with Ce also showing an inverse association with SOD (P < 0.05). Fisher's z-test further confirmed significant differences in correlation strength between the PCOS and control groups for Dy-MDA (z = 2.01, P = 0.031), Ce-MDA (z = 1.78, P = 0.037), In-GSH (z = - 2.24, P = 0.025), and In-SOD (z = - 2.39, P = 0.017). Moreover, significant correlations were found between Dy and Y (r = 0.41, P = 0.003), Ce and In (r = 0.41, P = 0.002), Ce and Y (r = 0.53, P < 0.001), and In and Y (r = 0.70, P < 0.001), suggesting interconnected roles of Dy, Ce, In, and Y in PCOS. These findings point to a potential link between OS and REE exposure in the development of PCOS. They suggest that metal-induced oxidative damage could be a key contributor to its pathophysiology. The study underscores the need for deeper investigation into environmental factors affecting reproductive health and for identifying strategies to mitigate these risks in women with PCOS.