Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients

Abstract Purpose Endometriosis is a prevalent gynecological disorder, yet data on the role of trace metal elements in its risk remain limited. We aimed to investigate the relationship between serum copper (Cu), zinc (Zn), iron (Fe), magnesium (Mg) levels, and the Cu/Zn ratio with the risk of endomet...

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Main Authors: Yanping Liu, Guihong Cheng, Hong Li, Qingxia Meng
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Reproductive Medicine and Biology
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Online Access:https://doi.org/10.1002/rmb2.12644
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author Yanping Liu
Guihong Cheng
Hong Li
Qingxia Meng
author_facet Yanping Liu
Guihong Cheng
Hong Li
Qingxia Meng
author_sort Yanping Liu
collection DOAJ
description Abstract Purpose Endometriosis is a prevalent gynecological disorder, yet data on the role of trace metal elements in its risk remain limited. We aimed to investigate the relationship between serum copper (Cu), zinc (Zn), iron (Fe), magnesium (Mg) levels, and the Cu/Zn ratio with the risk of endometriosis. Methods This study involved 568 infertile patients diagnosed with endometriosis, compared to 819 infertile patients without endometriosis (Control group). Basic characteristics, hormonal parameters, and essential trace elements of the patients were measured and analyzed. Results The findings indicated a notable decrease in serum Zn levels in the endometriosis group compared to controls, alongside a significant increase in the Cu/Zn ratio (p < 0.001). Restricted cubic spline (RCS) analysis revealed a linear relationship between Zn levels and the Cu/Zn ratio and endometriosis risk. Moreover, Zn levels exhibited a negative correlation with endometriosis risk (p trend = 0.005), while the Cu/Zn ratio displayed a positive correlation with endometriosis risk, even after adjusting for age, body mass index (BMI), and baseline hormones (p trend < 0.001). Compared to the first quartile of Cu/Zn ratio after adjustment, the odds ratios (ORs) with 95% confidence intervals (CIs) for the second and fourth quartiles were 1.97 (1.37, 2.83) and 2.63 (1.80, 3.84), respectively. Conclusions This study provided evidence of decreased serum Zn levels and an increased Cu/Zn ratio being associated with an elevated risk of endometriosis among infertile patients. These findings offer valuable real‐world data, enriching our understanding of endometriosis.
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spelling doaj-art-4833abe367ae4cec82dae8f87aa21e622025-08-20T06:16:47ZengWileyReproductive Medicine and Biology1445-57811447-05782025-01-01241n/an/a10.1002/rmb2.12644Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patientsYanping Liu0Guihong Cheng1Hong Li2Qingxia Meng3Center of Reproduction and Genetics The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School of Nanjing Medical University Suzhou ChinaCenter of Reproduction and Genetics The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School of Nanjing Medical University Suzhou ChinaCenter of Reproduction and Genetics The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School of Nanjing Medical University Suzhou ChinaCenter of Reproduction and Genetics The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School of Nanjing Medical University Suzhou ChinaAbstract Purpose Endometriosis is a prevalent gynecological disorder, yet data on the role of trace metal elements in its risk remain limited. We aimed to investigate the relationship between serum copper (Cu), zinc (Zn), iron (Fe), magnesium (Mg) levels, and the Cu/Zn ratio with the risk of endometriosis. Methods This study involved 568 infertile patients diagnosed with endometriosis, compared to 819 infertile patients without endometriosis (Control group). Basic characteristics, hormonal parameters, and essential trace elements of the patients were measured and analyzed. Results The findings indicated a notable decrease in serum Zn levels in the endometriosis group compared to controls, alongside a significant increase in the Cu/Zn ratio (p < 0.001). Restricted cubic spline (RCS) analysis revealed a linear relationship between Zn levels and the Cu/Zn ratio and endometriosis risk. Moreover, Zn levels exhibited a negative correlation with endometriosis risk (p trend = 0.005), while the Cu/Zn ratio displayed a positive correlation with endometriosis risk, even after adjusting for age, body mass index (BMI), and baseline hormones (p trend < 0.001). Compared to the first quartile of Cu/Zn ratio after adjustment, the odds ratios (ORs) with 95% confidence intervals (CIs) for the second and fourth quartiles were 1.97 (1.37, 2.83) and 2.63 (1.80, 3.84), respectively. Conclusions This study provided evidence of decreased serum Zn levels and an increased Cu/Zn ratio being associated with an elevated risk of endometriosis among infertile patients. These findings offer valuable real‐world data, enriching our understanding of endometriosis.https://doi.org/10.1002/rmb2.12644coppercopper/zinc ratioendometriosisinfertilityzinc
spellingShingle Yanping Liu
Guihong Cheng
Hong Li
Qingxia Meng
Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients
Reproductive Medicine and Biology
copper
copper/zinc ratio
endometriosis
infertility
zinc
title Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients
title_full Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients
title_fullStr Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients
title_full_unstemmed Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients
title_short Serum copper to zinc ratio and risk of endometriosis: Insights from a case–control study in infertile patients
title_sort serum copper to zinc ratio and risk of endometriosis insights from a case control study in infertile patients
topic copper
copper/zinc ratio
endometriosis
infertility
zinc
url https://doi.org/10.1002/rmb2.12644
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AT guihongcheng serumcoppertozincratioandriskofendometriosisinsightsfromacasecontrolstudyininfertilepatients
AT hongli serumcoppertozincratioandriskofendometriosisinsightsfromacasecontrolstudyininfertilepatients
AT qingxiameng serumcoppertozincratioandriskofendometriosisinsightsfromacasecontrolstudyininfertilepatients