Altered Serum Trace Elements and Vitamin D3 in PCOS: Implications for Hormonal Regulation and Nutritional Therapy

Objective: This study evaluates serum trace element and vitamin levels in women with polycystic ovary syndrome (PCOS) and explores their correlation with sex hormones to identify potential nutritional interventions.Methods: Between April and November 2023, 158 women aged 18–35 diagnosed with PCOS at West China Second University Hospital were included, with 132 healthy women as controls. Serum levels of magnesium (Mg), phosphorus (P), calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), aluminum (Al), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), selenium (Se), molybdenum (Mo), lithium (Li), and vitamins A, D, D2, D3, and E were measured using inductively coupled plasma mass spectrometry and liquid chromatography-tandem mass spectrometry. Sex hormones, including testosterone (T), follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEAS), androstenedione (AND), sex hormone-binding globulin (SHBG), and the free androgen index (FAI), were analyzed for correlations with micronutrients.Results: PCOS patients had significantly higher Mg, P, Ca, Fe, Cu, and Mo and lower Ni levels (P < 0.05). VitD levels were reduced (P < 0.05). Negative correlations were found between VitD3 and T, and VitE and LH (P < 0.05). VitA negatively correlated with DHEAS and positively with FAI, while Mo was negatively correlated with FAI (P < 0.05).Conclusion: PCOS is associated with micronutrient imbalances affecting metabolic and hormonal regulation. Nutritional interventions may help mitigate symptoms and improve metabolic outcomes.