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Updated: Jun 25, 2026
Evaluation of Hepatic Glucose Production in a Polycystic Ovary Syndrome Mouse Model
Published on: March 5, 2022
Associations between serum persistent organic pollutants and polycystic ovary syndrome risk: a case-control study
1Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Background:
Persistent organic pollutants (POPs), including organochlorine pesticides (OCPs) and per- and polyfluoroalkyl substances (PFAS), are endocrine-disrupting chemicals potentially linked to polycystic ovary syndrome (PCOS). However, evidence on their combined effects and underlying mechanisms remains limited.
Methods:
We conducted a case-control study including 146 women with PCOS and 241 controls recruited from the Affiliated Hospital of Hebei University, China (2023-2025). Serum concentrations of 15 POPs (6 OCPs and 9 PFAS) were measured using GC-MS/MS and UPLC-MS/MS. Associations with PCOS were evaluated using multivariable logistic regression, weighted quantile sum (WQS) regression, quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). Mediation analysis examined whether sex hormones mediated these associations.
Results:
In single-pollutant analyses, PFOS (OR = 2.63, 95% CI: 1.78-3.88), p,p'-DDE (OR = 2.25, 95% CI: 1.54-3.28), heptachlor (OR = 1.99, 95% CI: 1.26-3.14), and PFHxS (OR = 1.74, 95% CI: 1.15-2.62) were significantly associated with increased PCOS risk. Mixture analyses revealed strong positive associations between the overall POPs mixture and PCOS (WQS OR = 9.29, 95% CI: 3.38-25.50; qgcomp OR = 7.04, 95% CI: 2.79-17.80), with PFOS and p,p'-DDE identified as predominant contributors. BKMR confirmed PFOS (PIP = 1.000) and p,p'-DDE (PIP = 0.998) as the most important contributors. Mediation analysis indicated that testosterone mediated 49.3% of the PFOS-PCOS association, while progesterone mediated 20.9% of the PFOS-PCOS and 24.8% of the p,p'-DDE-PCOS associations.
Conclusion:
Exposure to POPs, particularly PFOS and p,p'-DDE, was associated with elevated PCOS risk among Chinese women. Sex hormones, especially testosterone and progesterone, partially mediated these associations, suggesting hormonal disruption as a potential mechanism linking POPs exposure to PCOS.
