ABSTRACT. Idiopathic male infertility (IMI) accounts for up to 60% of fertility disorders, and its pathogenesis, especially in ecologically disadvantaged northern regions, remains poorly understood. Trace element imbalance is considered a significant pathogenetic factor in IMI; however, comprehensive studies simultaneously assessing profiles in ejaculate, hair, and blood, with the construction of prognostic models, are lacking.
Objective. To identify a region-specific profile of trace element imbalance in three biological matrices among men with idiopathic male infertility (IMI) residing in the Khanty-Mansiysk Autonomous Okrug – Yugra (KhMAO-Yugra) and to build a multivariate prognostic model based on this profile.
Materials and methods. A prospective case-control study included 120 men (70 with IMI, 50 fertile controls) who had been permanent residents of the region for at least 5 years. Concentrations of 12-15 trace elements in ejaculate, hair, and blood serum were determined using inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis employed the Mann-Whitney U-test, ROC analysis, and stepwise binary logistic regression.
Results. A specific trace element profile of IMI was identified: in ejaculate – deficiency of P, Zn, Cu, Se; in hair – increased levels of Mg, Zn, Hg, Pb and decreased levels of Fe, Cu, Se, I; in serum – decreased levels of Zn and Se. ROC analysis identified the most informative markers (AUC>0.80): Mg in hair (0.897), I in hair (0.831), Pb in hair (0.818), and P in ejaculate (0.797). Logistic regression included 6 predictors in the final model: elevated levels of Mg and Pb, reduced levels of Se and Fe in hair; reduced level of Se in serum; reduced level of P in ejaculate. The model demonstrated outstanding discriminatory power: AUC=0.987 (95% CI: 0.946-0.999), sensitivity 98.6%, specificity 92%, overall classification accuracy 95.8%.
Conclusion. For the first time, a comprehensive specific region-associated profile (RAP) of trace element imbalance in IMI has been described, and a highly accurate prognostic model based on it has been developed. The obtained data pave the way for personalized, targeted diagnosis and correction of trace element imbalance as a key pathogenetic component of IMI in residents of northern industrial regions.
KEYWORDS: idiopathic male infertility, trace elements, ROC analysis, logistic regression, prognostic model, northern region, KhMAO-Yugra.
For citation: Belik O.S. Prognostic value of trace element profiles in ejaculate, hair, and blood serum for the diagnosis of idiopathic male infertility among residents of a Northern region (KhMAO-Yugra). Trace elemets in medicine. 2026;27(1):40-51. DOI: 10.19112/2413-6174-2026-27-1-40-51
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