Copper and Zinc Levels in Myelodysplastic Syndrome Patients versus Healthy Subjects.

Vahid Moazed,Foroogh Mangeli,Behjat Kalantari-Khandani,Bita Rashidinezhad,Ali Nemati,Elham Jafari,Ahmad Naghibzadeh Tahami

doi:10.31557/apjcp.2020.21.1.239

Abstract

Background:Myelodysplastic syndrome (MDS) is a heterogeneous hematological disease and certain serum factors are assumed to be involved in its pathogenesis and progression. Given this, our aim was to comparatively investigate the copper, zinc, and iron levels in MDS patients and healthy individuals. Methods:This case-control study was conducted on 31 patients with MDS (according to the WHO criteria after investigating laboratory tests such as peripheral blood smear and bone marrow aspiration) attending Bahonar Hospital, Kerman, Iran, and 31 healthy subjects from 2016 to 2018. The levels of copper, ceruloplasmin, zinc, ferritin, and iron were compared between the two groups. Results:Among the MDS patients, five individuals (16.13%) had low serum copper level (mean: 67.8 ± 4.35 µg/dl). Serum copper level was 111.3 ± 27.7 and 138.3 ± 26.6 in case and control groups, respectively (P = 0.0001). The serum zinc level and bone marrow iron level were also significantly different between the two groups (P < 0.05). Conclusion:Overall, it can be concluded that because only a small proportion of the MDS patients enrolled in this study were found to have lower copper levels compared with the MDS patients population, further studies with a larger sample size and also clinical trials in MDS patients with serum zinc, and copper deficiency are recommended, and post-treatment hematological reassessment would also be beneficial to achieving more definitive results.

Highlights

Myelodysplastic syndrome (MDS) is characterized by peripheral cytopenia and ineffective erythropoiesis diagnosed in bone marrow and peripheral blood smear, which mainly affects older individuals but can be seen in other age groups (Gangat et al, 2016)
Overall, it can be concluded that because only a small proportion of the MDS patients enrolled in this study were found to have lower copper levels compared with the MDS patients population, further studies with a larger sample size and clinical trials in MDS patients with serum zinc, and copper deficiency are recommended, and post-treatment hematological reassessment would be beneficial to achieving more definitive results
Copper deficiency was significantly associated with increased serum iron levels as shown by independent t-test (P = 0.001), with the serum iron level at 189.8 ± 73.2 and 88.7 ± 54.3 μg/dl in MDS patients with copper deficiency and normal serum copper level, respectively

Summary

Introduction

Myelodysplastic syndrome (MDS) is characterized by peripheral cytopenia and ineffective erythropoiesis diagnosed in bone marrow and peripheral blood smear, which mainly affects older individuals but can be seen in other age groups (Gangat et al, 2016). Copper deficiency and increased zinc levels are possible causes of anemia and neutropenia, which may mimic MDS symptoms (Bottomley et al, 2004; Sekeres et al, 2010). These conditions have always presented a challenge to hematologists with regard to both arriving at a definitive diagnosis and offering effective treatment. Our aim was to comparatively investigate the copper, zinc, and iron levels in MDS patients and healthy individuals. Conclusion: Overall, it can be concluded that because only a small proportion of the MDS patients enrolled in this study were found to have lower copper levels compared with the MDS patients population, further studies with a larger sample size and clinical trials in MDS patients with serum zinc, and copper deficiency are recommended, and post-treatment hematological reassessment would be beneficial to achieving more definitive results

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Conclusion