Serum Copper Levels Research Articles

1122 Geriatric Bariatrics: Do Post-Operative Patients Remain at Risk for Micronutrient Deficiencies?

INTRODUCTION: We have previously described high prevalence of thiamine deficiency and gastrointestinal symptoms (Nath et al, Nutrition Res, 2017) and of hypovitaminosis D and IBS-like symptoms (Nath et al, Nutrition Res, 2019) in individuals with medically-complicated obesity. As individuals who have undergone bariatric surgery age, it becomes increasingly difficult to obtain blood tests to look for micronutrient deficiencies. Our hypothesis is that older bariatric patients seen for evaluation in gastrointestinal clinic remain at risk for micronutrient deficiencies. METHODS: From April 2018 to April 2019, 33 postoperative patients (Gastric Bypass: n = 27; Sleeve Gastrectomy: n = 6) were seen in gastrointestinal clinic in an urban, community teaching hospital. This study included 3 males and 30 females with a mean age of 70 years (SD: 3.4; range 66 to 79), mean body mass index of 35 kg/m 2 (SD: 6.3; range 25.9 to 55.1), and a mean of 11 years since bariatric surgery (SD: 6.7; range 1 to 30). Six patients (22%) had anemia; 5 patients (17%) had weekly or more frequent alcohol use; 12 patients (36%) had a history of diabetes mellitus; 11 patients (33%) were using a diuretic; and 5 patients (15%) were not taking a daily multivitamin. Nine micronutrients were evaluated using commercially available blood testing, but 2 patients did not complete the suggested blood tests. RESULTS: Serum folic acid level was elevated in 17 of 22 patients (77%), which supports the presence of small bowel bacterial overgrowth. Hypovitaminosis D was identified in 32 of 33 patients (97%). Low vitamin B12 was identified in 10 of 31 patients (32%). Low vitamin B12 was identified in 10 of 31 patients (32%). Low vitamin A was identified in 3 of 18 patients (16%). Low vitamin E was identified in 4 of 13 patients (31%). Low zinc was identified in 2 of 9 patients (22%) and low iron was identified in 9 of 26 patients (35%), while 10 patients had normal serum copper level. Clinical Vitamin B1 deficiency was identified in 27 of 33 patients (82%). CONCLUSION: This study supports our hypothesis that geriatric patients who have undergone bariatric surgery are at risk for multiple micronutrient deficiencies. These results support the notion that ordering of specific micronutrients should focus on thiamine, 25 hydroxy-vitamin D, and serum folic acid in patients evaluated in gastrointestinal clinic. These micronutrients may provide explanations for complaints of gastrointestinal symptoms in this patient population.

Arsenic, Selenium, Zinc, Copper, Hormonal changes, and oxidative stress in AL-Basra and Missan provinces patients with prostate tumors

Prostate cancer (PCa) and benign prostatic hyperplasia (BPH), were investigated in both AL-Basra and Missan provinces–Iraq. The study provides data relating serum selenium (Se), arsenic(As), zinc(Zn), and copper(Cu) levels to activity ofGlutathione–S– transferase (GST), Malondialdehyde (MDA); and prostate specific antigen (PSA) . sixty patients (30 patientswith BPH mean age 56.40 ± 9.74 years and 30 patients with PCa mean age 57.55 ± 9.15 years) and thirty healthy controlsmean age (54.150 ± 7.856) years were participated in the study. The results revealed a highly significant difference (P<0.001)in MDA, PSA, and Se levels; significant different in GST, Zn, and Cu/Zn ratio levels. No statistical significant difference wasfound in mean age, As, Cu, and E2 in BPH as compared to control group. Also, there was no statistical significant differencein mean age, and E2 level in PCa patients when compared to control group, while there was a highly significant difference(p<0.001) in MDA, PSA, GST, Se, As, Zn, and Cu/Zn ratio levels; and significant difference in Cu and testosterone levels weredetected in PCa patients as compared to control group. Correlations studies indicated a significant correlation between MDAand ) PSA, GST, Se, As ,Zn ,Cu, Cu/Zn, Testosterone, and E2) in BPH and PCa patients. In conclusion, trace elements whichused in this study (Zn, As, Se, and Cu) can be used as a bioindicator for prostate illness. Serum MDA may be considered amarker for predicting prostate cancer as a compliment to PSA.

Quantitative Analysis of Serum Levels of Trace Elements in Sudanese Snuff Dippers

Background: Oral cancer in Sudan has high incidence rate due to the use of Toombak , a home- made smokeless tobacco, rich in tobacco specific nitrosamines .There have been calls for continuous monitoring on toombak users to discover very early the carcinogenic changes to avoid mortality, and morbidity.
 Objective: The purpose of this study was to assess technically, and financially affordable methodologies, that are reliable, reproducible, sensitive, specific and cost effective valid for use in mass screening amongst the high risk groups. (The toombak users).The present study was done to evaluate the levels of copper, zinc and magnesium in serum of toombak dippers. 
 Materials and Methods: The levels of copper, zinc, and magnesium were estimated in the serum of 150 toombak dippers . The values were compared with 50 normal age matched, healthy control subjects and 50 patients with oral squamous cell carcinoma, using Atomic absorption spectrophotometry.
 Results: There was significant difference of the mean serum copper, zinc, and magnesium levels of toombak dippers when compared to the normal controls. In oral cancer patients there was significant difference in the copper, zinc, and magnesium levels. Copper level was found increased gradually starting from control through toombak dippers to oral squamous cell carcinoma patients , while the level of zinc and magnesium was found decreased in the same sequence.
 Conclusion: Serum may be used as a potential diagnostic tool, which can be efficiently employed to evaluate the copper, zinc and magnesium levels in Sudanese snuff dippers for population based mass screening .Serum trace elements levels could be used as potential diagnostic markers for early changes caused by toombak dipping.
 Keywords: Atomic absorption spectrophotometry, copper, magnesiumm , zinc, oral squamous cell carcinoma, tobacco specific nitrosamines, serum , toombak.

Association between copper levels and heart failure: a meta-analysis

Background and Objectives: Copper dyshomeostasis can lead to many diseases, including cardiovascular disease. However, there are conflicting reports on the relationship between serum copper levels and heart failure (HF). To explore the relationship between serum copper levels and HF by performing a meta-analysis. Methods and Study Design: The PubMed and ScienceDirect databases until June 2019 were searched for reports on the association between serum copper levels and HF. Results: A total of thirteen studies including 1504 subjects were chosen for the meta-analysis. The pooled analysis indicated that patients with HF had higher copper levels than the control subjects [standardized mean difference (SMD), 0.982; 95% confidence interval (CI), (0.679, 1.285)]. Subgroup analysis stratified by different geographic locations found that HF patients had higher copper levels than the control subjects in Asia and Europe [Asia: SMD, 0.948 and 95% CI, (0.569, 1.327); Europe: SMD, 1.275 and 95% CI, (0.633, 1.917)], but not in America [America: SMD, 0.637 and 95% CI, (-0.109, 1.383)]. Additionally, subgroup analysis revealed that patients with ischemic cardiomyopathy (ICM) [SMD, 1.171; 95% CI, (0.717, 1.624)], idiopathic dilated cardiomyopathy (IDCM) [SMD, 0.569; 95% CI, (0.097, 1.042)] and other types of HF [SMD, 1.152; 95% CI, (0.594, 1.710)] all had higher copper levels than controls. Further subgroup analysis stratified by Newcastle-Ottawa Scale (NOS) scores also found higher serum copper levels in patients with HF than controls within each subgroup. Conclusions: Our meta-analysis identified a significant association between high copper levels and HF.

Copper-to-Zinc Ratio Correlates with an Inflammatory Marker in Patients with Sickle Cell Disease

Sickle cell disease (SCD) is an inherited disorder of major health challenge in Nigeria. Micronutrients deficiencies often associated with the disorder may cause inflammation and abnormal metabolisms in the body. The copper-to-zinc ratio is a more important assessment than the concentrations of either of the metals in clinical practice. This study seeks to evaluate serum levels of c-reactive protein (CRP), copper, zinc and copper-to-zinc ratio and to correlate copper-to-zinc ratio with CRP in adult subjects with SCD. Serum copper, zinc, CRP and plasma fibrinogen were assayed in 100 confirmed SCD patients in steady clinical state and 100 age and sex matched subjects with normal haemoglobin. Serum copper and zinc were assayed by colorimetric method using reagents supplied by Centronic, Germany while CRP and fibrinogen were assayed using reagents supplied by Sigma (St. Louis, MO, USA) and Anogen (Ontario, Canada), respectively. The copper to zinc ratio was calculated from serum levels of copper and zinc. The measured parameters were compared between the groups using Students t-test and Pearson correlation coefficient was used to relate CRP with the other parameters. Serum copper, CRP, fibrinogen and copper-to-zinc ratio were significantly higher (p < 0.001) while zinc level was lower in SCD patients than controls. Serum CRP concentration correlated with copper (r = 0.10; p < 0.02), zinc (r = −0.199; p < 0.05) and Copper-to-zinc ratio (r = 0.312; p < 0.002) but the correlation between CRP and fibrinogen was not significant. Inflammatory condition may modulate copper and zinc homeostasis and copper-to-zinc ratio may be used as marker of nutritional deficiency and inflammation in SCD patients.

Serum levels of copper, zinc and disease severity scores in sickle cell disease patients in Benin City, Nigeria

Micronutrient deficiency is recognized in sickle cell anaemia (SCA) but it is not known for certain whether changes in zinc, copper and copper-to-zinc ratio are associated with Sickle cell disease severity scores. To compare serum levels of copper, zinc and copper-to-zinc ratio in SCA subjects with control group and correlate the variables with objective disease severity scores. Serum copper and zinc were determined in 100 SCA patients and 50 controls using kits supplied by Centronic, Germany. Unpaired Students't-test was used to compare the variables between SCA patients in steady clinical state, vaso-occlusive crisis and controls, while Spearman correlation coefficient was used to associate the parameters with disease severity scores. Serum copper level was higher (P=0.008) in SCA patients than controls, while serum zinc level was lower (P<0.001) in SCA patients than controls. The copper/zinc ratio was higher (P<0.001) in SCA patients than controls. Significantly higher (P<0.001) copper and lower (P<0.001) zinc levels were observed in patients in vaso-occlusive crisis than in steady clinical state. Zinc correlated inversely (r=-0.2743; P=0.006) while copper-to-zinc ratio correlated positively with disease severity scores. Copper-to-zinc ratio may be an indicator of disease severity in SCA patients.

Status of trace elements zinc, copper, and selenium in transfusion dependent beta thalassemic Indian children: a cross sectional study

Background: Maintenance of normal levels of copper, selenium, and zinc play an important part in lessening the morbidities associated with thalassemia major. Levels of these elements have been found to be altered in this chronic transfusion dependent disease from all over the world, but with widely variable results. Besides repeated blood transfusions and use of chelating agents, their levels in thalassemics are affected by genetic and dietary factors also, compelling us to undertake this study in our population. The Objectives of this study was to assessment of serum levels of zinc, copper and selenium in transfusion dependent beta thalassemics. Methods: Cross sectional descriptive study conducted at Thalassemia Day-care Centre of a teaching hospital. Total 64 transfusion dependent thalassemics in the age group 3-18 years were subjected to serum levels of zinc, copper and selenium by inductively coupled plasma mass spectrometry technique. Results: Four (6.25%) had hypozincemia, 15 (23.43%) hypocupremia and one (1.565%) had hypercupremia. Two (3.12%) had higher selenium levels (&gt;190 µgm/l).Conclusions: In contrast to previous studies, hypocupremia has been found to be more prevalent than hypozincemia and hyposelenemia in our population.

Chronic Copper Exposure Induces Hypospermatogenesis in Mice by Increasing Apoptosis Without Affecting Testosterone Secretion.

Chronic copper exposure impaired spermatogenesis in adult male mice. The aim of this study was to determine whether chronic copper exposure can induce apoptosis of testicular cell and hypospermatogenesis via disturbing testosterone synthesis in adult male mice. In the present study, sixty CD-1 male mice were randomly divided into four groups, and were continuously administered for 8weeks by oral gavage with copper sulfate at a dose of 0, 25, 100, and 150mg/kg/day, respectively. We determined the content of serum and testicular copper, testicular coefficient, testicular histopathology, sperm count and motility, the mRNA and protein levels of Caspase-3, Bax, and Bcl-2, Leydig cell count, testosterone content, testosterone synthetase, and testosterone synthesis-related genes. The results showed that the copper levels in serum increased in a dose-dependent manner, and the copper levels in testes were significantly related to serum copper levels. Male mice given copper sulfate 100 and 150 dosage groups showed significant decreased in sperm motility and sperm number as well as increased in testes damage, and there was no significant change in testicular coefficient in the four groups. The mRNA levels of Bcl-2 decreased and Caspase-3 increased in 150 dosage group, and Bax increased in two higher dosage groups. Meanwhile, Caspase-3 and Bax proteins increased in 150 dosage group, and Bcl-2 protein decreased in three copper treatment groups. Nevertheless, there were no differences on the levels of testosterone content and testosterone synthetase of 3β-HSD, 17β-HSD, 17α-Hyd, and 20α-Hyd, mRNA levels of Cyp11a1, Cyp17a1, and Star, and quantity of Leydig cells in four groups. Overall, these data showed that chronic copper exposure led to copper residues in the testes, and the doses of 100 and 150mg/kg/day copper sulfate may induce hypospermatogenesis by increasing apoptosis without affecting testosterone secretion.

Serum copper profile in patients with type 1 diabetes in comparison to other metals

BackgroundType 1 diabetes (T1D) is a chronic condition in which the pancreas loses the ability to produce insulin due to an autoimmune destruction of the insulin producing beta cells in the pancreatic islets of Langerhans. Pathophysiological complications related to diabetes include micro and macrovascular disease, nephropathy, and neuropathy that can also be affected by environmental factors such as lifestyle and diet. ObjectivesThe current study aimed to evaluate the serum levels of total copper, the copper-carrying protein, ceruloplasmin and nonceruloplasmin bound copper (nonceruloplasmin-Cu) and other essential and environmental metals and metalloids in subjects with T1D compared with healthy controls. MethodsA cohort of 63 subjects with T1D attending Diabetes Clinics at the University of Miami and 65 healthy control subjects was studied. Metals and metalloids were measured by inductively coupled plasma mass spectrometry. ResultsA main finding of this study was that total copper and ceruloplasmin levels were higher in persons with T1D compared to healthy controls. In comparison to other metals and clinical variables, elevated copper was the strongest factor associated with T1D resulting in a15-fold increased odds of having the disease per standard deviation increase. ConclusionOur results suggest a metal and metalloid perturbation in T1D with a significant involvement of Copper dysfunction in the disease pathology, possibly linked to inflammatory processes.

Report of a novel ATP7A mutation causing distal motor neuropathy

We describe a novel ATP7A gene mutation associated with distal motor neuropathy, mild connective tissue abnormalities and autonomic disturbances. Next-generation sequencing analysis of a lower-motor neuron diseases gene panel was performed in two sibs presenting with distal motor neuropathy plus an autonomic dysfunction, which main manifestations were retrograde ejaculation, diarrhea and hyperhydrosis. Probands underwent dysmorphological, neurological, electrophysiological as well as biochemical evaluations and somatic and autonomic innervation studies on skin biopsies. A novel missense mutation (p.A991D) was identified in the X-linked ATP7A gene, segregating in both brothers and inherited from their healthy mother. Biochemical studies on patients’ blood samples showed reduced serum copper and ceruloplasmin levels. Clinical and neurophysiological evaluation documented dysautonomic signs. Quantitative evaluation of skin innervation disclosed a small fiber neuropathy with prevalent autonomic involvement. Mutations in the ATP7A gene, encoding for a copper-transporting ATPase, have been associated with the severe infantile neurodegenerative Menkes disease and in its milder variant, the Occipital Horn Syndrome. Only two ATP7A mutations were previously reported as causing, a pure axonal distal motor neuropathy (dHMN-SMAX3). The phenotype we report represents a further example of this rare genotype-phenotype correlation and highlights the possible occurrence in SMAX3 of autonomic disturbances, as described for Menkes disease and Occipital Horn Syndrome.

Assessment of Mineral Pathophysiology in Patients with Diabetic Foot Ulcer.

Chronic non-healing diabetic foot ulcers (DFU) with a recurrence rate of over 50% in 3years account for more than 1,08000 non-traumatic lower extremity amputations. Reports of altered mineral status and their role in pathogenesis of diabetes are well documented. However, little is known regarding their status and impact on severity of complications like foot ulcer. A hospital-based case control study was conducted in 64 subjects aged 40-60years, attending the Podiatric and the Diabetes clinic of the institutional hospitals. Study subjects included were 32 diagnosed cases of type 2 diabetes having foot ulcers along with 32 age-matched diabetics without foot ulcer as controls. Fasting and post-prandial plasma glucose were estimated by glucose oxidase peroxidase method and HbA1c by high-performance liquid chromatography method. Serum zinc, magnesium and copper levels were estimated by colorimetric methods in semi-autoanalyser. Serum levels of zinc, copper and magnesium were significantly decreased in DFU cases as compared with diabetics without ulcers (p < 0.05). Correlation analysis revealed a significant inverse correlation of these minerals with all the glycaemic indices; the association being the strongest in case of zinc in both groups. The higher degree of mineral insufficiencies in the foot ulcer group of this study could be responsible for worsening the glycaemic control in diabetics leading to delayed healing of foot ulcers. The observed decrease of serum copper, magnesium and zinc levels in diabetics with foot ulcers appears to be proportionally related to the length of the diabetic disease. Thus, continuous monitoring and dietary supplementation of minerals in case of severe deficiencies might be beneficial in halting the progression of such complications.

Serum levels of copper, iron, and manganese in women with pregnancy, miscarriage, and primary infertility

BackgroundIron (Fe), copper (Cu), and manganese (Mn) play a significant role in female reproduction and fetal development. At the same time, high levels of metals may exert toxic effects. Correspondingly, both excess and deficiency of essential trace elements were shown to be associated with female infertility and adverse pregnancy outcome, although the existing data are rather contradictory. Therefore, the objective of the present study was to reveal the potential role of altered iron, copper, and manganese status in female reproductive health problems through assessment of serum metal levels in healthy non-pregnant and pregnant women, as well as patients with miscarriage and primary infertility. MethodsA total of 150 healthy controls, 169 pregnant women (II trimester of pregnancy), 75 women with miscarriage, and 91 patients with primary infertility were enrolled. Serum metal levels were assessed using ICP-MS. ResultsPregnant women are characterized by a significant increase in serum Cu an Mn levels by 40% (p < 0.001) and 16% (p = 0.043) as compared to the controls, respectively. Serum Cu levels in women with miscarriage and infertility were 30% and 35% lower than those in pregnant women (p < 0.001). No significant difference in serum iron levels were observed between the control and pregnant women. Women who had miscarriage were characterized by 13% (p = 0.042) higher serum Fe levels as compared to the pregnant ones. Multiple regression analysis demonstrated that serum copper levels was significantly associated both with pregnancy (β = 0.436; p < 0.001) and reproductive health problems in women (β = −0.272; p < 0.001). The latter was improved significant after adjustment for serum Fe and Mn levels, age, and BMI (β = −0.431; p < 0.001). The model incorporating serum Cu, Fe, Mn, and anthropometric parameters accounted for 23% of variability in reproductive status (p < 0.001). ConclusionsIt is proposed that the lack of pregnancy-associated increase in metal levels in miscarriage and infertility may be indicative of at least partial role of metal insufficiency in impaired pregnancy and reproductive function in general. However, detailed clinical studies as well as experimental investigations are required for assessment of the potential causes and mechanisms of the observed associations.

Vitamin B6 deficiency is prevalent in primary and secondary myelofibrosis patients.

Vitamin B6 (VB6) deficiency contributes to oncogenesis and tumor progression in certain cancers, and is prevalent in cancer patients in general. VB6 is also an essential element of heme synthesis, and deficiency can lead to anemia. Primary myelofibrosis (PMF) and secondary myelofibrosis (sMF) are myeloproliferative neoplasms often presenting with anemia along with other cytopenias. We performed a prospective study to determine whether PMF and sMF patients suffer from VB6 deficiency, and whether VB6-deficient patients show improvement of anemias with VB6 supplementation. Twelve PMF patients and 11 sMF patients were analyzed. A total of 16 of 23 patients (69.6%) were found to have VB6 deficiency, but VB6 supplementation with pyridoxal phosphate hydrate did not elevate hemoglobin levels in deficient patients. None of the patients presented with vitamin B12, iron, or copper deficiencies. Four patients showed serum folate levels below the lower limit of normal and eight patients showed serum zinc levels below the lower limit of normal; however, these deficiencies were marginal and unlikely to contribute to anemia. Compared to VB6-sufficient patients, VB6-deficient patients showed significantly lower serum folate levels and higher serum copper levels. Studies elucidating the relationship of VB6 deficiency and etiology of PMF/sMF are warranted.

Serum Copper and Zinc Levels in Patients with Endometrial Cancer.

The aim of the present study was to evaluate serum concentrations of copper (Cu) and zinc (Zn), in relation with metabolic profile and clinicopathologic features of patients with endometrial cancer. A total of 47 women with endometrial cancer and 45 controls were eligible for the study. Clinicopathologic features and metabolic profile as well as serum copper and zinc levels were evaluated in each subject. Patients with endometrial cancer (Cu mean 3.72 ± 2.15mg/L, median 3.54 [0.41-9.16] mg/L and Zn mean 1.83 ± 0.71mg/L, median 1.77 [0.71-4.02]mg/L) exhibited lower Cu and Zn levels than those of controls (Cu mean 6.06 ± 1.79mg/L, median 6.32 [2.95-9.05]mg/L and Zn mean 2.48 ± 0.89mg/L, median 2.23 [1.23-4.54]mg/L) (p < 0.001). Cu/Zn ratio was also higher (0.85 ± 1.96 vs. 2.57 ± 0.73) in controls as compared with patients with endometrial cancer. While Cu levels showed no significant correlation with age, body mass index, gravidity, and parity, a positive correlation was found between Zn levels and parity. When cancer patients were evaluated on their own, both Cu and Zn levels showed positive correlation with age. Additionally, the cancer patients with myometrial invasion > 1/2 exhibited lower Cu levels compared with the cancer patients with myometrial invasion < 1/2. The data of the present study suggested that women with endometrial cancer are characterized by altered serum Cu and Zn levels as compared with controls. Imbalance of these trace element levels might be associated with endometrial cancer among Turkish patients.

Intrahepatic Cholestasis of Pregnancy: A Case Study of the Rare Onset in the First Trimester

Intrahepatic cholestasis of pregnancy (ICP) is a gestation-specific liver disorder, defined most often as the onset of pruritus, usually from the third trimester of pregnancy, associated with abnormal liver test results and/or increased total serum bile acids and spontaneous relief after delivery. The 21-year-old patient was admitted to our ward in the 11th week of pregnancy due to raised liver enzymes. The first onset of pruritus and jaundice appeared a month before hospitalization. Immunology tests and Toxoplasma gondii were negative. We excluded viral etiology, while alpha-1-antitrypsin, serum and urine copper levels, and thyroid hormones were within the reference values. The patient denied she had taken any medicines and herbal preparations before and during pregnancy. Total bile acids in the serum were significantly elevated (242 μmol/L). The abdominal ultrasound revealed a regular finding. Liver biopsy suggested a cholestatic liver disorder. After a presentation of all risks, the patient decided to stop the pregnancy. After a month, the hepatogram was within the reference values. Very rarely an ICP can occur in early pregnancy (first trimester), which calls for close monitoring. The risk of serious adverse fetal outcomes and spontaneous preterm delivery is proportional with increased levels of maternal serum bile acid.

A Case Control Study on Serum Level of Micronutrients in Decompensated Liver Cirrhosis Patients in Mymensingh, Bangladesh

Liver cirrhosis is an end stage condition of liver disease and the leading cause of death for both men and women all over the world. It causes death due to acute or chronic gastrointestinal blood loss &amp; multi organ failure. The aim of the study is to evaluate the serum Copper, Zinc and Iron levels in patients with liver cirrhosis. A total 120 subjects were included in this study. Among them, 60 diagnosed decompensated liver cirrhosis patients denoted as case group (n=60) and 60 were normal healthy individuals denoted as control group (n=60), both the case and control groups were male because liver cirrhosis occurs rarely female in Bangladesh. The subjects were briefed and written consents were taken. Under all aseptic precaution 5 ml of venous blood was collected from median cubital vein, analysis was carried out in the Department of Biochemistry, Mymensingh Medical College, Mymensingh, over a period of one year from July 2015 to June 2016. All statistical analysis was performed by SPSS windows package, version 20. Significance of the difference between two groups were evaluated by using student's unpaired 't' test. All the values were expressed as mean ± SD and P value 0.05 was taken as the level of significance. After careful evaluation, in the present study we found significant increase in the serum Copper levels and significant decreases in the serum Zinc and Iron levels in liver cirrhosis patients when compared with that of control group. It can be concluded that to overcome fatal consequences of decompensated liver cirrhosis patients we should avoid high Copper containing food provides Zinc and Iron supplementation as well as blood transfusion may be beneficial.&#x0D; CBMJ 2019 July: Vol. 08 No. 02 P: 10-16

Nutraceutical effect of vitamins and minerals on performance and immune and antioxidant systems in dairy calves during the nutritional transition period in summer.

We aimed to determine whether the use of injectable vitamins and minerals improves growth performance and immune and antioxidant responses in dairy calves during pre- and post-weaning period in summer. Twenty dairy calves (45 days of age) were randomized to two groups (10 each): control group (CON) and treated group [TREAT; injection providing 0.20, 0.80, 0.20, 0.10, 35 and 1 mg/kg of copper, zinc, manganese selenium, and vitamins A and E, during two periods (15 days pre- and 15 days post-weaning)]. The animals were weighed and blood samples were collected on days 1, 15, 30 and 45 of the study. Levels of serum copper, selenium, zinc, and manganese were measured on day 1; and the results showed that calves were not deficient in these minerals. The TREAT group had greater BW gain during the final third of the experiment. There was an increase in total leukocyte numbers as a result of elevation in neutrophil counts (day 45) and monocytes (days 30 and 45) in the TREAT group. This group also had lower reactive oxygen species (ROS) content (days 15, 30 and 45) and lipid peroxidation (LPO; days 15 and 45). Furthermore, the TREAT group had greater antioxidant capacity against peroxyl radicals (ACAP; days 15 and 30), activities of the enzymes glutathione peroxidase (GPx; days 15, 30 and 45) and superoxide dismutase (SOD; day 15), concentrations of total serum proteins (day 30), serum globulin (days 15 and 30), ceruloplasmin (day 15), tumor necrosis factor-alpha (TNF-α), interleukin-1, (IL-1; days 30 and 45) and interferon gamma (IFNγ; day 45), compared to CON group. High respiratory rates during hot times of the day in all study calves was suggestive of heat stress. Taken together, the data suggest that mineral and vitamins injections increased the growth performance and boosted the antioxidant and immunological systems of dairy calves during the diet transition period in summer.

Serum Zinc and Copper in Children with Febrile Seizures in Basrah,Iraq

&#x0D; Background:Trace elements are essential micronutrients that exist in very low concentrations in the body. They play an important role in various physiological processes and are crucial for proper functioning of the immune system. Many studies have shown that some micronutrients may have a role in febrile seizure&#x0D; such as selenium, zinc and copper.&#x0D; objectives :To determine the level of serum zinc and copper in children with febrile seizures and explore their&#x0D; relation to selected patients' variables.&#x0D; Methods: The study included 66 infants and children with simple febrile seizures with two control groups;a&#x0D; febrile control group which includes (62) children with febrile illnesses who were admitted to emergency department at Basrah Maternity and Children Hospital and Basrah General Hospital from the 1st of March to&#x0D; the end of October 2013, and ahealthy control group which includes ( 58) children. Serum zinc and copper ere measured for all infants and children enrolled in the study.&#x0D; Results: Patients with febrile seizure had a significantly lower mean serum zinc level (8.85 ±3.26) in comparison to febrile patients and healthy children (14.98 ±2.20), (13.33 ±1.99) respectively. There is no&#x0D; significant association between the level of serum zinc and selected variables.S erum copper level did not show a significant difference between patients with febrile seizures and control groups.&#x0D; Conclusion: Zinc supplementation may be considered in children who are at risk of recurrent febrile seizure&#x0D; .&#x0D;

The role of zinc supplementation on the metallothionein system in children with autism spectrum disorder.

The present research was carried out to elucidate the role of zinc (Zn) supplementation on the plasma concentration and gene expression, as well as the effects on cognitive-motor performance, in a cohort of children with autism spectrum disorder (ASD). The study was performed on a cohort of 30 pediatric subjects with ASD, encompassing an age range of 3-8years. The impact of Zn supplementation was investigated in 3months (or 12weeks) on the ASD children. Each daily dosage of Zn was calculated as being equal to the body weight in kg plus 15-20mg. The effect of Zn was also evaluated on the serum level of metallothionein 1 (MT-1A), and the severity of autism via scores on the Childhood Autism Rating Scale. The effect of Zn was investigated on the gene expression of MT1-A before and after Zn supplementation. The data of the present study showed an increase in cognitive-motor performance and an increased serum metallothionein concentration, as well as a significant lowering in the circulating serum levels of copper (Cu) following Zn supplementation. In the cohort of ASD patients, the genetic expression of MT-1 was higher after Zn therapy than before the treatment. In conclusion, Zn supplementation might be an important factor in the treatment of children with ASD.

The Relationship Between Serum Copper and Overweight/Obesity: a Meta-analysis.

The relationship between serum copper (Cu) level and overweight/obesity remains controversial. The purpose of this meta-analysis is to evaluate the relationship. A comprehensive literature search was performed in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases for relevant articles until March 20, 2019. The random-effect model (REM) was adopted to compute the combined standardized mean difference (SMD) with 95% confidence interval (CI). Publication bias was estimated using the visualization of funnel plots and Egger's test. In the end, twenty-one articles were included in the meta-analysis. Compared with controls, serum Cu level was higher in obese children (SMD (95% CI) 0.74 (0.16, 1.32)) and in obese adults (SMD (95% CI) 0.39 (0.02, 0.76)). There was no significant difference in serum Cu between overweight and control groups in children (SMD (95% CI) 1.52 (- 0.07, 3.12)) and in adults (SMD (95% CI) 0.16 (- 0.06, 0.38)). Moreover, subgroup analysis revealed a higher serum Cu level in obese children (SMD (95% CI) 0.90 (0.36, 1.45)) and obese adults (SMD (95% CI) 0.47 (0.05, 0.88)) compared with healthy weight controls. The SMD differs significantly between obese children diagnosed by weight-for-height and controls (SMD (95% CI) 1.56 (0.57, 2.55)), and there was a significant difference of serum Cu level between obese adults diagnosed by BMI (WHO) and controls (SMD (95% CI) 0.54 (0.08, 1.01)). This meta-analysis indicates that a higher serum Cu level might be associated with the risk of obesity in children and adults, and these findings need to be further confirmed.