Serum Copper Levels Research Articles

The effect of some trace elements on the expression of telomerase gene in lung cancer

Lung cancer is a disorder that begins due to genetic and epigenetic changes. These changes cause the activation of oncogenes and the inactivation of tumor suppressor genes. Various factors influence the expression of these genes. In this research, we investigated the relationship between the number of trace elements zinc and copper and the ratio of these two in serum with the expression of the telomerase enzyme gene in lung cancer. For this purpose, we included 50 people with lung cancer in the study as the case group and 20 patients with non-tumor lung diseases as the control group. The TRAP assay method measured the telomerase activity in biopsy samples of lung tumor tissue. Also, serum copper and zinc were measured by atomic absorption spectrometry. The results showed that the mean serum concentration of copper and the ratio of copper to zinc in patients were significantly higher than in the controls (120.8 ± 5.7 versus 107.2 ± 6.5μg/dL)(P<0.05). However, there is no significant difference in the mean serum concentration of zinc between the two groups (p > 0.05). The patients' mean ratio of copper to zinc is significantly higher than the control group (1.6 ± 0.4 versus 1.1 ± 0.2)(p < 0.05). The average level of telomerase enzyme activity of patients showed a significant difference from the control group 32.8 ± 16.1 vs. zero percent) (p < 0.01). There is a direct and significant correlation between the serum level of copper and the level of telomerase enzyme activity in patients (r = 0.36 and p < 0.05). A positive correlation was observed between total serum copper concentration and the increasing age of patients (r = 0.39 and p < 0.01). The correlation between the ratio of copper to zinc and the serum copper concentration of the patients was positive and significant (r = 0.36 and p < 0.05), but the correlation between the amount of serum zinc and the ratio of copper to zinc was negative and significant (r = -0/ 72 and p < 0.01). The average copper serum concentration of people with small cell carcinoma (123.7 ± 2.8 μg/dL) compared to non-small cell carcinoma (117.6 ± 4.8 μg/dL) is high and significant (P< 0.05). Patients with small cell carcinoma had a high mean telomerase concentration (112 ± 0.57%) and significantly compared to non-small cell carcinomas (6.4 ± 2.5%)(P < 0.05). This situation regarding the zinc element and the ratio of copper to zinc in non-small cell carcinomas compared to small cell carcinomas were evaluated as non-significant (P>0.05). Based on the obtained results, it can be assumed that determining the amount of zinc and copper and the telomerase enzyme activity in lung cancer can have a biological role in the initiation and progression of tumor tissue, which requires more studies.

A Study of Micronutrient Levels in Premature Canities in Children

Abstract Background: Premature canities refer to the loss of hair pigment, at an earlier age than normal. Vitamins and minerals are involved in the various steps of melanogenesis. There is a paucity in the current literature on possible correlation between the serum levels of micronutrients and premature graying of hair. Materials and Methods: A case − control study was conducted on 56 patients of premature canities and 50 age- and sex-matched healthy controls between 12 and 18 years of age. After taking detailed history and physical examination, serum was analyzed for copper, zinc, iron, magnesium, Vitamin B12, folic acid, and Vitamin D levels in both cases and controls, and the results were compared. Results: Mean serum levels of zinc, magnesium, and Vitamin B12 were significantly lower in cases (P &lt; 0.01). No significant difference between mean serum copper, iron, Vitamin D, and folic acid levels between cases and controls was found. Patients having deficiency of copper, zinc, iron, magnesium, and Vitamin B12 were significantly higher in cases compared to controls (P &lt; 0.05). No significant association between the serum levels of micronutrients with severity of canities was found. Conclusion: On basis of our study, we conclude that patients of premature graying can have micronutrient deficiencies such as copper, zinc, iron, magnesium, and Vitamin B12. These micronutrients should be analyzed in patients of premature canities if facilities are available and if patients are found deficient, they should be supplemented for the same. However, further studies on a larger population and effect of supplementation of these micronutrients on premature graying are required.

Monitoring and treatment of Wilson disease: progress and challenges

In The Lancet Gastroenterology & Hepatology, Michael L Schilsky and colleagues report the results of a multicentre, randomised, open-label, non-inferiority, phase 3 trial on the copper chelator trientine tetrahydrochloride (TETA4),1 a new trientine formulation that is stable at room temperature, compared with penicillamine in patients with Wilson disease. The study included 53 patients with Wilson disease with both hepatic and neuropsychiatric manifestations who were considered to be stable according to clinical presentation and copper metabolism parameters, particularly 24 h urinary copper excretion and non-caeruloplasmin-bound copper (NCC) serum levels.

Effect of serum magnesium, and copper in breast carcinoma patients: A comparative cross sectional study in tertiary care hospital, Madhya Pradesh, India

Background: In our country, there has been little study on breast cancer individuals during and progression of the cancer on magnesium, and copper have not been considered in existing studies. Aim: To determine the effect of serum magnesium, and copper in breast cancer subjects and to compare them with the apparently healthy controls. Methods: Lately diagnosed female subjects with breast cancer in the age group of 40-60 years were included in the study. Apparently healthy controls were selected from the group of people who were attending for annual health check-up and found to be healthy. Results: On comparison between the two groups, the present study observed that serum copper level was lower in case of apparently healthy controls than breast cancer subjects. Comparing between the groups of serum magnesium level, the present study observed significant difference. Similarly, the serum copper level was also found to be significantly differed when compared between the two groups. Conclusion: The altered values of magnesium and copper are responsible for the initiation of breast cancer. In addition, present study implies that serum copper can be used as biomarkers for early identification and diagnosis of breast cancer.

Assessment of copper and zinc in liver diseases

The liver is a primary storage site for a variety of metabolites. It plays a role in wide variety of metabolic, toxic, excretory, circulatory and defence functions inside the body. Damage to the organ may not evidently affect its activity since the liver has considerable functional reserve. Liver disease is a common term for any damage that reduces the functioning of the liver. Chronic liver disease is identified by gradual destruction of liver cells resulting in fibrosis. It is affected by different conditions including viral hepatitis, excessive alcoholism, genetic, autoimmune and NAFLD. The present study was carried out in Govt. Medical College, Jalaun at Department of Biochemistry. The diagnosis of Liver disease was done by ultrasonographic examination of liver. This study comprised a total of 50 patients, 25 of whom were healthy controls and 25 of whom were Liver Disease patients. After overnight fasting 8-12 hours (under aseptic condition) blood sample (8ml) was drawn from antecubital vein of each subject using a plain vial and was analyzed for serum Cu, Zn &amp; liver profile parameters (serum bilirubin, serum SGOT, serum SGPT and serum ALP done by colorimetric method and calmagnite method, diazo method, IFCC method and assessed by kinetic method respectively. The present study’s findings, indicates that the level of serum copper in liver disease patient was 127.38±28.81µg/dl, which is significantly higher than that of 86.54 ± 15.88µg/dl found is healthy controls (p&amp;#60;0.001). Also, serum copper is strongly linked with biochemical parameters of liver enzyme (SGOT &amp; SGPT). Likewise, the mean value of serum zinc in liver disease were 58.08 ± 13.11µg/dl, which is significantly lower than that of69.88± 6.67µg/dl found in healthy subjects. Further, serum zinc has shown a significant weakly linked with serum SGPT.Therefore, during routine assessments of individuals with liver disease, serum trace elements (Cu and Zn) can be highly effective indicators for detecting the severity of liver damage. Thus, based on the findings of our current investigation, zinc and copper supplementation, as well as a reduction in copper intake, may help to enhance patient survival and preventing the development of hepatitis B to liver cirrhosis.Considering findings of the study, it is recommended that serum trace element concentrations be corrected on a regular basis to help with various problems of liver cirrhosis and maybe to slow the progression of liver disease.

Efficacy of Melatonin Administration Via Different Route on Reproductive Performance and Blood Mineral Profile in Chhotanagpuri Ewe

The present study aimed to evaluate the comparative efficacy of melatonin administration via different routes on reproductive performance and blood mineral profile of Chhotanagpuri ewe. A total of forty-two non-pregnant, non-lactating healthy ewes, not exposed to rams for 2 months, were allocated to seven equal groups each of six animals, viz., G1 (Normal day light control), G2 (Long day control, 16-18 h light; sunlight + artificial light), G3 (Long day as G2 + 3 mg melatonin daily orally), G4 (long day as G2 + 1 mg melatonin daily subcutaneous), G5 (Short day control, 8 hours sun light, rest darkness), G6 (short day as G5 + 3 mg melatonin daily orally), and G7 (short day as G5 + 1 mg melatonin daily subcutaneous). The melatonin treatment was given for one month to ewes of G3, G4, G6 and G7 and then were exposed to ram for one month, i.e., from day 61st to 90th; whereas the ewes of normal, long day and short day control (G1, G2, G5) were exposed to ram for one month from day 31st to 60th. Blood samples were collected from each animal, day before the start of experiment (day 0) and thereafter, every 30 days for five occasions. The estrus induction response was cent per cent in oral melatonin treated ewes (G3 and G6) compared to subcutaneous route (83.33%, G4 and 66.66%, G7) and controls (33.3 to 50.0%). After melatonin treatment, the overall estrus induction response and subsequent lambing rate were improved. The serum calcium level was significantly (p&lt;0.05) lower in late pregnancy in G1 and G6; the serum phosphorus level was significantly (p&lt;0.05) low in late pregnancy in all groups, except G5; the serum copper level was significantly lower in G6 compared to day 0 value. Furthermore, magnesium and zinc levels did not differ significantly within the treatment groups. In conclusion, the melatonin treatment can be used to improve reproductive performance of Chhotanagpuri ewe.

Trace elements in hypothyroidism in relation to L-thyroxine therapy

Hypothyroidism is a common disorder in the population with a female predominance. Most hypothyroidism cases were found in the age group range of 30–35 in both the sexes of individuals but women were more prone to develop it. Disturbance or imbalance in the thyroid hormone levels is the underlying cause of resultant hypothyroidism. A comparative study of serum T3 (triiodothyronine), T4 (thyroxine), TSH (thyroid stimulating hormone), copper, zinc, magnesium and iron was done in 100 normal individuals as controls (Group I). 100 Hypothyroid patients showing Good Response to Levothyroxine Therapy – GRLT as (Group II A) and 100 Hypothyroid patients showing Poor Response to Levothyroxine Therapy – PRLT as (Group II B) over a period of 1 and half year in the age group of 20 to 45 years. The levels of TSH were found to be elevated in hypothyroid patients with relatively lower levels of serum T3 and T4 as per our study conducted in hypothyroid patients with PRLT when compared with the healthy subjects and patients in GRLT group. A study of implementation of levothyroxine therapy in hypothyroid subjects showed improvement in the patients with all the hormone levels returning back to the pre – hypothyroid state in majority of the hypothyroid patients with GRLT in comparison with the controls. Results of the study indicate a significant decreased levels of serum copper, zinc and iron in hypothyroid patients showing poor response to levothyroxine therapy whereas the magnesium levels in the serum of hypothyroid individuals with poor response to levothyroxine was found elevated. The serum levels of all the trace elements studied i.e., copper, zinc, magnesium, and iron in GRLT hypothyroid individuals and controls were within the normal ranges. Further studies are however needed on these parameters for establishing serum levels of trace elements in hypothyroidism in relation to response to levothyroxine therapy.

Serum Trace Elements in Children with Well-Controlled and Drug Refractory Epilepsy Compared to Controls

Trace elements have been implicated in pathogenesis of epilepsy. Studies till date have shown altered levels of serum trace elements in children with epilepsy. The objective of the current was to estimate serum levels of trace elements in children with well-controlled and drug refractory epilepsy and compare it with controls. In a tertiary care teaching hospital of North India, serum selenium, copper, zinc, and iron were estimated in well-controlled and drug refractory epileptic children aged 2-12 years and compared with age and gender matched controls. A total of 106 children with epilepsy (55 drug refractory and 51 well controlled) and 52 age and gender matched controls were included in the study. Serum selenium and copper were significantly decreased in cases compared to controls. After classifying epilepsy into well-controlled and drug refractory cases, only in the latter the significant difference for serum selenium and copper levels remained compared to controls. Additionally, in the drug refractory cases, serum iron levels were significantly reduced compared to controls. Serum trace elements are altered in children with epilepsy (more so in the drug refractory group) compared to controls. Monitoring of serum trace elements in children with epilepsy should be considered. Up to one-third of epilepsy is drug refractory of which only another third are amenable to surgery. It is worth investigating the therapeutic potential of altered micronutrient status in these patients.

Serum copper concentration reflect inflammatory activation in the complex coronary artery disease – A pilot study

IntroductionCoronary artery disease possess inflammatory background related to enzymatic processes with trace elements involvements as co-factors. The aim of the study was to compare serum, urine and salivary copper, magnesium, calcium and zinc levels with inflammatory indices obtained from the whole blood count in patients with complex coronary artery disease. Material and methodFifty-two (42(81 %) males, 10 (19 %) females) consecutive patients (mean (SD) age 68 (9) years with symptomatic complex coronary artery disease were enrolled into prospective single center study in 2021. Serum, saliva and urine samples were collected at the day of admission for trace elements concentration (copper, zinc, magnesium, calcium) and compared with inflammatory indexes obtained from preoperative and perioperative period. ResultsMultivariable regression analysis revealed relation between the copper serum concentration and neutrophil to lymphocyte ratio (NLR) and systemic inflammatory index (SII). ConclusionSerum copper concentration interplay with preoperative inflammatory activation in complex coronary disease measured by NLR and SII. The copper serum concentration possesses the strongest relation to preoperative inflammatory activation in patients reffered for off-pump coronary artery bypass grafting.

Trace Mineral Levels in Postmenopausal Women Compared to Premenopausal Women Living Within Port Harcourt Metropolis

Aim: The physiological transformation of women from pre to post-menopause is often accompanied with many changes in biochemical parameters which instigates some physiological alterations in the body system of the women. Research has shown some alterations in trace mineral nutrition and metabolism following attainment of menopause. This study was aimed at investigating the trace mineral status in premenopausal and postmenopausal women in Port-Harcourt metropolis.&#x0D; Methods: This study was carried out among fifty (50) apparently healthy postmenopausal women aged between 45-65 years and twenty (20) premenopausal women aged between 22-38 years. Five milliliters (5 mL) of venous blood was withdrawn from each participant after an informed consent was obtained. Blood samples were emptied into a plain tube and allowed to clot. Samples were spun and serum separated into separate tubes and stored at -200C until analysis. Serum levels of trace mineral magnesium, calcium, zinc and copper were evaluated using Atomic absorption Spectrophotometer ELICO, India, Model No. SL173. Data generated were analyzed using Graph-Pad Prism version 8.0.2 and p &lt; 0.05 was considered significant.&#x0D; Results: Result reveal a significant reduction in serum levels of magnesium in post-menopausal women (0.39± 0.29 mmol/L) when compared with the premenopausal women (1.14 ± 0.54 mmol/L) (P&lt; 0.0001). Similarly, the serum zinc declined in postmenopausal women 6.12 ± 6.42mmol/L compared with the premenopausal women 23.02± 12.25mmol/L (P&lt; 0.0001). However, serum levels of copper and calcium were not statistically different in the two groups (p&gt; 0.05).&#x0D; Conclusion: The findings in this work suggests a decrease in serum zinc and magnesium levels in postmenopausal women, hence dietary supplements of these trace minerals is advocated for post-menopausal women.

Comparison of Serum Zinc and Copper Level in Psoriatic and Non-Psoriatic Individual

Psoriasis is a common chronic inflammatory disease of skin and multiple organs of body. The exact etiology of psoriasis is not yet certain. It is assumed that trace elements may have some role in pathogenesis of psoriasis. They can act as co-enzymes for metabolism and can act as antioxidants against free radicals. Therefore they can participate in epidermal proliferation and inflammatory process of psoriasis. This study aimed to evaluate the relation between psoriasis and trace elements namely zinc and copper. This study was conducted on 40 diagnosed cases of psoriasis and 40 non psoriatic individuals in the department of Dermatology and Venereology in Bangabandhu Sheikh Mujib Medical University, Dhaka. Biochemical analyses of serum copper and zinc were analyzed and compared statistically with cases and healthy controls. Serum zinc level was significantly lower and serum copper level was significantly higher in patient with psoriasis compared to control (p= &lt; 0.001). Individuals with moderate to severe psoriasis had significantly lower zinc levels and significantly higher copper levels than patients with mild psoriasis, according to Psoriasis area and Severity Index Score (p= &lt; 0.05). Correction of serum zinc and copper level could be beneficial for psoriasis patients. Bangladesh Med J. 2021 May; 50(2) : 28-31

Overweight and Obesity Are Positively Associated with Serum Copper Levels in Mexican Schoolchildren.

Due to its relationship with oxidative stress and inflammation responses, obesity and its cardiometabolic implications have been related with serum copper (Cu). Hence, we analyzed the association of overweight (OW) and obesity (OB) status and cardiometabolic traits with serum Cu level in Mexican schoolchildren. Anthropometrical data and cardiometabolic traits were analyzed in this cross-sectional study. Serum Cu level was measured by inductively coupled plasma mass spectrometry. The study involved 191 schoolchildren (93 girls and 98 boys) with a mean age of 8.054 ± 1.170years. Children with OW and OB had higher serum Cu levels than children with normal weight (NW) (mean difference: OW vs NW = 51.85µg dL-1, OB vs NW = 47.22µg dL-1, p < 0.001). In a multiple linear regression model, OW and OB status were positively associated with serum Cu levels (βOW = 49.85, 95% confidence interval (95% CI) 35.84-63.87, p < 0.001; βOB = 44.38, 95% CI 27.70-61.05, p < 0.001). We did not identify any significant association between cardiometabolic traits and serum Cu level. In conclusion,our results show an association of the presence of OW and OB with higher serum Cu levels, for the first time in Mexican schoolchildren. However, further functional studies are needed to better understand the role of Cu in the pathophysiology of obesity.

Natural copper isotopic abnormity in maternal serum at early pregnancy associated to risk of spontaneous preterm birth

Spontaneous preterm birth (SPB) has drawn public attention due to its increasing incidence and adverse effects on fetal growth. Effect of copper (Cu) imbalance in maternal bodies on the risk of SPB remains a subject of debate, and the related mechanisms are still unraveled. Here we applied natural stable copper isotopes to explore the underlying association and mechanism of copper imbalance with SPB using a nested case-control study. We collected maternal sera at the early pregnancy stage and then measured their copper isotopic ratio (65Cu/63Cu, expressed as δ65Cu) as well as physiological and biochemical indexes from women with and without delivering SPB. We found that SPB cases had no significant difference in serum copper level from their controls, but their serum copper was significantly isotopically heavier than the controls (δ65Cu value = 0.15 ± 0.34 ‰ versus −0.15 ± 0.17 ‰, P = 0.0149). Compared with the controls with lower δ65Cu values, the crude odds ratio (OR) associated with SPB risk increased to 4.00 (95 % confidence interval (CI): 1.37–11.70) and the adjusted OR reached up to 11.35 (95 % CI: 1.35–95.60). Furthermore, via the copper isotopic fractionation, we revealed that dietary intake and blood ceruloplasmin may play more important roles than blood lipids and mother-to-child transmission in the copper imbalance associated with SPB. Further studies will be needed to understand the mechanisms of isotope fractionation related to reproductive health.

Assessment of coagulation markers, serum zinc and copper in children with beta-thalassemia major in Egypt.

Thalassemia is one of the commonest single gene disorders usually associated with many complications. Coagulation changes as well as trace elements levels alterations have been described in children with β thalassemia. Activation of coagulation can be assessed by measuring thrombin-antithrombin (TAT) complex, plasmin-antiplasmin (PAP) complex and β-thromboglobulin (β-TG). A total of 200 children and adolescents were enrolled in the study; 100 were from the Al-Azhar University hospital's pediatric hematology clinic diagnosed as thalassemia major, while the other 100 were apparently healthy volunteers who acted as the control group. Complete blood count, liver function test, kidney function tests, TAT complex, PAP complex, β-TG as indicators of coagulation changes, serum zinc and copper were performed on all participants. Significantly higher levels of TAT complex, PAP complex and β-TG in thalassemia children than the controls. Decreased serum zinc and increased serum copper levels in thalassemia children compared to the controls. A negative correlation was observed between the serum level of TAT and hemoglobin level, besides the negative correlation of TAT complex and β-TG with the serum zinc. Thalassemia major was associated with increased serum level of coagulation activation markers, increased serum copper while decreased serum zinc.

Study of Serum Ferritin, Zinc, and Copper Levels in Children With Helicobacter pylori Gastritis and the Effect of the Treatment.

This study aimed to assess serum iron, zinc, and copper in symptomatic children with Helicobacter pylori infection, to correlate their serum levels with the degree of gastritis, and to evaluate the effect of H. pylori treatment on their levels. This study was carried out on 70 children with upper gastrointestinal tract symptoms. H. pylori infection was diagnosed by the H. pylori antigen test in the stool and histopathologic findings during upper gastrointestinal endoscopy. Patients were divided into 2 groups; H. pylori -positive and H. pylori -negative groups. Hemoglobin, serum ferritin, transferrin (sTfR), zinc, and copper were assessed in all included children. The hemoglobin level, serum ferritin, and zinc were significantly lower in H. pylori -positive patients compared to H. pylori -negative patients. However, the serum copper level was comparable between the 2 groups. After treatment, the hemoglobin level, serum ferritin, and serum zinc significantly increased in H. pylori -positive patients, especially in those who responded to treatment compared to their levels before treatment. There was a significant negative correlation between the severity of histopathologic abnormalities and hemoglobin level, serum ferritin, and zinc levels, but a significant positive relation with sTfR concentrations in H. pylori -positive patients. H. pylori -infected children had low serum ferritin and zinc levels but high sTfR level with no effect on serum copper levels. After treatment, hemoglobin, serum ferritin, and zinc levels significantly improved in H. pylori -positive patients. Gastric histologic findings correlated significantly with hemoglobin, serum ferritin, zinc, and sTfR levels.

Comparative study of copper, zinc levels in uncontrolled type 2 diabetes mellitus with normal subjects

accounts for majority of the cases, can lead to multiorgan complications. Direct association of minerals , Trace elements and vitamins in the pathogenesis and natural cause of type 2 diabetes mellitus has been observed in many research studies. Aim: To estimate the levels of Copper , Zinc and HBA1c in uncontrolled Type 2 Diabetes mellitus patient. Material and methods: A cross sectional analytical studies was conducted in DR B R AMC. Study group included 40 known case of uncontrolled Diabetes mellitus. Results: In the present Study serum copper levels in uncontrolled Type 2 Diabetes Mellitus patients was 204.3 ± 49.0 and in controls it was132.4 ± 20.2. There was a statistically significant increase in the mean copper values in uncontrolled Type 2 Diabetes Mellitus patients (P&lt; 0.0001). Serum Zinc levels in uncontrolled Type 2 Diabetes Mellitus patients was 174.7 ± 31.0 µg/dl and in the controls it was 207.4 ± 36.6 µg/dl. There was a statistically significant decrease in the mean Zinc values (P&lt;0.0001). Conclusion: Trace elements play a vital role in maintaining the normal metabolism and homeostasis.

Relationship of serum copper and zinc with kidney function and urinary albumin to creatinine ratio: Cross-sectional data from the NHANES 2011-2016.

Chronic kidney disease (CKD) is a common condition in worldwide with underlying causes. The role of trace elements such as copper and zinc in CKD is uncertain. We aimed to examine the relationship of serum copper and zinc with kidney function status and explore its possible effect modifiers in the general population. Data from 5353 National Health and Nutrition Examination Survey (NHANES) participants from 2011 to 2016 were analyzed for the role of trace elements in the age range 18 to 80 years. The kidney outcomes were reduced estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and increased urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/g. Findings showed a significant positive association between serum copper and urinary ACR (OR = 1.04, 95% CI = 1.00-1.07). Serum copper levels of 18.0 μmol/L (median) or higher (reference level <18.0 μmol/L) were significantly associated with increased urinary ACR (OR = 1.67, 95% CI = 1.21-2.31) after adjusting for confounding factors. In contrast, there was a significant inverse association between serum zinc and reduced eGFR (OR = 0.89,95% CI = 0.81-0.99). Where serum zinc level was greater than 12.3 μmol/L (median), the prevalence of reduced eGFR was lower (OR = 0.65, 95% CI = 0.16-0.60). In addition, a stratified analysis based on various risk factors found that in those individuals with serum albumin greater than 43 g/L or systolic blood pressure greater than 120 mmHg, positive correlations between serum copper and risk of increased urinary ACR was more significant. Our findings suggest that the reference levels of serum copper and zinc levels in healthy individuals may be different from current understanding. If further studies substantiate the same, the results will be a useful guide for designing future clinical trials and nutritional guidelines.

Spastic Paraplegia and Ataxia in a Welder.

A 51-year-old welder (nonsmoker) developed subacute lower paresthesias and progressive spastic paraplegia and ataxia. Symptoms appeared 10 days after the first zinc exposure in the yacht construction site (8-hour day/40 days in a confined space with face shield only). Examination revealed loss of vibratory sensation, spasticity, hyperreflexia, and sensory ataxia. Serum heavy metals (Cu 1 mg/L and Pb 4,22 μg/L), B-complex vitamins, and paraneoplastics on serum and CSF were unremarkable. The elevated zinc level (137 μg/dL) was found. Spinal MRI showed combined degeneration (Figure). Myelopathy in zinc smelter workers was reported in the 19th century1 and recently rediscovered in excessive zinc ingestion. Copper secondary deficiency is hypothesized even if the normal copper serum level is reported.2 Two months later, copper became low (0.8 mg/L), a time-dependent process might explain late copper deficiency in our case. Symptoms ameliorated 4 months later with normalization of serum zinc/copper levels.

Evaluation of trace elements in essential thrombocytosis and reactive thrombocytosis

BackgroundTrace elements (TE) are vital for cellular mechanisms at biological, chemical and molecular levels. The effects of TE in diagnosis, progression and treatment of essential thrombocytosis (ET), which is one of the chronic myeloproliferative neoplasms is a rare clonal stem cell disease characterized by increased thrombocyte numbers with impaired function, have not been elucidated in detail yet. The aim of the present study was to investigate the effects of TE alterations in an ET model and the efficacy of TE in ET treatment protocol by means of a vast number of TE. MethodsStudy groups were categorized as patients with ET diagnosis (ET group, n:30), patients with reactive thrombocytosis secondary to iron deficiency anemia (IDA-RT) (IDA-RT group, n:30) and healthy controls (HC group, n:30). Serum levels of copper (Cu), iron (Fe), cobalt (Co), chromium (Cr), aluminum (Al), silicon (Si), nickel (Ni), zinc (Zn), selenium (Se), manganese (Mn), boron (B) and magnesium (Mg) were analyzed utilizing inductively coupled plasma-optical emission spectrophotometer instrument (ICP-OES). Statistical analysis was evaluated using SPSS 23.0. ResultsET group had statistically higher serum levels of Co and Mg (p < 0.05), Ni and Mn (p < 0.001), and lower Si (p < 0.05) than IDA-RT group. ET group had statistically higher serum levels of Co and Mn (p < 0.05), and Ni (p < 0.001), and lower Al, Si and Se (p < 0.001) than HC group. Serum levels of Fe, Al and Se (p < 0.001), and Mg (p < 0.01), and Zn (p < 0.05) in IDA-RT group were significantly lower than HC group. ConclusionThis novel study pointed out that alterations of many serum TE by means of both increment or decrement might have close relationship with mechanisms and complications of ET onset and follow-up. We consider that further research of TE would elucidate ethiopathogenesis and prognosis of ET. Thus, analysis of serum trace elements in essential thrombocytosis patients may be an important protocol by means of diagnosis, treatment and follow-up intervals.

A correlative study of copper, ceruloplasmin, iron, total iron binding capacity and total antioxidant capacity in diabetic nephropathy

Introduction and Aim: Diabetic nephropathy is the common cause of final stage of kidney disease. Studies on trace elements and oxidant-antioxidant status in diabetes mellitus are required for establishing the mechanisms involved in pathogenesis of diabetic complications, and also to establish biomarkers of diabetic nephropathy in addition to the conventional markers. The present study aimed to assess and correlate the blood levels of copper, iron, ceruloplasmin, total iron binding capacity (TIBC) and total antioxidant capacity (TAC) in diabetic nephropathy patients in comparison to diabetic individuals without complications and normal healthy controls. Materials and Methods: The study subjects were, diabetic patients with nephropathy (group 1), diabetic patients without complications (group 2), and healthy controls (group 3). In the serum samples of all study subjects levels of copper, iron, ceruloplasmin, TIBC and TAC were estimated by standard spectrophotometric methods. Results: Levels of copper, ceruloplasmin, iron and TIBC in serum were significantly higher and TAC was lower in diabetic patients when compared to controls, and more pronounced changes were seen in diabetic nephropathy patients when compared to diabetic patients with no complications. There was significant positive correlation among glycated hemoglobin, copper, iron and microalbumin in diabetic patients with or without nephropathy. Serum Total antioxidant capacity showed significant negative correlation with HbA1c, microalbuminuria, copper, and iron in diabetic patients with and without nephropathy. Conclusion: Serum levels of trace elements could serve as diagnostic and prognostic biomarkers of diabetic nephropathy complimentary to microalbuminuria and glycated haemoglobin. Monitoring the trace elements and oxidative stress biomarkers in diabetic patients could be beneficial to prevent oxidative stress and pathogenesis of diabetic complications.