Serum Chromium Levels Research Articles

Lower Circulating Levels of Soluble TNF-Like Weak Inducer of Apoptosis and Chromium in Treated Brucella Infection

Brucellosis is a common infectious disease around the globe. The aim of the present investigation was to evaluate the effect of brucellosis on the serum levels of chromium (Cr), lead (Pb), soluble TNF–like weak inducer of apoptosis (sTWEAK) as well as high-sensitivity C-reactive protein (hs-CRP) and homocysteine in patients suffering from brucellosis. The present case-control study was executed on 40 treated brucellosis patients (case) and 40 healthy individuals (control). Blood samples were obtained from all the participants for the measurement of the desired indices. The serum levels of chromium in the case group (0.109±0.025 μg/L) was significantly lower compared with that in the control group (0.121±0.027 μg/L, P=0.047). The levels of lead in serum were almost unchanged between the two groups (12.58±1.94 vs. 12.28±2.42 μg/dL, P=0.533). The sTWEAK levels were significantly lower in the case group as compared to the control subjects (235.20±48.45 pg/mL vs. 262.00±67.25 pg/mL, P=0.044). The levels of hs-CRP were significantly higher in the case group (2.23±0.34 mg/L) than that in the control group (2.05±0.32 mg/L, P=0.016); similarly, homocysteine levels were higher in the serum of patients in case group as compared to the control ones (16.18±4.47 µmol/L vs. 14.36±3.06 µmol/L, P=0.038). The current investigation underlined that brucellosis causes alterations in serum chromium and sTWEAK levels, the markers that are considered as the predictors of cardiovascular disease.

Assessment of Serum Chromium and Zinc Levels in Patients with Chronic Renal Failure

Background: Chromium (Cr) and Zinc (zn) are very important in human nutrition. Many researchers reported that serum chromium and serum zinc are impaired in patients with chronic renal failure,(CRF).
 Objectives: This study aimed to assess chromium and Zinc in chronic renal failure patients.
 Materials and Methods: This study was conducted at Khartoum state during November 2017 to May 2018.The study enrolled 35 patients with CRF and 40 healthy controls. Serum Chromium and Zinc levels were estimated using Atomic absorption spectrophotometry, (AAS), technique.
 Results: the current study demonstrated a highly significant a lower level of Cr in patients in contrast to healthy controls, (0.032 versus 0.147 mg/dl; respectively, P<0.001), and also of Zn level in patients as compared to healthy controls (0.165 versus 0.564 mg/dl; respectively, P<0.001). In contrary, the level of both Cr and Zn were significantly higher after dialysis as compared to their levels, before dialysis (0.137 versus 0.032 mg/dl; respectively, P<0.001) and (0.253 versus 0.165 mg/dl; respectively, P<0.001) for Cr and Zn, respectively.
 Conclusion: The present study revealed that, Zn and Cr levels decreased in CRF patients and increased after dialysis.

Association of serum chromium levels with malnutrition in hemodialysis patients

BackgroundChromium is an essential trace metal that reduces oxidative stress and inflammation. In patients undergoing maintenance hemodialysis (MHD), a correlation among chromium exposure, inflammation, and malnutrition remains unclear. This study examined the possible effects of serum chromium levels (SCLs) in MHD patients.MethodsInitially, 732 MHD patients in dialysis centers were recruited. A total of 647 patients met the inclusion criteria and were stratified by SCL into four equal-sized groups: first quartile (< 0.29 μg/L), second quartile (0.29–0.56 μg/L), third quartile (0.57–1.06 μg/L), and fourth quartile (> 1.06 μg/L). Demographic, biochemical, and dialysis-related data were obtained for analyses. The analysis included nutritional and inflammatory markers.ResultsAs compared with the highest quartile group, more subjects in the lowest quartile group were of an older age; had lower hemoglobin and creatinine levels; had a higher prevalence of DM and malnutrition (serum albumin level < 3.6 g/dL); and higher serum transferrin saturation and ferritin levels. A stepwise multiple linear regression analysis revealed a significant negative correlation between malnutrition and SCL (β coefficient = − 0.129, p = 0.012) and negative associations among body mass index (β coefficient = − 0.010, p = 0.041), ferritin (β coefficient = − 0.107, p = 0.001) and SCL. A multivariate logistic regression analysis also demonstrated a negative correlation between malnutrition and SCL. With a 10-fold increase in SCL, the risk ratio of malnutrition was 0.49 (95% confidence interval: 0.25–0.96; p = 0.039).ConclusionsSCL is significantly associated with malnutrition in MHD patients. Further evaluation of the relationship between clinical outcomes (morbidity/mortality) and SCL is necessitated.

Immune regulation features in workers engaged into underground mining of chromite ores

The study of immune regulation features in workers engaged into underground mining of chromite ores demonstrated that high serum chromium levels were associated with increased phagocytic activity, if compared to physiologic normal values, in 25.7% of the workers. Findings also are phagocytic activity reliably changed by phagocytic index criterion, and significantly (1.2–1.33 times) increased absolute and relative phagocytosis and phagocytic index vs. the reference group values. IgM levels appeared 1.2 times lower vs. the reference group values, in association with IgG deficiency and increased IgA production vs. the reference values. The authors also revealed changes in cellular subpopulations balance and T-cell receptors transformation, with depressed regulatory marker CD95 in 90.0% in the main group workers, and higher number of CD4+CD25+CD127 lymphocytes, increased CD3+ and CD4+ cells 1.5- and 1.2-fold respectively vs. the reference group values. Other findings are disordered launching and regulation of apoptosis via lower Fas-receptor expression and changed balance of regulatory proteins Bcl–2 and Bax vs. the normal value in 50.0–62.5% of the workers, with reliable 2.6-fold increase of Bax level vs. the reference group.

Are Serum Metal Ion Levels a Concern at Mid-term Followup of Revision Knee Arthroplasty With a Metal-on-metal Hinge Design?

Elevated serum levels of chromium and cobalt ions in metal-on-metal (MoM) bearing surfaces is a well-known phenomenon in THA. However, few studies have addressed this issue in complex primary and revision knee arthroplasty using a MoM hinged mechanism, and no study, to our knowledge, has investigated knees with MoM hinges in patients without megaprostheses (tumor prostheses). We analyzed a series of patients who received MoM hinged revision knee prostheses and asked: (1) What are the serum metal ion levels at short-term followup? (2) Is there any correlation between metal ion levels and the Knee Society Score (KSS) at this followup? Between 2013 and 2017, we performed 198 revision knee arthroplasties, of which 32 (17.7%) were performed with a latest-generation MoM hinge knee design. In addition, three complex primary TKAs utilizing the same design were included in this study. The device features a metal-on-polyethylene bearing with a MoM hinge. During that period, our general indications for using a hinge were single-stage and two-stage revision surgeries, revisions with large bone defects, and primary TKA with > 20° mechanical malalignment or collateral ligament insufficiency. Of the 35 patients who received this device, 23 patients (65% of the overall group who received this implant; 11 males, 12 females) were available for followup at a median of 28 months (range, 13-61 months), and the remaining 12 (35%) patients were lost to followup. Our rationale for reporting before the more typical 2-year minimum was the finding of elevated serum ion levels with unclear clinical significance. Median age at the time of surgery was 68 years (range, 52-84 years). None of the patients included in the study had other implants with MoM bearings. Serum ion levels of chromium (III) and cobalt were assessed using mass spectrometry. Ion levels > 5 ppb were considered elevated. Clinical outcome was assessed using the original KSS. Median chromium serum level was 6.3 ppb (range, 0.6-31.9 ppb) and median cobalt serum level was 10.5 (range, 1.0-47.5 ppb). Of the 23 patients, 16 had elevated serum ion levels. There was a moderate correlation between KSS and both chromium (p = 0.029, r = 0.445) and cobalt (p = 0.012, r = 0.502) levels. Elevated metal ion levels and radiolucent lines are common after surgery with this MoM hinge design at short-term followup, and we believe this finding is of great concern. Although no patient has yet been revised, these patients will be closely monitored. We recommend that serum ion analysis become a routine part of followup after any hinge TKA in an attempt to better understand the potential consequences of this phenomenon. Level IV, therapeutic study.

Serum Chromium Level is Increased in Jordanian Smokers, Decreased in Jordanians with Prediabetes and type 2 Diabetes, But not Altered in Jordanians with Hypertension, With Obesity, or With Family History of Diabetes.

Background:Chromium was found to be crucial for several biochemical processes in the human body, including, in particular, carbohydrate and lipid metabolism whereas the exact mechanisms of its actions have yet to be explored. Here, we asked whether low serum chromium levels are present in Jordanian smokers and Jordanians with prediabetes and type 2 diabetes (T2D), with hypertension, with overweight and obesity, and with a family history of diabetes.Methods:A total of 360 patients (120 with T2D, 120 with prediabetes, and 120 healthy controls) were recruited randomly based on the American Diabetes Association criteria. Smokers (n = 26), and patients with hypertension (n = 46), with overweight (n = 47) and obesity (n = 57), and with family history of diabetes (n = 63) were included in the tested population. Serum chromium concentration was measured using the graphite furnace atomic absorption spectrometry.Results:The results from this study revealed significant increase (P = 0.001 univariate, P = 0.038 multivariate) and significant decrease (P = 0.046 univariate,P = 0.038 multivariate) in serum chromium concentrations in smokers and people with T2D and prediabetes, respectively. In addition, serum chromium insignificantly altered (P > 0.05) in people with hypertension, with a family history of diabetes, and with overweight or obesity.Conclusions:Higher levels of serum chromium were observed in smokers, whereas lower levels were found to be present in patients with T2D and patients with prediabetes. In addition, serum chromium level may not be affected by hypertension, overweight and obesity, and family history of diabetes.

A Study of Correlation of Serum Chromium Level with Glycosylated Haemoglobin (HbA1c), Total Cholesterol and Triglycerides, among Type 2 Diabetes Patients

Background: Diabetes mellitus is a common disease and it is a major cause of morbidity; several studies indicate that diabetes is a likely under reported cause of death. Chromium’s is important trace element to control diabetes mellitus and metabolism of carbohydrate, lipid and protein. Objective: The purpose of this study was to understand the relationship between serum chromium, with HbA1c, Total cholesterol and Triglycerides among type 2 diabetes patients among diabetic patients. Methodology: This is cross-sectional study done in Jabber Abu Ezz Centre for treatment and care of diabetics in Khartoum—Sudan. Four hundred subjects were enrolled in this study; one hundred subjects were normal healthy as control group, and three hundred subjects diabetic patient type 2 as test group; demographic and biochemical data were collected; serum chromium, Glycosylated Haemoglobin (HbA1c), Total cholesterol Triglycerides, were determined by using NYCOCARD READER II, spectrophotometer (Biosystem 310) and spectrophotometer 210-VGP. Result: In this study there is significant parameters level means of FBS HbA1c, Total Cholesterol, Triglycerides and Chromium of the test groups when compared with healthy control groups subjects (P = 0.001, 0.018, 0.01, 0.011, 0.004), respectively. Significant negative correlation is between FBS, HbA1c, Total Cholesterol, Triglycerides and Chromium (r = ?0.555, P value = 0.003), (r = ?0.668, P value = 0.002), (r = ?0.335, P value = 0.004) and (r = ?0.774, P value = 0.002) respectively. Conclusion: There was significant correlation between serum Chromium level with fasting blood sugaer, Glycosylated Haemoglobin (HbA1c), Total cholesterol and Triglycerides among type 2 diabetes patients.

In vivo study on the release of nickel, chromium, and zinc in saliva and serum from patients treated with fixed orthodontic appliances

Fixed orthodontic appliances can release metal ions such as nickel, chromium, and zinc into saliva and blood, which can cause contact dermatitis, hypersensitivity, and cytotoxicity. This study was undertaken to assess the release of nickel, chromium, and zinc in saliva and serum of patients undergoing fixed orthodontic treatment. This in vivo study was conducted on 80 participants with an age range of 15-40 years. Thirty were included as controls and 50 participants were treated with fixed orthodontic appliances. Saliva and blood samples were collected at five different periods, before insertion of fixed orthodontic appliance and at 1 week, 3 months, 1 year, and 1.5 years after insertion of appliance, respectively. The metal ion content in the samples were analyzed by atomic absorption spectrophotometry. Mean levels of nickel, chromium, and zinc in saliva and serum were compared between groups using independent sample t-test and before and after results using paired t-test. P < 0.05 was considered as statistically significant. At the end of 1.5 years, the mean salivary levels of nickel, chromium, and zinc in controls were 5.02 ppb, 1.27 ppb, and 10.24 ppb, respectively, as compared to 67 ppb, 30.8 ppb, and 164.7 ppb at the end of 1.5 years. This was statistically significant with P < 0.001. A significant increase in the metal ion levels were seen in participants with before and after insertion of appliance (P < 0.001). Orthodontic appliances do release considerable amounts of metal ions such as nickel, chromium, and zinc in saliva and serum. However, it was within permissible levels and did not reach toxic levels.

Zinc Deficiency in Autism: A Controlled Study

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by impaired socialisation and restricted and repetitive patterns of behaviour. Zinc deficiency has previously been reported in patients with ASD. A retrospective controlled trial of serum zinc levels in patients with ASD vs. non-ASD controls was undertaken to explore the potential presence of zinc deficiency in the ASD population. 72 patients with ASD were compared with 234 non-ASD controls. Serum zinc levels were compared between groups and correlations analysed for age, sex, supplement use and diet. Serum chromium and manganese levels were also compared between ASD and control groups to assess general micronutrient status. Further analysis was undertaken in the ASD group investigating potential correlations between serum zinc levels and immune function. 86% of patients with ASD were found to be zinc deficient versus 24% of the non-ASD control group. There was a mean difference of serum zinc levels between the ASD and non-ASD groups of 1·75 μmol/l (P<0·001, CI 1·2-2·1). There was no effect of age or sex on serum zinc levels in either the ASD or control groups. There was no significant difference in chromium or manganese levels between the ASD and control group. These results suggest zinc deficiency is likely to be common in ASD patients and is a potentially modifiable environmental factor associated with the condition. Zinc’s potential role in the aetio-pathogenesis and disease evolution is discussed, and the need to consider zinc status in patients with ASD is highlighted.

Increased prevalence of Sjogren's syndrome in where soils contain high levels of chromium

Previously, we showed that farm soil levels of chromium were strongly correlated with people's serum chromium levels and an increase (3.6 fold) in both the incidence and prevalence of sicca syndrome in areas where farm soil chromium was high. Because Sjogren's syndrome (SS) is the major disease causing a dry mouth and dry eyes, we aimed in the study to investigate whether these areas with high soil chromium have a high SS prevalence. We used a database from the authority in charge of catastrophic illness certificates. Heavy metal concentrations in farm soils were retrieved from nationwide surveys. We used spatial regression models to study the relationships between the SS prevalence and soil metal concentrations. There were 11,220 people, 1165 men and 10,055 women who received a SS certificate from 2000 to 2011. The SS prevalence was 31 per 105 people, 5.59 for men and 55.01 for women. The highest SS prevalence in Taiwan (53 per 105) was located in an area where farm soils contain the highest amounts of chromium. In contrast, other types of heavy metal did not show such a strong association. In conclusion, the SS prevalence is significantly increased in areas where soils contain high levels of chromium. Chromium is likely a risk for SS.

Abstract 17269: Incidence of Atrial Fibrillation in Patients With Cobalt and Chromium Containing Hip Arthroplasty

Background: Worldwide, approximately one million patients have had total hip arthroplasty with 35% being cobalt and chromium Metal-on-Metal (MoM) or Metal-on-Polythelene (MoP) implants. Animal models have suggested that cobalt and chromium can affect all chambers, but there seems to be an atrial predilection. There are several case reports of metal containing hip arthroplasty causing atrial arrhythmias but the true incidence of atrial fibrillation associated with metal hip arthroplasty remains undefined. Objective: We sought to determine the incidence of atrial fibrillation in patients with metal containing hip arthroplasty. We also examined the association between serum cobalt and chromium levels and arrhythmias in this cohort and all cause mortality. Methods: We retrospectively examined the records of patients from the Mayo Clinic total hip arthroplasty registry (Metal group - Metal-on-Metal: MoM and Metal-on-Polyethylene: MoP, Non-Metal group - Ceramic-on-Ceramic: CoC and Ceramic-on-Polyethylne: CoP) to obtain demographic data, comorbidities, laboratory, ECG, and echocardiographic data. Out of a total of 1756 patients, Cobalt and Chromium levels were available in 138 patients. Results: The mean age of patients with metal containing hip replacement was 50 years and were predominantly male. During a follow up period of 10 years, the incidence of atrial fibrillation in our study population was 8% in metal group compared to 2% (p=0.11) in non-metal group. There was no association between cobalt or chromium levels with the incidence of atrial fibrillation. All-cause mortality was significantly higher in metal group versus non-metal group (p=0.005). Conclusion: The incidence of atrial fibrillation was relatively more in patients with metal versus non-metal hip arthroplasty but there was no association of serum cobalt or chromium levels with incidence of atrial fibrillation in the subset of patients. In addition, all-cause mortality was significantly higher in the metal group suggesting potential toxic effects of metal containing hip arthroplasty.

Trunnion corrosion in metal-on-polyethylene hip arthroplasty: a simple diagnosis and treatment?

To report our experience with trunnion corrosion following metal-on-polyethylene total hip arthroplasty, in particular to report the spectrum of presentation and determine the mean time to presentation. We report the presenting symptoms and signs, intraoperative findings, and early results and complications of operative treatment in nine patients with a mean age of 74 years (60 to 86). The onset of symptoms was at a mean of seven years (3 to 18) after index surgery. Patients presented with a variety of symptoms including pain, limp and rash. The preoperative mean serum cobalt level was 7.1 ppb (2.2 to 12.8) and mean serum chromium level was 2.2 ppb (0.5 to 5.2). Metal artifact reduction sequence (MARS) MRI showed fluid collection and possible pseudotumour formation in five hips, fluid collection in two hips, and synovitis/debris in one hip, with no MRI in one patient. Acetabular revision was performed in three patients, six patients underwent liner and head exchange only. The postoperative metal levels decreased in all patients: mean cobalt 0.5 ppb (0 to 1.8) and mean chromium 0.9 ppb (0 to 2.6) at a mean of five months (3 to 8) postoperatively. Seven patients had good pain relief and no complications at one year. There were two major complications requiring reoperation: acute infection at six weeks, for which the patient required two-stage reimplantation; and recurrent dislocation, for which the patient was revised to a dual mobility component. Trunnion corrosion in metal-on-polyethylene THA has a range of presenting symptoms, and may present later than previously described. A high index of suspicion is warranted, and serum cobalt and chromium levels are recommended for diagnosis. Patients should be counselled about possible postoperative complications. Cite this article: Bone Joint J 2018;100-B:898-902.

Long-term results of metal on metal total hip arthroplasty in younger patients (

IntroductionMetal on Metal (MoM) hip arthroplasty saw a new era of popularity with development of its second generation bearing surfaces, in the first decade of this century. However, by the end of that decade, concerns had been raised due to metal debris related complications.We aimed to determine the survival of MoM stemmed hip replacement in younger population. We also studied the rate of revision related to adverse reaction to metal debris (ARMD) along with reviewing the clinical and radiological progress of MoM hip arthroplasty in younger age (<55 yrs) group. Patients & MethodsThis is a retrospective cohort study of patients 55 yrs old or younger, who had metal on metal (MoM) hip arthroplasty for osteoarthritis. We had 109 procedures performed on 90 patients with a mean follow up of 10 years. All patients were reviewed as per MHRA guidelines in planned follow-up clinics. Data analyses were performed using SPSS. ResultsSurvival of implant in our younger cohort was 88.1% at a mean age if 10 years, with revision for any cause as an endpoint. Most of the patients were happy with the outcome of their hip replacement as they were able to perform activities of daily living and work without compromise. Mean Oxford hip score was 43.Altogether, there were 12 revisions, 7 of these were for metallosis and associated symptoms. Average time to revision was 7 years. Other analysis revealed mean acetabular cup inclination angle to be 49 degrees but no significant correlation was found between this angle and serum metal ion levels. Serum Chromium and Cobalt levels were significantly higher in revision group. DiscussionMetal on metal hip arthroplasty prime popularity time has gone. In younger population, although revision rates are higher, the surviving implants give a very good outcome in terms of patient satisfaction. Most of the patients report a desired outcome of ‘forgotten hip’.

Serum Metal Levels in Maxillofacial Reconstructive Surgery Patients: A Pilot Study

The aim of this pilot study was to assay metal concentrations in the serum of patients who had undergone dental implant placement, orthognathic surgery using rigid metal fixation plates and screws, and total temporomandibular joint replacement (TMJ TJR). Thirty patients were identified and included in this pilot study. Sixteen patients (9 men and 8 women), with an average age of 44years (range, 19 to 79yr), provided informed consent to participate and were divided into 3 study groups with 4 patients in each (group 1, orthognathic surgery; group 2, TMJ TJR; and group 3, dental implant placement). A control group consisted of volunteers without any implanted metallic devices. Blood samples for serum metal analysis were obtained and analyzed in accordance with the standardized collection and testing protocols used at the Trace Metal Analysis Laboratory of the Department of Orthopedic Surgery at the Rush University Medical Center (Chicago, IL). All control participants had levels below the normal reference range for all serum markers assessed. In the orthognathic group, 1 patient had an increased serum cobalt level. In the TMJ TJR group, 1 patient had an increased serum cobalt level and another patient had an increased serum chromium level. In the dental implant group, 1 patient had an increased serum titanium level and another had increased serum levels of titanium and chromium. This is the first study to report on the release of metal into the bloodstream in patients with different maxillofacial implanted metallic objects. The results raise questions regarding the types and magnitude of metal released from maxillofacial reconstruction devices and their potential long-term local and systemic effects. Future large-scale prospective studies involving serial measurements in homogeneous groups of patients could further elucidate the impact of these findings.

Changes in serum chromium levels over 12 years after Metasul metal-on-metal total hip arthroplasty

We reported the longitudinal changes in serum chromium levels over a minimum of 7 years postoperatively in five men and 25 women with a mean age of 60.3 years after primary unilateral total hip arthroplasty with a Metasul metal-on-metal articulation. The serum chromium ion level showed little variation (0.6–1.2 μg/L) from 2 to 12 years postoperatively in 16/30 patients after unilateral primary Metasul metal-on-metal total hip arthroplasty. On the other hand, the serum chromium level stayed high or showed gradual elevation in 8/30 patients, even though they had well-fixed and well-functioning prostheses.

Serum chromium and selenium levels in type 2 diabetes mellitus

Background: Emerging evidence suggests that several trace elements such as serum chromium (Cr) and selenium (Se) levels are altered in type 2 DM and its deficiencies are associated with the development of diabetes related complications.Objective: To assess the serum Cr and Se levels in patients of type 2 diabetes mellitus.Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2014 to June 2015. Fifty type 2 diabetic patients with age ranging from 40 to 55 years were study group and fifty ages, BMI matched healthy subjects were control group. Patients were selected from Bangladesh Institute of Research for Diabetic Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka. Serum Cr and Se levels were estimated by flame atomic absorption spectrophotometry. For statistical analysis unpaired Student’s‘t’ test and Chi square test were performed.Results: In this study, serum Cr and Se levels were significantly (P&lt;0.001) lower in patients than that of control group. In addition 20% patients had low Cr and 16% had Se deficiencies. Moreover, 6% of control had low Cr and 4% had low Se.Conclusion: From this study, it is concluded that serum Cr and Se deficiencies are associated with type 2 diabetes mellitus.Bangladesh Soc Physiol. 2017, December; 12(2): 72-75

Comparison Between Nickel and Chromium Levels in Serum and Urine in Patients Treated with Fixed Orthodontic Appliances: A Longitudinal Study

Objective: To compare levels of nickel and chromium in serum and urine in orthodontic patients treated with fixed orthodontic appliances. Material and Methods: Nickel and chromium ion concentration were measured in serum and urine of twenty patients (12 females and 8 males, aged 17-28 years old) who had fixed orthodontic treatment using Coupled Plasma-Atomic Emission Spectroscopy. The samples were taken before treatment (Baseline), two months, and six months later during treatment. Data were analyzed using repeated ANOVA, Bonferroni post-hoc test, and paired t-tests. The level of significance was set at 5%. Results: Average serum nickel level changed from 6.420 ppb to 6.855 ppb. Average serum chromium level changed from 5.305 ppb to 5.505 ppb in 6 months. Average urinary nickel level changed from 5.320 ppb to 5.610 ppb. Average urinary chromium level changed from 5.370 ppb to 5.520 ppb in 6 months. There was a statistically significant difference in serum (p<0.001) and urinary chromium (p=0.007) levels between observation times. Conclusion: Orthodontic treatment might raise both urinary and serum nickel levels, but the differences were not statistically significant; the alterations in chromium levels were not consistent; nickel levels were higher in serum than in urine; chromium levels were higher in urine than in serum.

Estimation of Trace Elements in Gingival Crevicular Fluid and Serum-Comparative Study in Healthy and Periodontitis

Background: This study aims to determine and compare the levels of trace elements copper, zinc, selenium and chromium in GCF and serum of patients with periodontitis and healthy individuals. Methods: This cross sectional study includes 24 study subjects recruited from the patients reporting to the Department of Periodontics , Tagore Dental College Chennai. All the selected patients were subjected to a clinical examination done by a single examiner. The estimation of trace elements Copper, Zinc, Selenium and Chromium in GCF and serum is performed using Perkin Elmer optima 5300 Inductively Coupled Plasma Emission Spectrometer (ICPOES). Results: GCF and serum copper levels showed no significant difference in both periodontitis and healthy groups . Selenium levels tend to be the same in both groups. Serum zinc levels are more in periodontitis patients than healthy subjects (p less than 0.01). GCF chromium levels are found to be more in patients with periodontitis than healthy. Conclusions : More research is therefore needed to monitor the role of these trace elements C with an increased sample size to ascertain whether they are associated with a reduced risk of periodontitis.

Serum Metal Levels for Diagnosis of Adverse Local Tissue Reactions Secondary to Corrosion in Metal-on-Polyethylene Total Hip Arthroplasty

BackgroundRecently, corrosion at the head-neck junction in metal-on-polyethylene bearing surface total hip arthroplasty (THA) has been recognized as a cause of adverse local tissue reactions (ALTRs). Serum metal levels have been advocated as a tool for the diagnosis of ALTR; however, no prior studies have specifically examined their utility. The purpose of this study was to determine the optimal cutoff values for serum cobalt and chromium levels in diagnosing ALTR after metal-on-polyethylene bearing surface THA. MethodsWe reviewed 447 consecutive patients with serum metal levels tested at our institution and identified 64 patients with a metal-on-polyethylene bearing who had axial imaging or underwent reoperation to confirm the presence or absence of ALTR. Receiver-operating characteristic curves were produced to identify cutoff thresholds to optimize sensitivity, and diagnostic test performance was characterized. ResultsForty-four of the 64 patients (69%) were positive for an ALTR. The best test for the diagnosis of ALTR was the serum cobalt level (area under the curve [AUC] = 99%). A threshold cutoff of ≥1.0 ng/mL had a sensitivity of 100%, specificity of 90%, positive predictive value (PPV) of 96%, and negative predictive value (NPV) of 100%. Serum chromium levels were also diagnostic (AUC = 87%). A threshold cutoff of ≥0.15 ng/mL had a sensitivity of 100%, specificity of 50%, PPV of 81%, and NPV of 100%. Finally, serum cobalt-to-chromium ratio was also helpful for diagnosis (AUC = 90%). A threshold cutoff value of 1.4 for the cobalt-to-chromium ratio offered a sensitivity of 93%, specificity of 70%, PPV of 87%, and NPV of 82%. ConclusionMeasurement of serum cobalt level with a threshold value of 1.0 ng/mL in our experience is the best test for identifying the presence of ALTR in patients with a metal-on-polyethylene THA. Measurement of chromium level and the ratio of cobalt-to-chromium levels are also of value.

Systematic Screening of Adverse Reactions to Metal Debris after Recap-M2A-Magnum Metal-on-Metal Total Hip Arthroplasty.

An adverse reaction to metal debris is a known complication after large diameter head metal-on-metal total hip arthroplasty. However, the failure rate varies depending on the implant design. Therefore, we investigated the prevalence of adverse reaction to metal debris, as well as the symptoms and risk factors after undergoing a ReCap-M2a-Magnum large diameter head metal-on-metal total hip arthroplasty. Between 2005 and 2012, 1188 patients (1329 hips) underwent ReCap-M2a-Magnum total hip arthroplasty at our institution. Systematic screening for adverse reaction to metal debris was arranged using the Oxford Hip Score questionnaire, hip and pelvic radiographs, and assessments of the serum chromium and cobalt ion levels. Clinical evaluation and magnetic resonance imaging were performed for the symptomatic patients, as well as those with either chromium or cobalt ion levels ⩾5 µg/L. The prevalence of adverse reaction to metal debris after ReCap-M2a-Magnum total hip arthroplasty was assessed, and the risk factors for adverse reaction to metal debris were evaluated using logistic regression. The mean follow-up time was 5.2 (0.003-9.1) years. This study was an extension of a previous study conducted at our institution with 80 patients. In total, 33 patients (33 hips, 2.5% of all hips) required a revision operation due to adverse reaction to metal debris. Moreover, 157 hips exhibited definitive adverse reaction to metal debris, but a revision operation was not performed (157 of 1329 hips, 11.8% of all hips). Overall, 190 out of 1329 (14.3%) hips had definitive adverse reaction to metal debris. Pain, subluxation sensation, clicking, swelling, a small head size, and a fair/poor Oxford Hip Score were associated with definitive adverse reaction to metal debris. We found a high prevalence of adverse reaction to metal debris in the ReCap-M2a-Magnum total hip arthroplasty patients in this study; however, most of the patients did not require revision operations.