Clinical significance of the ratio of serum copper to zinc in patients with inflammatory bowel disease / 中华消化杂志

Objective:To explore the serum levels of copper and zinc and the application value of the ratio in assessing disease activity in patients with inflammatory bowel disease (IBD).Methods:From March 2019 to April 2020, 200 patients with IBD hospitalized at the Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University were selected by prospective random direct sampling method, including 100 patients with Crohn′s disease (CD) and 100 patients with ulcerative colitis (UC). The Crohn′s disease activity index (CDAI) and the modified Mayo score were used to evaluate the disease activity of CD patients and UC patients. In the same period 100 healthy individuals in the routine physical examination were selected as healthy control group. The serum levels of copper and zinc of the healthy control group, the CD group and the UC group were determined by atomic absorption spectrometry. The levels and the ratio of serum copper to zinc of three groups were compared. The ratio of serum copper to zinc of CD patients and UC patients with different disease activity were compared. The correlation between the ratio of serum copper to zinc and IBD activity indexes were analyzed, which included fecal calprotectin (FC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), CDAI and Mayo score. Receiver operating characteristic curve was drawn to analyze the value of the ratio of serum copper to zinc, CRP and ESR in predicting disease activity of patients with IBD. Independent sample t test, least significant difference- t test and Pearson correlation analysis were performed for statistical analysis. Results:The serum copper levels and the ratio of serum copper to zinc of the CD group and the UC group were both higher than that of the healthy control group, however the serum zinc levels were lower than that of the healthy control group ( (32.27±7.69) and (29.80±9.68) mol/L vs. (20.16±6.67) mol/L; 2.81±1.57 and 2.29±1.09 vs. 0.68±0.36; (14.64±7.11) and (15.65±8.17) mol/L vs. (34.29±16.40) mol/L), and the differences were statistically significant ( t=2.81, 5.87, 1.47, 7.21, 1.73 and 2.56, all P<0.05). Among CD patients, the the ratio of serum copper to zinc of patients at remission stage (29 cases), mild activity stage (23 cases), moderate activity stage (30 cases) and severe activity stage (18 cases) was 2.61±1.43, 2.75±1.35, 3.15±2.37 and 4.17±1.77, respectively, and the ratios of serum copper to zinc of patients at mild activity stage, moderate activity stage and severe activity stage were all higher than that of patients at the remission stage, and the differences were statistically significant ( t=3.41, 7.92 and 5.84, all P<0.05). There were statistically significant differences in the ratios of serum copper to zinc between patients at mild activity stage and moderate activity stage, severe activity stage, and between patients at moderate activity stage and severe activity stage ( t=5.82, 6.23 and 3.45, all P<0.05). Among UC patients, the ratio of serum copper to zinc of patients at remission stage (10 cases), mild activity stage (30 cases), moderate activity stage (45 cases) and severe activity stage (15 cases) was 1.52±0.44, 1.74±0.58, 2.38±0.83 and 3.80±1.19, respectively, the ratio of serum copper to zinc of patients at moderate activity stage was higher than that of patients at remission stage and mild activity stage, and the ratio of serum copper to zinc of patients at severe activity stage was higher than those of patients at remission stage, mild activity stage and moderate activity stage, and the differences were statistically significant ( t=7.92, 5.83, 3.21, 9.54 and 2.83, all P<0.05). There was no statistically significant difference in serum copper to zinc ratio between patients at remission and at mild activity stage ( P>0.05). The ratio of serum copper to zinc of CD patients was positively correlated with FC and CRP ( r=0.697 and 0.586, P=0.014 and 0.001), however was not correlated with ESR or CDAI score (both P>0.05). The ratio of serum copper to zinc of UC patients was positively correlated with FC, ESR and Mayo score ( r=0.488, 0.452 and 0.331, P=0.001, P<0.01 and P=0.041), however was not correlated with CRP ( P>0.05). The cut-off value of the ratio of serum copper to zinc, CRP and ESR for the diagnosis of CD activity was 1.76, 8 mg/L and 20 mm/1 h, respectively. Among them, ESR was the most effective in the diagnosis of CD activity with an area under the curve (AUC) value of 0.830, and to the sensitivity and specificity was 69.0% and 86.2%, respectively. The cut-off value of the ratio of serum copper to zinc, CRP and ESR for the diagnosis of UC activity was 1.63, 8 mg/L and 20 mm/1 h, respectively; among which the the ratio of serum copper to zinc had the highest efficacy in the diagnosis of UC activity, with an AUC value of 0.862, sensitivity and specificity of 73.0% and 90.9%, respectively. Conclusion:The the ratio of serum copper to zinc is correlated with the disease activity of IBD, which may become a new auxiliary indicator for the evaluation of disease activity.

Role of serum copper and lipid profile in cardiovascular diseases patients of Southern Rajasthan

Background: It is clear that deficiencies of some trace elements cause marked alterations in lipid and lipoprotein metabolism. The mechanisms of their effects are not completely obvious and inspite of intense research, the role of these microelements need further elucidation. Thus, the objective of this study is to evaluate the correlations of serum concentrations of trace elements including copper with lipid profile parameters of adult men in Southern Rajasthan.Methods: Present study was conducted in Cardiology and Biochemistry Department in GMCH, Udaipur during the year 2019. A total of 150 MI cases/controls were selected. Blood sample was collected by vein puncture using an aseptic technique. The blood was allowed to settle at 37ºC and then centrifuged at 3000 rpm for 15 min. Serum was then separated and stored at -20ºC until analysis.Results: The study cases had significantly higher lipid values than those of controls (p<0.001). In cases the copper levels are higher than the controls. Copper levels were more in males 95.40±18.93 than in females 86.93±14.54 (p<0.05). Lipid levels were higher in urban population related to rural, TC (238.47 V/s 266.59), TG (219.83 V/s 202.40), HDL (64.39 V/s 54.19) and LDL (131.28 V/s 139.48) (p<0.05). Significant negative correlation was seen in study group between serum copper levels and TC (r=-0.288, p<0.05), TG (r =-0.236, p<0.05), HDL (r=-0.946, p<0.05) and VLDL levels (r=0.102, p<0.05). This indicates that as copper level reduces lipids increases.Conclusions:Our findings indicate the possible effect of Cu level in serum lipid profile and this effect may be due to the role of Cu as an antioxidant. The correlations between the serum concentrations of trace elements with lipid profile in physiological concentrations may not be the same as the changes observed during deficiencies of the trace elements as in hyperlipidemic patients

The evaluation of Serum Copper Level in Hemodialysis Patients with and without anemia Compared with Healthy Controls.

ntroduction: Anemia is a common complication of ESRD with different etiologies. The most common cause of anemia in such patients is insufficient production of erythropoietin by kidneys. Another possible reason is copper deficiency, thus, this study is aimed to evaluate the serum copper level among hemodialysis patients with and without anemia and to compare them to healthy controls. Material and Methods: A total number of 56 patients who underwent regular hemodialysis due to their ESRD were enrolled and divided into two groups of 28 according to their Hgb results including patients with anemia (Hgb<11 gr/dl) and patients without anemia (Hgb>11 gr/dl). Also, 28 healthy individuals participated as the control group. Venous blood samples were collected from patients prior to hemodialysis. Spectrophotometry employed for copper measurements. Data were analyzed using t-test and Pearson regression analysis. Results: Mean age of patients was 44.36±15.80 years. No significant difference was present among the three groups with regarding to age and gender. Mean and SD of serum copper in patients with anemia, without anemia, and controls were 180.11±54.48, 139.66±35.57 and 155.82±42.06 μg/dl respectively. Serum copper level was significantly higher in hemodialysis patients with anemia compared with those without anemia (p<0.03). Also a significant inverse regression between serum copper and Hgb was present in all hemodialysis patients (p=0.02, r=-0.37). Conclusion: Higher levels of serum copper in anemic patients could be a result of restraining role of high serum copper on iron absorption that has a negative effect on the production of Hgb. However, complementary studies are required.

Study of Serum Sialic Acid and Copper as Inflammatory Markers in Type 2 Diabetes Mellitus.

The study aims to understand the relationship between increased serum levels of acute- phase reactants like Sialic Acid (SA) and transitional metals like Copper (Cu) which are indicated to be associated with the etiology and pathogenesis of type 2 diabetes mellitus (DM) and its various chronic complications. Serum SA and Cu levels, measured colorimetrically using Ehrilch’s reagent and Atomic Absorption Spectrophotometer (AAS) respectively among 30 cases each of type 2 DM with and without long-term complications, were significantly higher in all the cases compared to controls. The values are even higher in cases with complications, compared to diabetics without complications. Serum lipid profile was significantly altered in both the experimental groups. Serum SA and Cu levels are positively correlated to duration and degree of impaired glycemic status and altered lipid profile in type 2 DM. Measurement of these new serum markers can explain the inflammatory process, implicated towards the development of diabetic complications like cardiovascular diseases and microangiopathies thereby helping in early medical intervention.

Development of a new biodosimetry based on serum copper in γ-ray irradiated mice / 中华放射医学与防护杂志

Objective To investigate the changes of serum copper in mice after whole-body irradiation and analyze the feasibility of these changes as a biological dosimeter.Methods Serum copper in mice exposed to 60 Co γ-rays(0,1,2,3,5 Gy) was collected from the orbital of mice and detected with 5-Br-PADAP colorimetric method at 30 min and 7 d after radiation.One-way analysis of variance was used to analyze the difference of serum copper in each group and Dunnett-t test was used to compare the difference between control group and irradiated groups.Linear and quadratic linear fitting function was used to analyze the relationship between serum copper and radiation dose.The change of serum copper was detected at 30 min,1,3,5,7,10,13 and 16 d after radiation to observe the persistence of serum copper.The established relationships were used to estimate the dose in 8 mice irradiated by a blind dose.Results The amount of serum copper in irradiated mice were significantly (F =208.20,145.98,P ＜ 0.05)dependent on the radiation doses with dose responses of y =-0.091x + 0.936 and y =-0.011x2-0.032x + 0.962 (r =0.989,0.995) at 30 min and 7 d post-irradiation,respectively.The concentration of serum copper at 2.0 Gy decreased at 30 min post-irradiation,increased at 1-7 d,then kept at a stable level at 7-14 d even increased slightly after 14 d.With these dose response curves,after radiation with a blind dose of 2 Gy,the absorb doses of mice were assessed to be (1.83-2.25) Gy and (1.82-2.11) Gy at 30 min and 7 d in 95％ confidence interval,respectively.Conclusions The serum copper is a quick,simple,and sensitive biomarker for the early assessment of absorb dose of irradiated mice.

Serum Copper and Plasma Protein Status in Normal Pregnancy.

Background: Gradual alteration of serum copper and some plasma protein levels may occur with advancement of pregnancy, which is associated with increased maternal and infant morbidity and mortality. Objective: To observe serum copper and plasma protein levels in normal pregnant women of different trimesters in order to find out their nutritional status. Methods: This cross sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka, between 1st January 2010 and December 2010. Ninety normal pregnant women of different trimesters with age 20-30 years were included in the study group. They were selected from Out Patient Department of Obstetrics and Gynaecology, SSMC. Age matched 30 non-pregnant women were taken as control. Serum copper level was measured by Spectrophotometric method, serum total protein and albumin levels were estimated by standard method. Statistical analysis was done by one way ANOVA, Bonferroni and Pearson’s correlation coefficient test as applicable. Results: Serum Cu levels were significantly higher in all trimesters of pregnant women compared to control. Again, this value was significantly higher in 3rd trimester than that of in 1st and 2nd trimester and also in 2nd trimester than that of in 1st trimester. In addition, mean serum total protein level was significantly lower in 3rd trimester than control but no statistically significant difference was observed among different trimesters. Again, mean serum albumin level was significantly lower in 2nd and 3rd trimester than 1st trimester and control. In addition, serum Cu concentration showed significant positive correlation with different trimesters of gestation. Conclusion: This study reveals that hypercupremia along with hypoproteinemia occur in pregnant women from 1st to 3rd trimester of gestation. This gradual alteration of micro and macronutrients become more profound with advancement of pregnancy.

Serum zinc and copper concentrations and socioeconomic status in a large Persian cohort.

Background: We have previously reported that serum zinc (Zn) and copper (Cu) are affected by a number of factors. In the current investigation we have investigated the association between serum Zn and Cu concentrations and socio-economic factors in an Iranian population. Materials and methods: A Persian sample population (n = 2233; n = 1106 (49.5%) males and n = 1127 (50.5%) females) was recruited by cluster-stratified sampling. Individuals were aged 15-65 years, and included urban and rural residents of the Great Khorasan province, Iran. Anthropometric measurements, serum Zn and Cu analysis and socio-economic status were determined using standard protocols. Results: The mean serum Cu and Zn concentrations for the whole group were 14.7?3.3 ?mol /L (range 4.5-28.4 ?mol /L), and 11.7?1.9 ?mol/L (range 3.6-28.3 ?mol/L) respectively, and the mean serum Zn:Cu ratio for the group was 0.83?0.2. The highest mean copper concentrations were found in the age range 50-59 years (p < 0.01). The total population of urban residents had higher serum zinc (p <0.01) and lower serum copper concentrations (p <0.05) than rural residents. Poorly educated male subjects had significantly higher serum concentrations of copper than males in the other subgroups (p <0.001). Serum Cu and Zn:Cu ratio were associated with height and body mass indices (p <0.01). Conclusion: Low serum zinc and copper appears to be common in Persian individuals. Urbanization and also educational attainment may contribute to changes in serum levels of Cu and Zn. This is probably related to lifestyle habits.

Zinc plasmático, cobre sérico y zinc y cobre eritrocitarios en adultos sanos de Buenos Aires / Plasmatic zinc, serum copper and erythrocyte zinc and copper levels in healthy adult people living in Buenos Aires

Se estudiaron adultos, clínicamente sanos, 21 varones (V) y 19 mujeres (M), de: edad (años): V: 48±14 (28-78); M: 41±14 (23-66); Índice de masa corporal (kg/m²): V: 26,7±2,3 (23,1-31,9); M: 22,2±3,5 (19,3-29,6). Se realizó una encuesta nutricional y se extrajo sangre en ayunas. Se realizaron las determinaciones de rutina del laboratorio clínico. Se determinó zinc en plasma (ZnPl), cobre en suero (CuS); en eritrocitos: Zinc (ZnGR) y cobre (CuGR), por espectrometría de absorción atómica. La totalidad de los V y M presentaron ingestas adecuadas de energía, proteínas, Zn y Cu. Los resultados expresados como: promedio ± desvío estándar y rangos fueron: ZnPl (μg/dL): V: 93±27 (49-161); M: 79±28 (42-157); ZnGR (μg/dL): V: 1.380±210 (1.110-2.010); M: 1.350±130 (1.090-1.520); CuS (μg/dL): V: 89±20 (40- 122); M: 93±28 (45-157). CuGR (μg/dL): V: 59±12 (37-78); M: 63±19 (30- 110). No se evidenciaron diferencias significativas entre V y M. Los resultados para la población estudiada fueron, percentilos 5 y 95, respectivamente: ZnPl: 49 a 131 μg/dL; ZnGR: 1.130 a 1.610 μg/dL; Zn/Hb: 34,4 a 47,5 μg/g; CuS: 45 a 124 μg/dL; CuGR: 36 a 78 μg/dL. Los valores de ZnPl y CuS se encuadraron dentro de los rangos de valores de referencia internacionales, sin diferencias significativas de acuerdo con el género.

Two groups of adult healthy people were studied: 21 males (M) and 19 females (F). Mean age (ys) was: M: 48±14 (28-78); F: 41±14 (23-66); body mass index (Kg/m²) was: M: 26.7±2.3 (23.1-31.9); F: 22.2±3.5 (19.3-29.6). A nutritional survey was recorded and mean daily intake of energy, protein, Zinc (Zn) and Copper (Cu) were calculated. Fasting blood samples were obtained in order to determine Hemoglobin (Hb), plasmatic Zn (PlZn), serum Cu (SCu), erythrocyte Zn (EZn) and erythrocyte Cu (ECu) levels. Zn and Cu were determined by AAS. Results were: mean±SD and ranges: PlZn (μg/dL): M: 93±27 (49-161); F: 79±28 (42-157); EZn (μg/dL): M: 1380±210 (1110-2010); F: 1350±130 (1090-1520); SCu (μg/dL): M: 89±20 (40-122); F: 93±28 (45-157). ECu (μg/dL): M: 59±12 (37-78); F: 63±19 (30-110). All individuals presented adequate intake of energy, protein, Zn and Cu. There were no significant differences between M and F for PlZn, EZn, Zn/Hb ratio, SCu and ECu. The results for the adult healthy population in Argentina, and which were in accordance with the international published values were: (percentiles 5 y 95, respectively): PlZn: 49 - 131 μg/dL; EZn: 1130 - 1610 μg/dL; Zn/Hb: 34,4 - 47,5 μg/g; SCu: 45 - 124 μg/dL; ECu: 36 - 78 μg/dL.

The Effect of Anticonvulsants on Serum Copper and Zinc Concentrations / 소아과

PURPOSE: Anticonvulsants have a number of side effects and some of them may be attributed to a disturbance of serum trace metal homeostasis. Although they are minor building components in tissues, they play important functional roles in the peripheral and central nervous system. We measured serum copper and zinc levels in epileptic children who were treated with anticonvulsants to know the effects of anticonvulsants on serum copper and zinc levels. METHODS: Serum copper and zinc levels were determined in 64 epileptic patients receiving anticonvulsant therapy in Chungnam National University Hospital, and in 20 normal controls. Sixty-four epileptic patients were divided into three groups:16 patients who were treated with valproic acid monotherapy; 26 patients who were treated with valproic acid in addition to other anticonvulsants; and 22 patients who were treated with anticonvulsants except for valporic acid. RESULTS: All patients receiving anticonvulsants had significantly lower serum copper levels(80.21+/-19.42 microgram/dL) in comparison to the normal controls(102.12+/-32.8 microgram/dL). Serum zinc levels in patients receiving anticonvulsants(79.78+/-21.88 microgram/dL) were not statistically different from those of controls (85.26+/-29.81 microgram/dL). There were no significant difference of serum copper and zinc levels among the three groups. CONCLUSION: In this study, we clearly showed that anticonvulsants decreased serum copper levels. Although we did not observe any clinical findings related to copper deficiency, we should pay attention to potent copper deficiency in patients with anticonvulsant treatment.

Direct spectrophotometric method to determing serum copper with a new water soluble reagent / 中华检验医学杂志

Objective To establish a simple and sensitive method for the determination of serum copper by spectrophotometry.Methods Nitro-PAPS was used as a coloring agent for serum copper in the presence of surfactants Tween-80 and Triton X-100 and the formed complex was measured by spectrophotometry.Results The maximum absorption wavelength of the complex was 570 nm and the molar absorption coefficient was 7.95?10~4 L/(mol?cm).The lineafity of the method was up to 63.0 ?mol/L and the recoveries ranged from 98.6% to 103.1%.The within-run and between-run CVs were 2.1%-3.3% and 2.7%-3.8%.The method(Y)was compared with an AAS method(X)and a correlation of Y=1.01X -0.27(r=0.998 2)was obtained.A reference interval(x~-?2s)determined with this method on 68 individuals was 9.7-24.1 ?moL/L.Conclusions A simple and sensitive method for serum copper has been established.It may used for the analysis of serum copper in clinical laboratories.

The Serum Copper and Zinc Concentration according to the Progression of Pneumoconiosis / 대한산업의학회지

OBJECTIVES: Copper and Zinc, the trace elements of a living body, take a part in immunologic mechanism and induce the pulmonary fibrosis which is the pathologic progress of pneumoconiosis. This study was performed to assist the identification of the pathologic process of pulmonary fibrosis in pneumoconiosis. METHODS: The subjects of this study was 200 diagnosed persons as pneumoconiosis, of whom 100 persons was the visitors in the outpatients departments of pneumoconiosis and 100 admissive pneumoconiosis patients. The serum copper and zinc are measured and com pared. RESULTS: The mean serum copper concentration of visitor group was significantly higher than that of control group, and that of stage V3 subgroup of visitor group was highest because of their advanced fibrosis. But, there was not the difference of serum copper concentration between patient and control group. We thought that the reason was poor nutritional and health status of the patient. The mean of serum zinc concentration of visitor and patient control was lower than that of control group. As the degree of pulmonary fibrosis was more severe from stage Vl, V2, V3 of visitor to stage Pl, P2, P3 of patient, the mean of serum zinc concentration was lower. The ratio of serum copper/zinc of visitor and patient was higher than that of control, and that of patient was higher than that of visitor. Those results showed that the ratio of serum copper/zinc ratio more greatly expressed the degree of progression of pneumoconiosis than only copper or zinc concentration by adjustment of nutritional and health status of the patient. CONCLUSIONS: As above study results, the degree of pulmonary fibrosis of pneumoconiosis could be estimated by means of serum copper/zinc ratio.

The Influence of Smoking and Alcohol Intake on Copper, Zinc, and Nitric Oxide Concentration in Serum / 예방의학회지

To investigate the change of nitric oxide(No), copper, and zinc in serum on smoking and alcohol ingestion in young adults, this study was performed in a cross-sectional study in 127 healthy, men in Korea who had HBsAg(-), HCVAb(-), and no symptomatic liver, heart, gastrointestinal, chronic diseases, and inflammatory sign(lower than 10,000 white blood cell count in CBC). At the men's entry into the study, blood samples were drawn from each subject and immediately centrifuged for analysis of NO, copper, and zinc. Each man completed a questionnaire that provided information on smoking, alcohol intake and present and past medical history. NO was analyzed by HPLC(Green et al., 1982), copper and zinc by atomic absorption spectrophotometer with air-acetylene flame and total cholesterol(TC) by Spectrum EPX. smoking(number of cigarettes per day and pack-year) and alcohol intake was grouped tertile. Copper was adjusted for age and zinc and for age and TC. NO, copper, and zinc on smoking and alcohol ingestion were analyzed in general linear models, respectively. NO, copper and zinc in serum did not show statistical differences between non-smoking and high-smoking group and no-alcohol intake and high-alcohol intake group. This study, suggested that copper, zinc, and NO was not good biological marker for early effect by smoking and alcohol intake in young adults. However, selection bias should be Considered in evaluation of this result. A large prospective study, will be needed in advance on usefulness of copper, zinc, and NO as a marker for risk fictors and early change of atherosclerosis.

Analysis of Serum Zinc and Copper Levels in Alopecia Areata

BACKGROUND: As co-factors of metalloenzymes, zinc(Zn) and copper(Cu) have a considerable effect on nearly all the metabolism that takes place in organs of the body, including the skin. OBJECTIVE: The purpose of this study was to evaluate zinc and copper status in alopecia areata patients. METHODS: We measured serum levels of zinc and copper in 30 cases of alopecia areata patients and 10 normal individuals by atomic absorption spectrometry. Furthermore, we studied the significance of the ratio between serum levels of the two metals. RESULTS: The serum levels of zinc were significantly lower in alopecia areata patients than in healthy controls. The serum levels of copper were slightly lower in alopecia areata patients than in healthy controls. Ratios of Cu/Zn were slightly higher in alopecia areata patients than in healthy controls. But their differences were not statistically significant. CONCLUSION: We suggest that a serum Zn assay should be included in the chemical assessment of patients with alopecia areata.

THE RELATION BETWEEN SERUM COPPER VALUE AND PLACENTAL FUNCTION IN PREGNANT WOMEN / 西安交通大学学报(医学版)

we examined the serum copper level in 125 pregnant women (83) normal pregnant women of 28～40 weeks of pregnancy; 12 patients with se-vere edema-proteinurine-hyperterision syndromeduring 37～40 weeks of pregnancy; 30 patientswith prolonged pregnancy) and compared it withurine E/C value and Apgar score in order to deter-mine the reliability of serum copper value in diag-nosing placental insufficiency. The results con-firmed that the serum copper value was increasingwith the growth of weeks of pregnancy, but it wasdecreasing after the fortieth week of pregnancy.Comparison of the serum copper value with theurine E/C value showed that when the E/C or = 10. And when the Apgar score7. These results indicatethat the serum copper value can serve as an indexof placental function in the third trimester of preg-nancy.