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Fang X, Wang X, Hao M, Zhong G, Gao M, Ma Y, Pan Y, Yang H, Yin X, Shen J, Huang S, Wang Q. The role of copper homeostasis and cuproptosis in cerebrovascular diseases:A novel therapeutic target. Eur J Pharmacol 2025; 1001:177649. [PMID: 40320113 DOI: 10.1016/j.ejphar.2025.177649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Revised: 04/08/2025] [Accepted: 04/17/2025] [Indexed: 06/02/2025]
Abstract
Copper has a broad and important role in biological systems, where it acts as a cofactor at the active sites of a variety of enzymes and is involved in a wide range of physiological activities such as oxidative stress, lipid metabolism, and energy metabolism. Like other trace elements, copper levels maintain a balanced homeostasis in the body, and imbalances in copper homeostasis and cuproptosis it induces are involved in the progression of a range of diseases, such as cerebrovascular diseases (CVDs), including atherosclerosis (AS), hypertension, and stroke. Therefore, a deeper understanding of the relationship between copper and cerebrovascular pathologies may unearth more effective therapeutic strategies that can be effectively applied in the clinic. In this paper, we will briefly describe the process of copper metabolism and cuproptosis, and analyze how copper acts in CVDs from multiple perspectives, to further deepen the understanding of copper metabolism and provide new ideas for the treatment of CVDs.
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Affiliation(s)
- Xiaoling Fang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Xinyue Wang
- Department of Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China; Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, Guangdong Research Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
| | - Mengmeng Hao
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Guangcheng Zhong
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Minghuang Gao
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yujie Ma
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yaru Pan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Hongying Yang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Xuanying Yin
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Jiangang Shen
- School of Chinese Medicine, University of Hong Kong, Hong Kong, China.
| | - Shuiqing Huang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Qi Wang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, China.
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Tirani SA, Rouhani P, Saneei P. Hypertension in Relation to Circulating Magnesium Levels: A Systematic Review and Meta-Analysis of Observational Studies. Nutr Rev 2025; 83:1277-1289. [PMID: 40152122 DOI: 10.1093/nutrit/nuaf014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2025] Open
Abstract
CONTEXT There was no consistency regarding the findings of preceding studies on the association between magnesium levels and hypertension. OBJECTIVE The aim of the present systematic review and meta-analysis of observational studies was to investigate the relationship between circulating magnesium concentration and hypertension. DATA SOURCES To obtain epidemiological studies that investigated the association between circulating magnesium and hypertension, Web of Science (ISI), MEDLINE (PubMed), and Scopus databases as well as Google Scholar were searched up to February 2024, with no time or language restriction. DATA EXTRACTION Observational studies examined the relationship between hypertension and circulating magnesium levels were included and related data were extracted. DATA ANALYSIS In total, 3 cohort studies (with 15 730 subjects) and 19 cross-sectional studies (with 42 702 subjects) were included. The combination of 25 effect sizes from 22 studies showed an inverse relationship between circulating magnesium concentration and hypertension (OR = 0.65; 95% CI: 0.56-0.76) by comparing highest versus lowest levels of circulating magnesium concentration. We note, however, that there was a significant heterogeneity between studies (I2 = 81.1%; P < .001). A linear dose-response analysis of 21 eligible studies revealed that each 0.5 mg/dL increase in circulating magnesium concentration was linked to 7% decreased odds of hypertension (OR = 0.93; 95% CI: 0.91-0.95). A nonlinear U-shaped association was also found between circulating magnesium concentration and hypertension (Pnonlinearity = .01): Circulating magnesium levels of between 1.6 and 3.5 mg/dL were associated with a significantly decreased risk of hypertension. CONCLUSION Circulating magnesium concentration was inversely associated with odds of hypertension in a dose-response manner. Considering the high observed level of heterogeneity, it is necessary to conduct further population-based prospective studies to confirm this finding. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration No. 42024519446.
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Affiliation(s)
- Shahnaz Amani Tirani
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
| | - Parisa Rouhani
- Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
- Center for Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, SA 5005, Australia
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 8174673461, Iran
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Zhang Y, Zhang Z, Li H, Xiao Y, Ying H. Recent advancements in the application of multi-elemental profiling and ionomics in cardiovascular diseases. J Trace Elem Med Biol 2025; 88:127616. [PMID: 39933207 DOI: 10.1016/j.jtemb.2025.127616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Revised: 02/03/2025] [Accepted: 02/06/2025] [Indexed: 02/13/2025]
Abstract
BACKGROUND Trace elements and minerals are crucial for human growth and health, whose imbalance is associated with a variety of diseases. Recently, multi-elemental profiling and ionomics have been rapidly developed and widely used to study the distribution, variation, and interactions of various elements in diverse physiological and pathological conditions. By utilizing high-throughput elemental analytical techniques and bioinformatics approaches, researchers can uncover the relationship between the metabolism and balance of different elements and numerous human diseases. METHODS The presented work reviews recent advances in multi-elemental and ionomic profiling of human biological samples for several major types of cardiovascular diseases. RESULTS Research indicates distinct and dynamic patterns of ion contents in these diseases. Accumulation of copper and environmental toxic metals as well as deficiencies in zinc and selenium appear to be the most significant risk factors for the majority of cardiovascular diseases, suggesting that an imbalance in these elements may play a role in the development of these illnesses. Furthermore, each type of cardiovascular disease exhibits a relatively unique distribution of ions in biofluid and hair samples from patients, potentially serving as indicators for the specific disease. CONCLUSION Multi-elemental profiling and ionomics not only enhance our understanding of the association between elemental dyshomeostasis and the development of cardiovascular diseases but also facilitate the discovery of novel diagnostic and prognostic markers for these conditions.
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Affiliation(s)
- Yan Zhang
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong Province 518055, PR China; Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, Guangdong Province 518055, PR China.
| | - Zaicheng Zhang
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong Province 518055, PR China
| | - Hengtao Li
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong Province 518055, PR China
| | - Yao Xiao
- Shenzhen Key Laboratory of Marine Bioresources and Ecology, Brain Disease and Big Data Research Institute, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong Province 518055, PR China
| | - Huimin Ying
- Department of Endocrinology, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province 310023, PR China.
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Li B, Ma H, Yu Y, Chen J, He S, Yang L. Exploring the potential association between serum selenium and hypertension in obese adult males in the United States. Sci Rep 2025; 15:1268. [PMID: 39779781 PMCID: PMC11711189 DOI: 10.1038/s41598-025-85343-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 01/02/2025] [Indexed: 01/11/2025] Open
Abstract
Previous studies on the correlation between serum selenium and hypertension have yielded inconsistent results. Our previous analysis of participants from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 indicated that elevated serum selenium concentrations were associated with an increased risk of metabolic abnormalities in obese individuals, with the primary effect being on blood pressure in males. The aim of this study was to further elucidate the relationship between serum selenium and the risk of hypertension in obese males. In this study, we examined the correlation between serum selenium concentrations and hypertension in 2,585 male participants with a body mass index (BMI) ≥ 30 kg/m2 aged between 20 and 80 years from the 2011-2018 NHANES database. The associations between serum selenium levels and hypertension were evaluated through weighted generalized linear regression analyses. To examine the saturation threshold effect between serum selenium and hypertension, a generalized additive model (GAM) and a two-piecewise linear regression model were employed. Furthermore, the saturation threshold effect was evaluated separately in subgroups stratified by BMI and age. The weighted prevalence of hypertension (51.84%) was slightly higher than that of nonhypertension (48.16%) in the participants included in this study. After rigorous adjustment for sociodemographic, physical, and laboratory test covariates, the weighted odds ratio (OR) of hypertension increased by 103% for every 1 standard deviation (SD) increase (approximately 24.41 µg) in the serum selenium concentration in participants assigned to the highest serum selenium group (weighted OR = 2.03; 95% CI = 1.24-3.32; P = 0.013). A calculation was subsequently performed to determine the saturation threshold effect of selenium on hypertension among participants in the medium and highest selenium concentration subgroups. The findings indicated that participants with serum selenium concentrations exceeding the saturation threshold (2.56 µM) demonstrated an elevated risk of developing hypertension (weighted OR = 9.58; 95% CI = 2.74-33.46; P = 0.000) in comparison to those with serum selenium concentrations below the threshold. Subgroup analyses demonstrated that serum selenium concentrations exceeding the saturation threshold were associated with an increased risk of hypertension in participants with a BMI ≤ 35 kg/m2 (weighted OR = 9.11; 95% CI = 1.43-58.24; P = 0.030) or those aged less than 55 years or younger (weighted OR = 8.37; 95% CI = 1.71-40.94; P = 0.014). For obese adult males who require additional selenium supplementation to enhancing their overall health and well-being, it is strongly recommended that the serum selenium concentrations be monitored throughout the course of supplementation to ensure that they remain within the relatively safe range (approximately less than 215.75 µg/L).
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Affiliation(s)
- Bei Li
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, People's Republic of China
| | - Haiyan Ma
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, 518026, People's Republic of China
| | - Ying Yu
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, People's Republic of China
| | - Jieli Chen
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, People's Republic of China
| | - Shengnan He
- Department of Breast and Thyroid Surgery of Shenzhen Second People's Hospital, Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, People's Republic of China
| | - Lan Yang
- Department of Gastroenterology of Shenzhen Second People's Hospital, Health Science Center, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, People's Republic of China.
- Shenzhen Second People's Hospital, Health Science Center, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, People's Republic of China.
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Chen YF, Qi RQ, Song JW, Wang SY, Dong ZJ, Chen YH, Liu Y, Zhou XY, Li J, Liu XY, Zhong JC. Sirtuin 7 ameliorates cuproptosis, myocardial remodeling and heart dysfunction in hypertension through the modulation of YAP/ATP7A signaling. Apoptosis 2024; 29:2161-2182. [PMID: 39394530 DOI: 10.1007/s10495-024-02021-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2024] [Indexed: 10/13/2024]
Abstract
Myocardial fibrosis is a typical pathological manifestation of hypertension. However, the exact role of sirtuin 7 (SIRT7) in myocardial remodeling remains largely unclear. Here, spontaneously hypertensive rats (SHRs) and angiotensin (Ang) II-induced hypertensive mice were pretreated with recombinant adeno-associated virus (rAAV)-SIRT7, copper chelator tetrathiomolybdate (TTM) or copper ionophore elesclomol, respectively. Compared with normotensive controls, reduced SIRT7 expression and augmented cuproptosis were observed in hearts of hypertensive rats and mice with decreased FDX1 levels and increased HSP70 levels. Notably, intervention with rAAV-SIRT7 and TTM strikingly prevented DLAT oligomers aggregation, and elevated ATP7A and TOM20 expressions, contributing to the alleviation of cuproptosis, mitochondrial injury, myocardial remodeling and heart dysfunction in spontaneously hypertensive rats and Ang II-induced hypertensive mice. In cultured rat primary cardiac fibroblasts (CFs), rhSIRT7 alleviated CuCl2, Ang II or elesclomol-induced cuproptosis and fibroblast activation by blunting DLAT oligomers accumulation and downregulating α-SMA expression. Additionally, conditioned medium from rhSIRT7-pretreated CFs remarkably mitigated cellular hypertrophy and mitochondrial impairments of neonatal rat cardiomyocytes, as well as cell migration and polarization of RAW 264.7 macrophages. Importantly, verteporfin reduced CuCl2-induced cuproptosis, mitochondrial injury and fibrotic activation in CFs. Knockdown of ATP7A with si-ATP7A blocked cellular protective effects of rhSIRT7 and verteporfin in CFs. In conclusion, SIRT7 attenuates cuproptosis, myocardial fibrosis and heart dysfunction in hypertension through the modulation of YAP/ATP7A signaling. Targeting SIRT7 is of vital importance for developing therapeutic strategies in hypertension and hypertensive heart disorders.
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Affiliation(s)
- Yu-Fei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Rui-Qiang Qi
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jia-Wei Song
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Si-Yuan Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Zhao-Jie Dong
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yi-Hang Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Ying Liu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xin-Yu Zhou
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jing Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Xiao-Yan Liu
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jiu-Chang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
- Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
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Liu Y, Bao C, Wang H, Wei D, Zhang Z. Appraising the Role of Circulating Concentrations of Micronutrients in Hypertension: A Two-sample, Multivariable Mendelian Randomization Study. Glob Heart 2024; 19:81. [PMID: 39479260 PMCID: PMC11523844 DOI: 10.5334/gh.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 10/09/2024] [Indexed: 11/02/2024] Open
Abstract
Background Hypertension poses a significant global health challenge, warranting exploration of novel preventive measures. This study aimed to investigate the role of circulating concentrations of various micronutrients in hypertension using a Mendelian randomization (MR) approach. Methods Data on hypertension were obtained from FinnGen, comprising 55,917 cases and 162,837 controls of European ancestry. Fifteen micronutrients were evaluated and selected based on genome-wide association studies (GWAS) data. Instrumental single nucleotide polymorphisms (SNPs) were chosen according to strict criteria. Univariable Mendelian randomization (UVMR) analysis was conducted using the inverse variance weighted (IVW) method, supplemented by sensitivity analyses. Multivariate Mendelian randomization (MVMR) analysis was performed to assess interactions between micronutrients. Results In UVMR analysis, the IVW method revealed a potential influence of copper (OR = 1.052, 95% CI: 1.006-1.099, P = 0.025) and zinc (OR = 1.083, 95% CI: 1.007-1.165, P = 0.031) on hypertension. Sensitivity analyses supported these findings. MVMR analysis confirmed a direct positive effect of zinc on hypertension (OR = 1.087, 95% CI: 1.026-1.151, P = 0.005), while adjusting for zinc attenuated the effect of copper on hypertension (OR = 1.026, 95% CI: 0.987-1.066, P = 0.193). Conclusion Circulating zinc levels may be a potential risk factor for hypertension, while the association with other micronutrients remains inconclusive. These findings suggest that reducing zinc intake within a healthy range may help lower hypertension risk. Future research should further explore the role of zinc and nonlinear associations for a more comprehensive understanding.
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Affiliation(s)
- Yuting Liu
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Chenggong Bao
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Han Wang
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Dongsheng Wei
- The First Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Zhe Zhang
- Key Laboratory of Ministry of Education for TCM Viscera-State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
- Key Research Office of the State Central Management Bureau on the Treatment of Sputum and Stasis Diseases, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
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Mat Nasir N, Md Isa Z, Ismail NH, Ismail R, Mohd Tamil A, Jaafar MH, Mohamed Yassin MS, Zainol Abidin N, Ab Razak NH, Zulkifli A, Yusof KH. A cross-sectional analysis of the PURE study on minerals intake among Malaysian adult population with hypertension. Sci Rep 2024; 14:8590. [PMID: 38615144 PMCID: PMC11016102 DOI: 10.1038/s41598-024-59206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
Hypertension (HPT) is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. Currently, attention is given to various dietary approaches with a special focus on the role of micronutrient intake in the regulation of blood pressure. This study aims to measure the dietary intake of selected minerals among Malaysian adults and its association with HPT. This cross-sectional study involved 10,031 participants from the Prospective Urban and Rural Epidemiological study conducted in Malaysia. Participants were grouped into HPT if they reported having been diagnosed with high blood pressure [average systolic blood pressure (SBP)/average diastolic blood pressure (DBP) ≥ 140/90 mm Hg]. A validated food frequency questionnaire (FFQ) was used to measure participants' habitual dietary intake. The dietary mineral intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium, and zinc was measured. The chi-square test was used to assess differences in socio-demographic factors between HPT and non-HPT groups, while the Mann-Whitney U test was used to assess differences in dietary mineral intake between the groups. The participants' average dietary intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, sodium, and zinc was 591.0 mg/day, 3.8 mg/day, 27.1 mg/day, 32.4 mg/day, 0.4 mg/day, 1431.1 mg/day, 2.3 g/day, 27.1 µg/day, 4526.7 mg/day and 1.5 mg/day, respectively. The intake was significantly lower among those with HPT than those without HPT except for calcium and manganese. Continuous education and intervention should be focused on decreasing sodium intake and increasing potassium, magnesium, manganese, zinc, and calcium intake for the general Malaysian population, particularly for the HPT patients.
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Affiliation(s)
- Nafiza Mat Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Zaleha Md Isa
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia.
| | - Noor Hassim Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Rosnah Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Azmi Mohd Tamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Mohd Hasni Jaafar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Mohamed Syarif Mohamed Yassin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor Branch, Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Najihah Zainol Abidin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Department of Diagnostic and Allied Health Science, Faculty of Health and Life Sciences, Management and Science University, Shah Alam, Selangor, Malaysia
| | - Nurul Hafiza Ab Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
| | - Aziemah Zulkifli
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Institute for Environment and Development (LESTARI), Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Khairul Hazdi Yusof
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
- Risk Management Unit, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Cheras, Malaysia
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Wu K, Chen L, Kong Y, Zhuo J, Sun Q, Chang J. The association between serum copper concentration and prevalence of diabetes among US adults with hypertension (NHANES 2011-2016). J Cell Mol Med 2024; 28:e18270. [PMID: 38568081 PMCID: PMC10989603 DOI: 10.1111/jcmm.18270] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/17/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
The objective of this study was to examine the association between the serum copper concentration and the prevalence of diabetes among US adults with hypertension using the data from the National Health and Nutrition Examination Survey (NHANES). The study population was selected from adults aged over 20 years old in the three survey cycles of NHANES from 2011 to 2016. Logistic regression model analyses were applied to determine the independent risky effect of copper to the prevalence of diabetes. Also, a restricted cubic spline (RCS) model was performed to explore the potential nonlinear association between serum copper concentration and the prevalence of diabetes. A total of 1786 subjects (742 cases and 1044 controls) were included, and 924 were men (51.7%), and 742 (41.5%) were diabetic. Compared with non-diabetic individuals, the concentration of serum copper in diabetic patients with hypertension was higher. After adjusting for age, sex, race, education, marital status, body mass index (BMI), family poverty income ratio (PIR), smoking, alcohol drinking, physical activity, systolic blood pressure (SBP), diastolic blood pressure (DBP), and hyperlipidemia, the highest quartile of serum copper concentration significantly increased the risk of diabetes as compared with the lowest quartile (OR: 1.38, 95% CI: 1.01-1.92, ptrend = 0.036). The results of RCS analysis showed significant non-linear relationship between serum copper concentration and prevalence of diabetes (p-non-linear = 0.010). This study finds that serum copper concentration are significantly associated with risk of diabetes in hypertensive patients, which suggests copper as an important risk factor of diabetes development.
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Affiliation(s)
- Kaiming Wu
- Department of Chinese MedicineThe Second Affiliated Hospital of Guangdong Medical UniversityGuangdongChina
- Department of Chinese MedicineQingdao West Coast New Area People's HospitalQingdaoChina
| | - Lixia Chen
- Department of Chinese MedicineQingdao West Coast New Area People's HospitalQingdaoChina
| | - Yanyan Kong
- Rehabilitation Medicine DepartmentQingdao West Coast New Area People's HospitalQingdaoChina
| | - Jian‐Feng Zhuo
- Geriatrics DepartmentThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouChina
| | - Qiu Sun
- Surgery Teaching and Research OfficeHeilongjiang University of Chinese MedicineHarbinChina
| | - Jianfei Chang
- Department of Chinese MedicineThe Second Affiliated Hospital of Guangdong Medical UniversityGuangdongChina
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Wang X, Han X, Guo S, Ma Y, Zhang Y. Associations between patterns of blood heavy metal exposure and health outcomes: insights from NHANES 2011-2016. BMC Public Health 2024; 24:558. [PMID: 38389043 PMCID: PMC10882930 DOI: 10.1186/s12889-024-17754-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Extensive research has explored the association between heavy metal exposure and various health outcomes, including malignant neoplasms, hypertension, diabetes, and heart diseases. This study aimed to investigate the relationship between patterns of exposure to a mixture of seven heavy metals and these health outcomes. METHODS Blood samples from 7,236 adults in the NHANES 2011-2016 studies were analyzed for levels of cadmium, manganese, lead, mercury, selenium, copper, and zinc. Cluster analysis and logistic regression identified three distinct patterns of mixed heavy metal exposure, and their associations with health outcomes were evaluated. RESULTS Pattern 1 exhibited higher odds ratios (ORs) for malignancy during NHANES 2011-2012 (OR = 1.33) and 2015-2016 (OR = 1.29) compared to pattern 2. Pattern 3 showed a lower OR for malignancy during NHANES 2013-2014 (OR = 0.62). For hypertension, pattern 1 displayed higher ORs than pattern 2 for NHANES 2011-2012 (OR = 1.26), 2013-2014 (OR = 1.31), and 2015-2016 (OR = 1.41). Pattern 3 had lower ORs for hypertension during NHANES 2013-2014 (OR = 0.72) and 2015-2016 (OR = 0.67). In terms of heart diseases, pattern 1 exhibited higher ORs than pattern 2 for NHANES 2011-2012 (OR = 1.34), 2013-2014 (OR = 1.76), and 2015-2016 (OR = 1.68). Pattern 3 had lower ORs for heart diseases during NHANES 2013-2014 (OR = 0.59) and 2015-2016 (OR = 0.52). However, no significant trend was observed for diabetes. All three patterns showed the strongest association with hypertension among the health outcomes studied. CONCLUSIONS The identified patterns of seven-metal mixtures in NHANES 2011-2016 were robust. Pattern 1 exhibited higher correlations with hypertension, heart disease, and malignancy compared to pattern 2, suggesting an interaction between these metals. Particularly, the identified patterns could offer valuable insights into the management of hypertension in healthy populations.
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Affiliation(s)
- Xiangyu Wang
- Institute for Hospital Management of Henan Province, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, Zhengzhou, 450000, China
- Party Committee Office, Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xinhao Han
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Shufang Guo
- Department of Hematology and Oncology, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Yujie Ma
- Institute for Hospital Management of Henan Province, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, Zhengzhou, 450000, China.
| | - Yafeng Zhang
- Institute for Hospital Management of Henan Province, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, ErQi District, Zhengzhou, 450000, China.
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10
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Kerkadi A, Raïq H, Prince MS, Bader L, Soltani A, Agouni A. A cross-sectional analysis of zinc and copper levels and their relationship to cardiovascular disease risk markers in Qatar biobank participants. Front Cardiovasc Med 2024; 10:1305588. [PMID: 38250034 PMCID: PMC10796498 DOI: 10.3389/fcvm.2023.1305588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of mortality and morbidity worldwide. Dietary intake, particularly zinc (Zn) and copper (Cu) has been strongly associated with CVD. These trace elements play a crucial role in human enzyme activity, suppressing inflammation, catalyzing lipid metabolism enzymes, reducing oxidative stress, and regulating glucose metabolism. However, imbalances in these elements are linked to cardiovascular disturbances. Thus, this study aimed to investigate the association between circulating levels of Zn, Cu, and Zn/Cu ratio with CVD risk factors in the Qatari population. Bivariate logistic regression, adjusted for age, nationality, gender, and education was performed to examine the impact of Zn, Cu, and Zn/Cu ratio (as independent variables) on major CVD risk markers (as dependent variables). Participants in the highest Zn tertiles (T2 and T3) were at greater odds ratio (OR) of unfavorable metabolic functions such as elevated HbA1C [OR = 2.5, p = 0.015 (T2) and OR = 3.2, p = 0.002 (T3)], triglycerides [OR = 2.17, p = 0.015 (T2), and TyG index [OR = 2.21, p = 0.004 (T2), and OR = 2.67, p < 0.001 (T3)] compared to T1. Conversely, they had significantly lower ORs for prolonged prothrombin time [OR = 0.37, p = 0.001 (T3)]. Higher levels of Cu (T2 and T3) had higher OR for elevated HDL-C levels [OR = 1.69, p = 0.046 (T2), and OR = 2.27, p = 0.002 (T3)] and lower OR for elevated levels of triglycerides (OR = 0.4, p = 0.009, T3), diastolic blood pressure [OR = 0.41, p = 0.024 (T2), and OR = 0.47, p = 0.049 (T3)], and creatinine kinase (OR = 0.27, p = 0.014, T3) compared to T1. Higher levels of Cu (T2 and T3) were associated with a higher risk for elevated fibrinogen levels [OR = 3.1, p = 0.035 (T2), and OR = 5.04, p = 0.002 (T3)]. Additionally, higher Zn/Cu ratio (T2 and T3) were associated with lower ORs for elevated fibrinogen levels [OR = 0.3, p = 0.005 (T2), and OR = 0.27, p = 0.005 (T3)] compared to T1, indicating a lower risk of developing CVD. The study reveals a link between Zn, Cu, and the Zn/Cu ratio and cardiovascular disease risk. A higher Zn/Cu ratio may protect against CVD, while elevated Cu levels are linked to obesity, fibrinogen levels, and HbA1C. Maintaining optimal levels of these trace elements, either through diet or supplementation, may help reduce CVD risk.
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Affiliation(s)
- Abdelhamid Kerkadi
- Department of Patient Care & Health Technology, College of Health Sciences, University of Doha for Science and Technology, Doha, Qatar
| | - Hicham Raïq
- Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Mohammad Shoaib Prince
- Sport and Wellness Department, University of Doha for Science and Technology (UDST), Doha, Qatar
| | - Loulia Bader
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Abderrezzaq Soltani
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Office of Vice President for Health & Medical Sciences, Qatar University, Doha, Qatar
| | - Abdelali Agouni
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- Office of Vice President for Research & Graduate Studies, Qatar University, Doha, Qatar
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11
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Zhao H, Mei K, Hu Q, Wu Y, Xu Y, Qinling, Yu P, Deng Y, Zhu W, Yan Z, Liu X. Circulating copper levels and the risk of cardio-cerebrovascular diseases and cardiovascular and all-cause mortality: A systematic review and meta-analysis of longitudinal studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 340:122711. [PMID: 37852312 DOI: 10.1016/j.envpol.2023.122711] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/21/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Copper is an essential trace element in the human body; its relationship with cardio-cerebrovascular diseases (CCVDs) remains unclear. This study aimed to comprehensively investigate the association between circulating copper concentrations and CCVD risk and mortality. METHODS We searched the PubMed, Cochrane Library, Embase, Scopus, and Web of Knowledge databases for cohort studies reporting associations between circulating copper concentrations and cardiovascular diseases and mortality published up to August 23, 2023. Effect sizes were pooled using random-effects models. We graded the certainty of the evidence by the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework. RESULTS Our analysis included 47,813 patients across 17 cohort studies. Elevated circulating copper levels were linked to the risk of stroke (OR = 1.52; 95% CI 1.30-1.78), coronary artery disease mortality (RR = 2.77; 95% CI 1.82-4.19), cardiovascular mortality (RR = 1.79; 95% CI 1.52-2.11), and all-cause mortality (RR = 1.56; 95% CI 1.35-1.79) but not the risk of acute myocardial infarction (RR = 2.01; 95% CI 0.63-6.47). Continuous analysis (per 20 μg/dl increase) showed consistent results regarding the association between copper levels and stroke incidence (OR = 1.23; 95% CI 1.14-1.33), cardiovascular mortality (HR = 1.28; 95% CI 1.07-1.53) and all-cause mortality (HR = 1.22; 95% CI 1.04-1.44). Except for the low certainty of evidence of acute myocardial infarction incidence, all outcomes had moderate certainty of evidence. CONCLUSION Excessive circulating copper levels are associated with stroke, coronary artery disease mortality, cardiovascular mortality, and all-cause mortality with moderate certainty.
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Affiliation(s)
- Huilei Zhao
- Department of Anesthesiology, the Third Hospital of Nanchang, Nanchang, Jiangxi, China
| | - Kaibo Mei
- Department of Anesthesiology, the People's Hospital of Shangrao, Shangrao, Jiangxi, China
| | - Qingwen Hu
- Department of Metabolism and Endocrinology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yifan Wu
- Department of Metabolism and Endocrinology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yi Xu
- Department of Metabolism and Endocrinology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qinling
- Department of Metabolism and Endocrinology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Peng Yu
- Department of Metabolism and Endocrinology, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - You Deng
- Department of Cardiology, the Third People's Hospital of Pingxiang, Pingxiang, Jiangxi, China
| | - Wengen Zhu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ziwei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Xiao Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou Key Laboratory of Molecular Mechanism and Translation in Major Cardiovascular Disease, Sun Yat-Sen University, Guangzhou, Guangdong, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Guangzhou, Guangdong, China.
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12
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Heidari Seyedmahalleh M, Montazer M, Ebrahimpour-Koujan S, Azadbakht L. The Effect of Zinc Supplementation on Lipid Profiles in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Dose-Response Meta-Analysis of Randomized Clinical Trials. Adv Nutr 2023; 14:1374-1388. [PMID: 37604307 PMCID: PMC10721485 DOI: 10.1016/j.advnut.2023.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/20/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
Research on the effects of zinc supplementation on lipid profiles in people with type 2 diabetes mellitus (T2DM) has been inconsistent. This systematic review and meta-analysis was performed to summarize the current data on the effects of zinc supplementation on lipid profiles in patients with T2DM. Three online databases including PubMed, Scopus, and Web of Science were searched to find relevant studies published until September 2022. The exposure was zinc supplementation, and the outcomes were low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and total cholesterol (TC). Fourteen randomized clinical trials consisting of 1067 patients were included in the statistical analysis. Significant improvement was observed in all 4 lipid profile components. Following zinc supplementation, a significant decrease was observed in TC (weighted mean difference [WMD]: -16.16; 95% confidence interval [CI]: -26.43, -5.89; P = 0.002), LDL (WMD: -6.18; 95% CI: -9.35, -3.02; P < 0.001), and TG (WMD: -13.08; 95% CI: -21.83, -4.34; P = 0.003). After analyzing 13 studies reporting HDL, a significant increase was seen (WMD: 3.76; 95% CI: 1.30, 6.22; P = 0.003). In a nonlinear dose-response analysis, a significant inverse association was observed between <12 wk zinc supplementation and TC, LDL, and TG (TC: WMD: -5, Pnonlinearity < 0.001; LDL: WMD: -5, Pnonlinearity = 0.07, TG: WMD: -16.5, Pnonlinearity = 0.006). Nonlinear dose-response analysis shows that the optimum elemental zinc dosage for the best response to the supplementation for TC, LDL, and TG are 120, 100, and 140 mg/d, respectively (TC: WMD: -5, Pnonlinearity < 0.001; LDL: WMD: -10, Pnonlinearity = 0.006, TG: WMD: -50, Pnonlinearity = 0.031). In conclusion, we found significant changes in all 4 components of the lipid profile through zinc supplementation in T2DM patients. Based on our findings, zinc supplementation may have profound favorable consequences on the lipid profile of T2DM patients, especially in the zinc-deficient group.
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Affiliation(s)
- Mohammad Heidari Seyedmahalleh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Montazer
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Soraiya Ebrahimpour-Koujan
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Disease Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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13
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Xu RN, Zhang Y, Xu X, Li X, He L, Feng Q, Yang YH, He Y, Ma X, He YM. Serum Copper Concentrations, Effect Modifiers and Blood Pressure: Insights from NHANES 2011-2014. J Cardiovasc Dev Dis 2023; 10:432. [PMID: 37887879 PMCID: PMC10607875 DOI: 10.3390/jcdd10100432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/01/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: Epidemiological studies on the relationship between serum copper and hypertension are contradictory. We assessed the relationship between serum copper and blood pressure among adults in the United States. (2) Methods: We divided hypertension into two categories: treated hypertension and untreated hypertension. Linear or logistic regression analysis was applied to investigate the association between serum copper concentrations and blood pressure levels. (3) Results: As compared to quartile 1, the odds ratios (ORs) for untreated hypertension in quartiles 2, 3, and 4 were 1.02 (0.74-1.42), 1.23 (0.88-1.72), and 1.08 (0.74-1.58), respectively, in multivariable analysis (all p > 0.05). In non-hypertension, as compared with quartile 1, the β (95% CI) of systolic blood pressure for quartiles 2, 3, and 4 was -0.92 (-2.07-0.23), -0.05 (-1.30-1.20), and -0.48 (-1.83-0.88), respectively, in multivariable analysis (all p > 0.05). As compared to quartile 1, the ORs for treated hypertension in quartiles 2, 3, and 4 were 1.36 (0.88-2.10), 1.35 (0.87-2.09), and 1.56 (0.98-2.47), respectively, upon multivariable analysis including antihypertensive medication use as a covariate (all p > 0.05). Furthermore, 1SD increase in serum copper was non-significantly associated with 1.16 (0.97-1.37)-fold increased risk of hypertension in multivariable analysis (p = 0.096). (4) Conclusion: In the present study, we discovered that the serum copper concentration was not related with hypertension or blood pressure levels. Antihypertensive drug use may distort the correlation between copper and blood pressure levels. Information on antihypertensive drug use may be taken into account when identifying new risk factors for hypertension.
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Affiliation(s)
- Ruo-Nan Xu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Yue Zhang
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Xin Xu
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Xu Li
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Lan He
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
- Division of Ultrasound, The Shanghai Municipal No 8 People’s Hospital, 8 Caobao Street, Shanghai 200000, China
| | - Qiang Feng
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Yong-Hai Yang
- Division of Cardiology, Suzhou Yongding Hospital, 1388 Gaoxin Street, Suzhou 215299, China;
| | - Yang He
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Xiao Ma
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
| | - Yong-Ming He
- Division of Cardiology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, China; (R.-N.X.); (Y.Z.); (X.X.); (X.L.); (L.H.); (Q.F.); (Y.H.)
- Division of Cardiology, Suzhou Yongding Hospital, 1388 Gaoxin Street, Suzhou 215299, China;
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14
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Mohtashamian A, Soleimani A, Gilasi HR, Kheiripour N, Moeini Taba SM, Sharifi N. Association of Zinc Status with Matrix Metalloproteinases, Advanced Glycation End-Products, and Blood Pressure in Patients with Chronic Kidney Disease. Biol Trace Elem Res 2023; 201:4275-4285. [PMID: 36515817 DOI: 10.1007/s12011-022-03524-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
Inflammation, oxidative stress, and hypertension trigger the development of chronic kidney disease (CKD). Zinc is known to have antioxidant and anti-inflammatory properties and a possible role in regulating blood pressure. The aim of this study was to investigate the correlation of serum zinc with matrix metalloproteinase-2 and-9 (MMP-2, MMP-9), advanced glycation end products (AGEs), and blood pressure in patients with CKD. This cross-sectional study included 90 patients with CKD. Serum zinc and the levels of MMP-2, MMP-9, AGEs, and creatinine were measured using validated biochemical methods. Three 24-h food recalls were completed to evaluate dietary zinc intake. Systolic and diastolic blood pressure (SBP, DBP) were measured using a digital sphygmomanometer. Participants' mean age was 60.68 ± 8.81 years. The prevalence of zinc deficiency in our participants was 10%. Serum zinc was negatively correlated with MMP-9 (r = - 0.231, p = 0.032) and creatinine (r = - 0.304, p = 0.004). However, after adjusting for confounding variables, the association between serum zinc and MMP-9 was near the significance level (β = - 0.174, p = 0.09) and zinc remained in the model as one of the predictors. Serum zinc was positively correlated with the dietary intake of zinc (r = 0.241, p = 0.025) and estimated glomerular filtration rate (eGFR) (r = 0.259, p = 0.015). In conclusion, our results showed that serum zinc might be one of the predictors of serum MMP-9 in patients with CKD. In addition, serum zinc was positively associated with its dietary intake and eGFR. Future longitudinal studies or clinical trials are required to reveal any causal association between zinc status and profibrotic or inflammatory biomarkers among patients with CKD.
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Affiliation(s)
- Abbas Mohtashamian
- Student Research Committee, Department of Nutrition, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Soleimani
- Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Gilasi
- Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Nejat Kheiripour
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Basic Science Research Institute, Kashan University of Medical Sciences, Kashan, 87159-734741, Iran
| | - Seyed Masoud Moeini Taba
- Department of Internal Medicine, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Nasrin Sharifi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Basic Science Research Institute, Kashan University of Medical Sciences, Kashan, 87159-734741, Iran.
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15
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Yang L, Yang P, Lip GYH, Ren J. Copper homeostasis and cuproptosis in cardiovascular disease therapeutics. Trends Pharmacol Sci 2023; 44:573-585. [PMID: 37500296 DOI: 10.1016/j.tips.2023.07.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/08/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
Copper (Cu) homeostasis is gaining increasing attention in human health as both Cu overload and deficiency evokes pathological changes including cardiovascular diseases (CVDs). Cu supplementation, nanocarriers, and chelators have all exhibited therapeutic promise in some human diseases, although how Cu dyshomeostasis and cuproptosis, a novel form of regulated cell death, contribute to CVD pathology remains elusive. Here, we discuss Cu dyshomeostasis and the potential role of cuproptosis in various CVDs. We evaluate underlying cellular mechanisms, aiming to provide some insights regarding the utility of targeting Cu dyshomeostasis and cuproptosis as a novel strategy in the management of CVDs.
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Affiliation(s)
- Lifang Yang
- Department of Anesthesiology, Xi'an Children Hospital, Xi'an, Shaanxi, China
| | - Pingping Yang
- Department of Anesthesiology, Xi'an Children Hospital, Xi'an, Shaanxi, China
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jun Ren
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, USA.
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16
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Lei L, Zhang F, Huang J, Yang X, Zhou X, Yan H, Chen C, Zheng S, Si L, Jose PA, Zeng C, Yang J. Selenium deficiency causes hypertension by increasing renal AT 1 receptor expression via GPx1/H 2O 2/NF-κB pathway. Free Radic Biol Med 2023; 200:59-72. [PMID: 36868433 PMCID: PMC10164092 DOI: 10.1016/j.freeradbiomed.2023.02.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
Epidemiological studies show an association between low body selenium and the risk of hypertension. However, whether selenium deficiency causes hypertension remains unknown. Here, we report that Sprague-Dawley rats fed a selenium-deficient diet for 16 weeks developed hypertension, accompanied with decreased sodium excretion. The hypertension of selenium-deficient rats was associated with increased renal angiotensin II type 1 receptor (AT1R) expression and function that was reflected by the increase in sodium excretion after the intrarenal infusion of the AT1R antagonist candesartan. Selenium-deficient rats had increased systemic and renal oxidative stress; treatment with the antioxidant tempol for 4 weeks decreased the elevated blood pressure, increased sodium excretion, and normalized renal AT1R expression. Among the altered selenoproteins in selenium-deficient rats, the decrease in renal glutathione peroxidase 1 (GPx1) expression was most prominent. GPx1, via regulation of NF-κB p65 expression and activity, was involved in the regulation of renal AT1R expression because treatment with dithiocarbamate (PDTC), an NF-κB inhibitor, reversed the up-regulation of AT1R expression in selenium-deficient renal proximal tubule (RPT) cells. The up-regulation of AT1R expression with GPx1 silencing was restored by PDTC. Moreover, treatment with ebselen, a GPX1 mimic, reduced the increased renal AT1R expression, Na+-K+-ATPase activity, hydrogen peroxide (H2O2) generation, and the nuclear translocation of NF-κB p65 protein in selenium-deficient RPT cells. Our results demonstrated that long-term selenium deficiency causes hypertension, which is due, at least in part, to decreased urine sodium excretion. Selenium deficiency increases H2O2 production by reducing GPx1 expression, which enhances NF-κB activity, increases renal AT1R expression, causes sodium retention and consequently increases blood pressure.
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Affiliation(s)
- Lifu Lei
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fuwei Zhang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Huang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyue Yang
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China; Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, PR China
| | - Xiaoxin Zhou
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongjia Yan
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Caiyu Chen
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China; Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, PR China
| | - Shuo Zheng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China; Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, PR China
| | - Liangyi Si
- Department of Cardiology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Pedro A Jose
- Division of Renal Diseases & Hypertension, Department of Medicine and Department of Physiology and Pharmacology, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Chunyu Zeng
- Department of Cardiology, Daping Hospital, The Third Military Medical University, Chongqing, China; Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, PR China.
| | - Jian Yang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China; Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Abstract
Zinc is structurally and functionally essential for more than 300 enzymes and 2000 transcription factors in human body. Intracellular labile zinc is the metabolically effective zinc and tiny changes in its concentrations significantly affect the intracellular signaling and enzymatic responses. Zinc is crucial for the embrionic and fetal development of heart. Therefore, it is shown to be related with a variety of congenital heart defects. It is involved in epithelial-to-mesenchymal transformation including endocardial cushion development, which is necessary for atrioventricular septation as well as the morphogenesis of heart valves. In atherosclerosis, monocyte endothelial adhesion, and diapedesis, activation and transformation into macrophages and forming foam cells by the ingestion of oxidized LDL are monocyte related steps which need zinc. Intracellular zinc increases intracellular calcium through a variety of pathways and furthermore, zinc itself can work as a second messenger as calcium. These demonstrate the significance of intracellular zinc in heart failure and arterial hypertension. However, extracellular zinc has an opposite effect by blocking calcium channels, explaining decreased serum zinc levels, contrary to the increased cardiomyocyte and erythrocyte zinc levels in hypertensive subjects. These and other data in the literature demonstrate that zinc has important roles in healthy and diseased cardiovascular system but zinc-cardiovascular system relationship is so complex that, it has not been explained in all means. In this article, we try to review some of the available knowledge about this complex relationship.
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Affiliation(s)
- Serhan Ozyildirim
- Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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18
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Li Z, Kuang H, Li L, Wu M, Liao Z, Zeng K, Ye Y, Fan R. What adverse health effects will environmental heavy metal co-exposure bring us: based on a biological monitoring study of sanitation workers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:35769-35780. [PMID: 36538233 DOI: 10.1007/s11356-022-24805-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
To investigate the relationship between health effect profile and co-exposure to heavy metal, 254 sanitation workers from Guangzhou, China, were recruited. Ten urinary metals were determined by inductively coupled plasma mass spectrometry. Parameters of physical examination, including blood lipid metabolism, renal function, blood pressure, and lung function, were tested for each participant. The hazard quotients (HQs) of eight heavy metals were evaluated. Cobalt, copper (Cu), molybdenum (Mo), nickel (Ni), and tin (Sn) demonstrated the top five associations with human health with the ∑19β as 2.220, 1.351, 1.234, 0.957, and 0.930, respectively. Most physical examination parameters of workers were under the normal ranges, except the levels of forced mid expiratory flow rate (MMEF75/25), the maximum expiratory flow rate at 25% vital capacity (MEF25) and apolipoprotein B in the first quartile, and the level of uric acid in the third quartile of sanitation works. Moreover, Cu was significantly associated with diastolic pressure, pulse, and high density lipid (p < 0.05). Each unit increase in Mo level was related to a 120% increase odd ratio (OR) of abnormal of systolic pressure, but was significantly and negatively correlated with high density lipoprotein and apolipoprotein A, suggesting that Mo exposure may be a risk factor of cardiovascular disease. Each unit increase in Ni and Sn levels was associated with an increased OR of abnormal rate of MMEF75/25 and MEF25 (p < 0.001), suggesting the increasing risks of respiratory diseases. Sanitation workers exposed to Ni and Pb alone had no carcinogenic risks (HQ < 1). However, 23.8%, 34.6%, and 87.3% of sanitation workers confronted non-carcinogenic risks when exposed to Cu, Mo alone (HQ > 1), or co-exposed to the four heavy metals (HI > 1). Our study preliminarily revealed the potential sensitive health indicators of heavy metal co-exposure, which will provide beneficial health protection suggestions for the occupational populations.
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Affiliation(s)
- Zhilin Li
- South China Normal University-Panyu Central Hospital Joint Laboratory of Basic and Translational Medical Research, Guangzhou Panyu Central Hospital, Guangzhou, 511486, China
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
| | - Hongxuan Kuang
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
| | - Leizi Li
- South China Normal University-Panyu Central Hospital Joint Laboratory of Basic and Translational Medical Research, Guangzhou Panyu Central Hospital, Guangzhou, 511486, China
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
| | - Maorong Wu
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
| | - Zengquan Liao
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
| | - Keqin Zeng
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
| | - Yufeng Ye
- South China Normal University-Panyu Central Hospital Joint Laboratory of Basic and Translational Medical Research, Guangzhou Panyu Central Hospital, Guangzhou, 511486, China.
- Medical Imaging Institute of Panyu, Guangzhou, 511486, China.
| | - Ruifang Fan
- South China Normal University-Panyu Central Hospital Joint Laboratory of Basic and Translational Medical Research, Guangzhou Panyu Central Hospital, Guangzhou, 511486, China
- Guangzhou Key Laboratory of Subtropical Biodiversity and Biomonitoring and Guangdong Provincial Engineering Technology Research Center for Drug and Food Biological Resources Processing and Comprehensive Utilization, School of Life Sciences, South China Normal University, Guangzhou, 510631, China
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19
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Szadkowska I, Kostka T, Wlazeł RN, Kroc Ł, Jegier A, Guligowska A. Dietary Zinc Is Associated with Cardiac Function in the Older Adult Population. Antioxidants (Basel) 2023; 12:antiox12020265. [PMID: 36829824 PMCID: PMC9952641 DOI: 10.3390/antiox12020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
The elderly is a group at particularly high cardiovascular risk. The coexistence of chronic diseases and use of multiple medications creates the need to look for non-pharmacological agents to improve cardiovascular health in that population. In view of reports on the potential role of zinc in enhancing pathways of myocardial tissue repair, the aim of this study was to evaluate the association between dietary zinc intake and cardiac structure and function in individuals of advanced age. The study group included 251 community-dwelling patients, with a median age of 80 years. Dieta 6.0 software was used for calculation of zinc consumption. Percentage of Recommended Dietary Allowance (RDA) for zinc correlated with left ventricular ejection fraction (LVEF) (r = 0.196, p < 0.05), left ventricular mass index (r = -0.137, p < 0.05) and tricuspid annular plane systolic excursion (TAPSE) (r = 0.153, p < 0.05), while zinc density did so with E/E' ratio (r = -0.127, p < 0.05). In a multiple stepwise regression analysis, the best determinants of LVEF were %RDA for zinc (p = 0.014; β = 0.143), presence of coronary artery disease (p < 0.001; β = -0.39) and age (p = 0.036; β = -0.12). Furthermore, %RDA for zinc (p = 0.009; β = 0.16), female sex (p = 0.005; β = -0.171), beta-blocker use (p = 0.024; β = -0.136), body mass index (p = 0.008; β = 0.16) and heart rate (p = 0.0006; β = -0.209) had an independent effect on TAPSE. In conclusion, in individuals of very advanced age, lower zinc intake is associated with poorer cardiac function. Therefore, increasing the recommended zinc intake in this group deserves consideration.
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Affiliation(s)
- Iwona Szadkowska
- Department of Sports Medicine, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland
| | - Rafał Nikodem Wlazeł
- Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Łukasz Kroc
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland
| | - Anna Jegier
- Department of Sports Medicine, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Plac Hallera 1, 90-647 Lodz, Poland
- Correspondence:
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20
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Nyulas KI, Germán-Salló M, Fazakas Z, Preg Z, Pál T, Pál S, Tripon RG, Cseh MJ, Simon-Szabó Z, Arbănași EM, Nemes-Nagy E. Relationship between Nutrition, Lifestyle Habits and Laboratory Parameters in Hypertensive Patients with/without Cognitive Dysfunction. Life (Basel) 2023; 13:311. [PMID: 36836668 PMCID: PMC9960921 DOI: 10.3390/life13020311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
(1) Background: Cognitive dysfunction is a major concern in hypertensive patients. Lifestyle habits and nutrition influence laboratory parameters, with an impact on clinical course. The objective of the study was to evaluate nutrition and lifestyle habits in hypertensive patients with/without cognitive dysfunction and establish correlations to laboratory parameters. MATERIAL AND METHODS 50 patients admitted to the Cardiovascular Rehabilitation Clinic in Târgu Mureș were enrolled in this study between March-June 2021. We evaluated their cognitive function, and they filled in a questionnaire about lifestyle and nutrition. Biochemical blood tests were performed using a Konelab Prime 60i analyzer. IBM-SPSS22 and GraphPad InStat3 were used for statistics. RESULTS Mean age of hypertensive patients (n = 50) was 70.42 ± 4.82 (SD) years, half of them had cognitive dysfunction. Zinc deficiency was present in 74% of the subjects. The subgroup with cognitive dysfunction had significantly higher BMI (p = 0.009) and microalbuminuria (p = 0.0479), as well as significantly lower magnesium intake (p = 0.032) and cholesterol intake (p = 0.022), compared to those with normal cognitive status. CONCLUSIONS Nutrition is in a close relationship with laboratory parameters; significant differences (microalbuminuria, cholesterol intake, BMI, etc.) are present between hypertensive patients with/without cognitive dysfunction. A healthy diet is important for the maintenance of metabolic balance, the achievement of optimal body weight, and the prevention of complications.
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Affiliation(s)
- Kinga-Ilona Nyulas
- Doctoral School of GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Márta Germán-Salló
- Department of Internal Medicine II, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zita Fazakas
- Department of Biochemistry and Chemistry of Environmental Factors, Faculty of Pharmacy, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zoltán Preg
- Department of General Medicine, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Tünde Pál
- Emergency Institute for Cardiovascular Diseases and Transplantation, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Sándor Pál
- Department of Laboratory Medicine, Department of Transfusion Medicine, Medical School, University of Pécs, H-7622 Pécs, Hungary
| | - Robert Gabriel Tripon
- Department of Ophthalmology, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Margit Judit Cseh
- Nutrition and Dietetics Deparment, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Zsuzsánna Simon-Szabó
- Department of Pathophysiology, Faculty of Medicine, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
| | - Emil Marian Arbănași
- Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Târgu Mureș, Romania
| | - Enikő Nemes-Nagy
- Department of Chemistry and Medical Biochemistry, Faculty of Medicine in English, GE Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540136 Târgu Mureş, Romania
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21
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J-shaped association between dietary zinc intake and new-onset hypertension: a nationwide cohort study in China. Front Med 2022; 17:156-164. [PMID: 36562951 DOI: 10.1007/s11684-022-0932-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
Abstract
We aimed to investigate the relationship of dietary zinc intake with new-onset hypertension among Chinese adults. A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was assessed by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with systolic blood pressure ≽ 140 mmHg or diastolic blood pressure ≽ 90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up were defined as having new-onset hypertension. During a median follow-up duration of 6.1 years, 4269 participants developed new-onset hypertension. Overall, the association between dietary zinc intake and new-onset hypertension followed a J-shape (P for non-linearity < 0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary zinc intake (per mg/day: hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.88-0.98) in participants with zinc intake < 10.9 mg/day, and increased with the increment of zinc intake (per mg/day: HR 1.14; 95% CI 1.11-1.16) in participants with zinc intake ≽ 10.9 mg/day. In conclusion, there was a J-shaped association between dietary zinc intake and new-onset hypertension in general Chinese adults, with an inflection point at about 10.9 mg/day.
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22
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Influence of zinc levels and Nrf2 expression in the clinical and pathological changes in patients with diabetic nephropathy. Nutr Diabetes 2022; 12:37. [PMID: 35933424 PMCID: PMC9357008 DOI: 10.1038/s41387-022-00212-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/14/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022] Open
Abstract
Objective We investigated the correlation between zinc levels and Nrf2 expression and potential effects on the clinicopathology of patients with diabetic nephropathy (DN). Methods We selected 30 patients with DN, diagnosed via renal biopsy at our hospital from March 2018 to November 2019, and enrolled 30 healthy individuals from a medical examination center as the control group. Patients with DN were divided into normal-zinc and low-zinc groups. We detected the levels of zinc, copper, and Nrf2 mRNA in their serum, and collected the clinical and pathological data of DN patients. Results Serum zinc level and Nrf2 mRNA expression were significantly decreased in patients with DN compared to those of healthy people (P < 0.05). Of the 30 patients, 16 had low zinc (53.3%) and 14 had normal zinc levels (46.7%). There was no significant difference in the blood Nrf2 mRNA expression between the two groups (P > 0.05). However, the expression of Nrf2 in the kidney tissue of the low-zinc group was significantly lower compared to the normal-zinc group (P < 0.05). Diastolic blood pressure and copper levels were significantly higher in the low-zinc group (P < 0.05). In contrast, body mass index, red blood cell count, Hb level, and the ratio of zinc to copper were significantly lower in the low-zinc group (P < 0.05). The pathological classifications of the low-zinc group were more severe (P < 0.05). Conclusion Patients with DN were more likely to have zinc deficiency and lower expression of Nrf2. Additionally, DN patients with zinc deficiency were prone to have more severe clinical and pathological manifestations.
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23
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Cui Z, Chen H, Lu W, Wang P, Zhou Z, Zhang N, Wang Z, Lin T, Song Y, Liu L, Huang X, Chen P, Tang G, Gao J, Duan Y, Wang B, Zhang H, Xu X, Yang Y, Qin X, Meng H. The Association Between Plasma Copper Concentration and Prevalence of Diabetes in Chinese Adults With Hypertension. Front Public Health 2022; 10:888219. [PMID: 35747779 PMCID: PMC9210921 DOI: 10.3389/fpubh.2022.888219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022] Open
Abstract
Objective The relationship between plasma copper concentration and prevalence of diabetes in adults with hypertension is unclear. We aimed to determine the association between plasma copper concentration and prevalence of diabetes in Chinese adults with hypertension. Methods A total of 2,579 participants (697 cases and 1,882 controls) was included in this cross-sectional study. Plasma copper concentrations were determined by inductively coupled plasma mass spectrometry. Multivariable logistic regression model was used to determine the association between plasma copper concentration and prevalence of diabetes. Results According to the logistic regression analyses, the adjusted OR for the prevalence of diabetes in participants with plasma copper concentration ≥109.4 μg/dL was 1.26 (1.00, 1.58) compared with those with plasma copper concentration <109.4 μg/dL (P = 0.048). The association was no longer significant following further adjusting for serum high-density lipoprotein cholesterol (HDL-C) concentration as a potential confounder. Stratified analyses demonstrated that serum HDL-C concentration significantly modified the association between plasma copper concentration and prevalence of diabetes (P-interaction = 0.043). In the strata of serum HDL-C concentration ≥1.2 mmol/L, a 56% increased prevalence of diabetes was observed in participants with plasma copper concentration ≥109.4 μg/dL compared with those with plasma copper concentration <109.4 μg/dL (P = 0.008). No significant relationship between plasma copper concentration and prevalence of diabetes was found in other strata. Conclusion Our findings suggested that high plasma copper concentration (≥109.4 μg/dL) was associated with increased prevalence of diabetes in Chinese hypertensive adults with serum HDL-C concentration ≥1.2 mmol/L.
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Affiliation(s)
- Zhixin Cui
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hong Chen
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Wenhai Lu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Department of Disease Control and Prevention, Pingdi Center for Public Health Service of Longgang District Shenzhen Municipality, Shenzhen, China
| | - Ping Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Ziyi Zhou
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Department of Clinical Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Nan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Lishun Liu
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Department of Clinical Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xiao Huang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Genfu Tang
- School of Heath Administration, Anhui Medical University, Hefei, China
| | - Juan Gao
- Department of Neurology, Baoding First Central Hospital, Baoding, China
| | - Yong Duan
- Yunnan Key Laboratory of Laboratory Medicine, Kunming, China
- Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Binyan Wang
- Department of Clinical Research, Shenzhen Evergreen Medical Institute, Shenzhen, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Xiping Xu
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Yang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Nutrition Translation, Guangzhou, China
| | - Xianhui Qin
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huicui Meng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Nutrition Translation, Guangzhou, China
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24
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He P, Li H, Liu C, Liu M, Zhang Z, Zhang Y, Zhou C, Li Q, Ye Z, Wu Q, Jiang J, Wang G, Liang M, Nie J, Hou FF, Qin X. U-shaped association between dietary copper intake and new-onset hypertension. Clin Nutr 2022; 41:536-542. [PMID: 35030528 DOI: 10.1016/j.clnu.2021.12.037] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/10/2021] [Accepted: 12/26/2021] [Indexed: 02/02/2023]
Abstract
AIMS To investigate the relationship of dietary copper intake with new-onset hypertension among Chinese adults. METHODS A total of 12,245 participants who were free of hypertension at baseline from the China Health and Nutrition Survey (CHNS) were included. Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. New-onset hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up. RESULTS During a median follow-up of 6.1 years, 4304 participants developed new-onset hypertension. Overall, the associations between dietary copper intake and new-onset hypertension followed a U-shape (P for nonlinearity <0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary copper intake (per SD increment: HR, 0.71; 95% CI, 0.57-0.88) in participants with copper intake <1.57 mg/day, and increased with the increment of dietary copper intake (per SD increment: HR, 1.09; 95% CI: 1.07-1.12) in participants with copper intake ≥1.57 mg/day. CONCLUSIONS There was a U-shaped association between dietary copper intake and new-onset hypertension in general Chinese adults, with an inflection point at about 1.57 mg/day. Our results emphasized the importance of maintaining optimal copper intake levels for the primary prevention of hypertension.
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Affiliation(s)
- Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chengzhang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Qinqin Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Jianping Jiang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Guobao Wang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Min Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Jing Nie
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
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Kerkadi A, Alkudsi DS, Hamad S, Alkeldi HM, Salih R, Agouni A. The Association between Zinc and Copper Circulating Levels and Cardiometabolic Risk Factors in Adults: A Study of Qatar Biobank Data. Nutrients 2021; 13:nu13082729. [PMID: 34444889 PMCID: PMC8398315 DOI: 10.3390/nu13082729] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/16/2022] Open
Abstract
Cardiometabolic risk (CMR) factors increase the likelihood of developing cardiovascular diseases (CVD). In Qatar, 24% of the total deaths are attributed to CVDs. Several nutritional disturbances have been linked to high risk of CVD. Many studies have discussed the effects of zinc (Zn) and copper (Cu) on CMR factors; however, evidence has been controversial. This investigated the association between CMR factors and the status of Zn and Cu, in addition to Zn/Cu ratio. A total of 575 Qatari men and women aged 18 years and older were obtained from Qatar Biobank. Plasma levels of Zn and Cu were determined using inductively coupled plasma mass spectrometry (ICP-MS). Anthropometric data and CMR factors were determined using standard methods. Adjusted associations between trace minerals and CMR were estimated by logistic regression. Partial correlation was performed to test the strength of the associations. Zn was not strongly correlated (p-value ˃ 0.01) or significantly associated with CMR factors and metabolic syndrome (MetS). Cu levels correlated positively with body mass index (BMI) (0.23; p ˂ 0.001), pulse rate (PR) (0.18; p ˂ 0.001), total cholesterol (0.13; p = 0.01), and high-density lipoproteins (HDL) (0.27; p ˂ 0.001); and negatively with diastolic blood pressure (DBP) (−0.13; p = 0.01). High plasma Cu significantly decreased the risk of metabolic syndrome (MetS) (0.121; p ˂ 0.001). Furthermore, Zn/Cu ratio positively correlated with waist circumference (0.13; p = 0.01), systolic blood pressure (0.13; p ˂ 0.01), and DBP (0.14; p ˂ 0.01); and negatively with BMI (−0.19; p ˂ 0.001), PR (−0.17; p ˂ 0.001), and HDL (−0.27; p ˂ 0.001). High Zn/Cu ratio increased the prevalence of low HDL (4.508; p ˂ 0.001) and MetS (5.570; p ˂ 0.01). These findings suggest that high plasma Cu levels are associated with a protective effect on DBP, HDL and MetS and that high plasma Zn/Cu ratio is associated with the risk of having low HDL and MetS.
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Affiliation(s)
- Abdelhamid Kerkadi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (D.S.A.); (S.H.); (H.M.A.); (R.S.)
- Correspondence: ; Tel.: +974-4403-4806; Fax: +974-4403-4801
| | - Dana Samir Alkudsi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (D.S.A.); (S.H.); (H.M.A.); (R.S.)
| | - Sara Hamad
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (D.S.A.); (S.H.); (H.M.A.); (R.S.)
| | - Hanan Mohamed Alkeldi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (D.S.A.); (S.H.); (H.M.A.); (R.S.)
| | - Reem Salih
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (D.S.A.); (S.H.); (H.M.A.); (R.S.)
| | - Abdelali Agouni
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
- Biomedical and Pharmaceutical Research Unit (BPRU), QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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Zhong Q, Wu HB, Niu QS, Jia PP, Qin QR, Wang XD, He JL, Yang WJ, Huang F. Exposure to multiple metals and the risk of hypertension in adults: A prospective cohort study in a local area on the Yangtze River, China. ENVIRONMENT INTERNATIONAL 2021; 153:106538. [PMID: 33839551 DOI: 10.1016/j.envint.2021.106538] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/28/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Exposure to multiple metals is recognized as a common and real scenario in daily life. However, limited prospective studies have assessed associations between multiple metals exposure and hypertension. METHODS In total, 2625 adults in a local area on the Yangtze River were investigated at baseline from 2014 to 2015 and followed up in 2019. We measured baseline urine levels of 22 metals and used multivariate logistic analysis and Bayesian kernel machine regression (BKMR) to explore associations between multiple metals exposure and the risk of hypertension. RESULTS A total of 385 individuals (29.6%) were diagnosed with hypertension. Five metals (cadmium, copper, magnesium, molybdenum and zinc) were positively associated with hypertension in single-metal models. Cadmium and zinc remained significantly positive associations after adjusting for these five metals, with the odds ratio (OR) in the highest quartiles of 1.49 (95% CI: 1.01, 2.21; p-trend = 0.05) and 1.60 (95% CI: 1.08, 2.38; p-trend = 0.02), respectively. BKMR analysis showed a significant joint effect of multiple metals on hypertension when the concentrations of five metals were at or above their 55th percentile compared with their median values. A potential interaction between cadmium and zinc in increasing the risk of hypertension was observed with the ORint of 1.41 (95%CI: 1.05, 1.89). CONCLUSIONS We identified the joint effect of multiple metals on hypertension and observed a significant interaction between cadmium and zinc. Further cohort studies are needed to clarify the health effects of multiple metals exposure in a larger population.
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Affiliation(s)
- Qi Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hua-Bing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Qin-Shan Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Ping-Ping Jia
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Qi-Rong Qin
- Ma(,)anshan Center for Disease Control and Provention, Ma(,)anshan, Anhui, China
| | - Xiao-Dong Wang
- Yian Center for Disease Control and Provention, Tongling, Anhui, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wan-Jun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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Hu J, Cai X, Li J, Zheng N, Zhang J. Associations Between Serum Zinc Levels and Alanine Aminotransferase Elevation in Adults. Biol Trace Elem Res 2021; 199:2077-2084. [PMID: 32737810 DOI: 10.1007/s12011-020-02318-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/29/2020] [Indexed: 11/28/2022]
Abstract
Recent findings showed that zinc might be linked to alanine aminotransferase (ALT) elevation. This analysis aimed to explore the association between serum zinc levels and ALT elevation in adults. Data on serum zinc and ALT levels from adults aged 20 years and older who participated in the 2011-2016 National Health and Nutrition Examination Surveys were analyzed (N = 4138). Individuals with excessive alcohol consumption and hepatitis B or C infection were excluded. ALT elevation was defined as any value above normal of ALT (> 33 IU/L for males and > 25 IU/L for females). The multivariate logistic model and restricted cubic splines were adopted to assess the non-linear relationship. In a fully adjusted model, the odds ratio and 95% confidence interval of ALT elevation for quartile 4 (Q4) vs. quartile 1 (Q1) of serum zinc levels were 1.68 and 1.29-2.20 (per quartile: 1.20 (1.10-1.31)). In subgroup analysis, the association between serum zinc levels and ALT elevation was found in females (Q4 vs Q1: 1.95 (1.20-3.15)), obese individuals (Q4 vs Q1: 1.80 (1.19-2.74)), and young adults (Q4 vs Q1: 1.72 (1.09-2.72)), while the association was not evident in males, non-obese individuals, and adults older than 50 years old. A linear dose-response relationship between serum zinc levels and ALT elevation was found (Pfor non-linearity = 0.77). In conclusion, serum zinc was positively associated with ALT elevation in adults, and the association was mainly observed in females, obese individuals, and young adults.
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Affiliation(s)
- Jianwei Hu
- Department of Group Health, Maternal and Child Health Institution, Kunshan, 215301, Jiangsu, China
| | - Xiaoqin Cai
- Department of Clinical Laboratory, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, 215300, Jiangsu, China
| | - Jin Li
- Shandong Provincial Center for Disease Control and Prevention, Jinan, 250021, Shandong, China
| | - Ni Zheng
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Junguo Zhang
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
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28
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Tinkov AA, Bogdański P, Skrypnik D, Skrypnik K, Skalny AV, Aaseth J, Skalnaya MG, Suliburska J. Trace Element and Mineral Levels in Serum, Hair, and Urine of Obese Women in Relation to Body Composition, Blood Pressure, Lipid Profile, and Insulin Resistance. Biomolecules 2021; 11:biom11050689. [PMID: 34064348 PMCID: PMC8147795 DOI: 10.3390/biom11050689] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/01/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
The objective of this study was to evaluate serum, hair, and urinary trace element and mineral content in normal-weight and obese women in relation to metabolic risk factors. A total of 80 women aged 30–70 y.o. were enrolled in the obese group (n = 40) and normal-weight group (n = 40). Serum, hair, and urinary trace element and mineral levels were assessed using inductively coupled plasma spectrometry. Body fat percentage was evaluated using bioimpedance. Obese subjects were characterized by significantly higher body fat percentage, blood pressure, serum triglyceride concentration, and insulin resistance. Serum Ca, Fe, Mg, Se, V, Zn levels, hair Fe, Mg, V content, and urinary Se and V concentrations were found to be lower in obese subjects as compared to lean controls. In turn, serum Cu and urinary Fe levels in obese women were characterized by a significant increase. In multiple regression models serum Cu, Se, and Zn levels were significantly associated with BMI even after adjustment for blood biochemistry, body composition, and blood pressure. Serum trace element and mineral levels also significantly contributed to group discrimination. These findings allow to propose that obesity-associated disturbances in trace element and mineral status may at least partially contribute to metabolic risk in obese subjects.
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Affiliation(s)
- Alexey A. Tinkov
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Sovetskaya St., 14, 150000 Yaroslavl, Russia; (A.A.T.); (A.V.S.); (M.G.S.)
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego St. 84, 60-569 Poznań, Poland; (P.B.); (D.S.)
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznań University of Medical Sciences, Szamarzewskiego St. 84, 60-569 Poznań, Poland; (P.B.); (D.S.)
| | - Katarzyna Skrypnik
- Department of Human Nutrition and Dietetics, Poznan University of Life Science, ul. Wojska Polskiego 31, 60-624 Poznan, Poland;
| | - Anatoly V. Skalny
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Sovetskaya St., 14, 150000 Yaroslavl, Russia; (A.A.T.); (A.V.S.); (M.G.S.)
| | - Jan Aaseth
- Department of Research, Innlandet Hospital Trust, 2380 Brumunddal, Norway;
| | - Margarita G. Skalnaya
- Laboratory of Ecobiomonitoring and Quality Control, Yaroslavl State University, Sovetskaya St., 14, 150000 Yaroslavl, Russia; (A.A.T.); (A.V.S.); (M.G.S.)
| | - Joanna Suliburska
- Department of Human Nutrition and Dietetics, Poznan University of Life Science, ul. Wojska Polskiego 31, 60-624 Poznan, Poland;
- Correspondence:
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Lan Y, Wu S, Wang Y, Chen S, Liao W, Zhang X, Pan L, Jiang X, Zhang Y, Wang L. Association between blood copper and nonalcoholic fatty liver disease according to sex. Clin Nutr 2021; 40:2045-2052. [DOI: 10.1016/j.clnu.2020.09.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023]
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Chiu HF, Venkatakrishnan K, Golovinskaia O, Wang CK. Impact of Micronutrients on Hypertension: Evidence from Clinical Trials with a Special Focus on Meta-Analysis. Nutrients 2021; 13:588. [PMID: 33578935 PMCID: PMC7916651 DOI: 10.3390/nu13020588] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 02/07/2023] Open
Abstract
Hypertension (HT) is one of the pivotal risk factors for various detrimental diseases like cardiovascular diseases (CVDs), cerebrovascular disease, and renal dysfunction. Currently, many researchers are paying immense attention to various diet formula (dietary approach) with a special focus on micro and macronutrients along with modified lifestyle and standard anti-hypertensive drugs. Micronutrients (minerals/vitamins) play a central role in the regulation of blood pressure (BP) as they aid the function of macronutrients and also improve the anti-hypertensive functions of some anti-hypertensive agents. Even though several studies have demonstrated the beneficial effects of micronutrients on controlling BP, still some ambiguity exists among the nutritionists/doctors, which combination or individual mineral (dietary approach) contributes to better BP regulation. Therefore, this critical review article was attempted to delineate the underlying role of micronutrients (minerals and vitamins) for the management and prevention or delaying of HT and their related complications with strong affirmation from clinical trials as well as its mechanism of controlling BP. Moreover, the major source and recommended daily allowance (RDA) of various micronutrients are included in this review for guiding common readers (especially HT subjects) and dieticians to choose/recommend a better micronutrient and their combinations (other nutrients and standard anti-hypertensive drugs) for lowering the risk of HT and its related co-morbid conditions like CVDs.
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Affiliation(s)
- Hui-Fang Chiu
- Department of Chinese Medicine, Taichung Hospital Ministry of Health and Welfare, Taichung 40301, Taiwan;
| | - Kamesh Venkatakrishnan
- School of Nutrition, Chung Shan Medical University, 110, Sec. 1, Jianguo North Road, Taichung 40201, Taiwan;
| | | | - Chin-Kun Wang
- School of Nutrition, Chung Shan Medical University, 110, Sec. 1, Jianguo North Road, Taichung 40201, Taiwan;
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31
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Nevárez-López SC, Simental-Mendía LE, Guerrero-Romero F, Burciaga-Nava JA. Zinc deficiency is an independent risk factor for prehypertension in healthy subjects. INT J VITAM NUTR RES 2021; 91:25-30. [DOI: 10.1024/0300-9831/a000593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Abstract. Objective: To assess whether zinc deficiency is associated with prehypertension (preHTN) in apparently healthy subjects. Design: Apparently healthy women and men, aged 20 to 60 years were enrolled into a case-control study. Individuals with and without preHTN were allocated into the case and control groups, respectively. Hypertension, liver disease, renal disease, smoking, pregnancy, diabetes, malignancy, hypernatremia, hypomagnesemia, medical treatment, and use of supplements containing zinc were exclusion criteria. PreHTN was defined by systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) of 120–139 mmHg and/or of 80–89 mmHg, respectively, and the zinc deficiency by serum zinc levels < 74 μg/dL in men and < 70 μg/dL in women. Results: In total, 142 subjects (90 women and 52 men) were enrolled and allocated in the case (n = 71) and control (n = 71) groups. In the overall population, the frequency of zinc deficiency was 11.1%; individuals in the case group showed significant higher frequency of zinc deficiency as compared with the control group (16.9% vs 5.5%, p = 0.04). The logistic regression analysis showed a significant association between zinc deficiency and preHTN (OR = 4.61; 95% CI: 1.24–17.12, p = 0.02). Conclusion: Our results suggest that zinc deficiency is associated with the presence of preHTN in apparently healthy subjects.
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Affiliation(s)
- Sara C. Nevárez-López
- Departamento de Bioquímica, Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Durango, México
| | - Luis E. Simental-Mendía
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, México
| | - Fernando Guerrero-Romero
- Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, México
| | - Jorge A. Burciaga-Nava
- Departamento de Bioquímica, Facultad de Medicina y Nutrición, Universidad Juárez del Estado de Durango, Durango, México
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Relationship between Selected Trace Elements and Hematological Parameters among Japanese Community Dwellers. Nutrients 2020; 12:nu12061615. [PMID: 32486272 PMCID: PMC7352891 DOI: 10.3390/nu12061615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 11/23/2022] Open
Abstract
This study aimed (1) to assess serum trace elements concentrations and hematological parameters, (2) to evaluate the sex differences in the associations between serum trace elements levels and hematological parameters, and (3) to identify the associations between serum trace elements concentrations and risk of anemia among Japanese community dwellers. This is a community-based cross-sectional study that utilized the data of the 2014 Iwaki Health Promotion Project. Participants were 1176 community dwellers (>18 years) residing in the Iwaki District, Aomori Prefecture, Japan. We assessed the data of serum trace elements concentrations of cadmium (Cd), cobalt (Co), copper (Cu), selenium (Se), zinc (Zn), and iron (Fe) as well as the hematological parameters of red blood cells (RBC) counts, hemoglobin, packed cells volume (PCV), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). Serum concentrations of Zn (871.5 μg/L vs. 900.1 μg/L) and Fe (946.8 μg/L vs. 1096.1 μg/L) were significantly lower in females than in males, while serum concentrations of Co (0.4 μg/L vs. 0.3 μg/L) and Cu (1062.4 μg/L vs. 965.3 μg/L) were significantly higher in females. By multivariate linear regression, serum Se concentration was significantly, positively associated with PCV (β = 1.04; 95% confidence interval (CI): 0.17, 1.92; p = 0.016) among the study participants. Serum Zn also had positive associations with hemoglobin (β = 0.42; 95% CI: 0.07, 0.77; p = 0.020), PCV (β = 1.79; 95% CI: 0.78, 2.81; p < 0.001), and RBCs count (β = 15.56; 95% CI: 7.31, 31.69; p = 0.002). On the other hand, serum Co concentration was negatively associated with the hematological parameters, particularly in females. Moreover, serum Zn concentration had a decreased risk of anemia (lowest vs. highest quartiles: odds ratio (OR) = 0.42; 95% CI: 0.23, 0.76; p = 0.005) while higher Co concentrations had an increased risk of anemia (lowest vs. highest quartiles: OR = 1.95; 95% CI: 1.04, 3.67; p = 0.037). However, no significant association was found between serum Cu level and hematological parameters. There were substantial sex differences in serum trace elements, implying that trace elements metabolism differed between males and females. Zn can play a protective role in the development of anemia. Surprisingly, increased Co concentration increased the risk of anemia among our study population, which called for further studies to confirm and to consider for speciation analysis.
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Bastola MM, Locatis C, Maisiak R, Fontelo P. Selenium, copper, zinc and hypertension: an analysis of the National Health and Nutrition Examination Survey (2011-2016). BMC Cardiovasc Disord 2020; 20:45. [PMID: 32005161 PMCID: PMC6995060 DOI: 10.1186/s12872-020-01355-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/21/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hypertension is a major cardiovascular illness worldwide with many underlying causes. The role of trace elements selenium, copper, and zinc in hypertension is uncertain. The objective of this study was to evaluate the role of these trace elements in hypertension. METHOD Data from 6683 National Health and Nutrition Examination Survey (NHANES) participants from 2011 to 2016 were analyzed using Statistical Analytical System (SAS, version 9.4) software for the role of trace elements in hypertension in age range 8 to 80 years, irrespective of the antihypertensive medication taken. Recent American Heart Association guidelines and pediatric practice guidelines for hypertension were used. RESULTS Findings showed a significant positive association between serum selenium levels and hypertension but not serum zinc and copper. At optimal levels for transport and distribution, serum selenium levels of 120 μg/L or higher (reference level 70-150 μg/L) were significantly associated with hypertension (OR = 1.46, 95% CI = 1.29-1.66) after adjusting for confounding factors. At serum selenium level greater than 150 μg/L, the association with hypertension strengthened (OR = 1.69, 95% CI = 1.32-2.17). CONCLUSION A positive association was found between serum selenium and hypertension, irrespective of age or anti-hypertensive medications intake. These findings also suggest that the reference levels of serum levels in healthy individuals may need to be re-determined, if supported by additional studies. If validated, patients with hypertension may also need to be cautioned about selenium intake.
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Affiliation(s)
- Mrigendra M Bastola
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
| | - Craig Locatis
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | | | - Paul Fontelo
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
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Association Between the Change of Serum Copper and Ischemic Stroke: a Systematic Review and Meta-Analysis. J Mol Neurosci 2019; 70:475-480. [PMID: 31782058 DOI: 10.1007/s12031-019-01441-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 11/10/2019] [Indexed: 12/12/2022]
Abstract
Ischemic stroke is the most common stroke subtypes with all strokes. More and more studies found that serum copper was related to the ischemic stroke. However, the correlation between serum copper and ischemic stroke was inconsistent. We performed the meta-analysis to assess the association between the change of serum copper and ischemic stroke. Electronic databases were identified to search for relevant studies about serum copper and ischemic stroke from inception to February 28, 2019. Eight studies with a total of 777 participants were included into this meta-analysis. Because of high heterogeneity (I2 = 71%), we chose a random effect model. Our results showed the serum copper levels were significantly higher in ischemic stroke group compared with controls group (pooled mean difference, 1.25; 95% confidence intervals (CIs), 0.07-2.43; P = 0.04), in particular studies after the year of 2009 (I2 = 0%; pooled mean difference, 2.16; 95% CI, 1.37-2.95; P < 0.00001). Serum copper was associated with ischemic stroke, and it may be one of the risk factors of ischemic stroke.
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