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Malekahmadi M, Soltani S, Pahlavani N, Sharifi Zahabi E, Kazemizadeh H, Hadavi S, Farsani GM. Zinc status in cystic fibrosis patients; a systematic review and meta-analysis. Heliyon 2024; 10:e33686. [PMID: 39027558 PMCID: PMC11255513 DOI: 10.1016/j.heliyon.2024.e33686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
Background Cystic fibrosis (CF) is an autosomal recessive hereditary disease causes concentration of secretions and this affects the lungs and digestive system. These patients are exposed to zinc (zn) deficiency. In this review, we decided to investigate the status of zn in CF patients compared to control group. Also, the clinical trials that have so far performed zinc supplementation in these patients are examined. Method ISI Web of Science, Scopus, PubMed/Medline, and Cochrane database were searched, up to December 2023, for studies that reported the association between zn levels of CF patients compared to a healthy control group. A random-effect model was used to compute the pooled weighted mean difference (WMD) with 95 % confidence intervals (CI). Subgroup analysis was done for region, sample and method of measurement, zinc supplementation and age. Result Overall, meta-analysis of 9 studies (n = 383 participants) revealed that the zn levels were significantly lower in children and adolescents with CF compared with healthy subjects (WMD = -11.97 μg/dL, 95 % CI: -22.57 to -1.37; I2 = 92.83 %). Meta-analysis of 8 studies (n = 320 participants) revealed that the serum and plasma level of zn was significantly lower in CF patients compared with healthy subjects (WMD = -14.31 μg/dL, 95 % CI: -25.09 to -3.53; I2 = 88.14 %, P-heterogeneity <0.001) While the zn level in saliva and sputum was significantly higher in CF patients. Conclusion CF patients have decreased zn levels in circulatory reservoirs. zn may effective for the diminish the respiratory and gastrointestinal symptoms in CF patients, further well-designed clinical trial studies is required to prove these effects.
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Affiliation(s)
- Mahsa Malekahmadi
- Imam Khomaini hospital complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Naseh Pahlavani
- Social Determinants of Health Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Elham Sharifi Zahabi
- School of nutrition sciences and food technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Kazemizadeh
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Hadavi
- Treatment Department of Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Mohammadi Farsani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
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Rashidmayvan M, Mansoori A, Aghasizadeh M, Dianati M, Barati S, Sahranavard T, Darroudi S, Ahari RK, Esmaily H, Ferns G, Sarabi MRM, Faridni R, Ghayour-Mobarhan M, Moohebati M. Prediction of cardiovascular disease risk by serum zinc and copper concentrations and anthropometric measurements. J Trace Elem Med Biol 2024; 83:127385. [PMID: 38278053 DOI: 10.1016/j.jtemb.2024.127385] [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: 07/24/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/28/2024]
Abstract
INTRODUCTION We aimed to investigate the association between cardiovascular disease (CVD) and various anthropometric indices, as well as the serum levels of copper (Cu) and zinc (Zn), copper-zinc ratio (Cu/Zn ratio) and zinc-copper ratio (Zn/Cu ratio), in a large population sample from northeastern Iranian. METHOD 9704 individuals aged 35 to 65 were enrolled in the first phase of the study. After a 10-year follow-up, 7560 participants were enrolled into the second phase. The variables used in this study included demographic characteristics, such as gender and age; biochemical parameters including: serum Zn, Cu, Cu/Zn ratio, and Zn/Cu ratio; anthropometric parameters including: waist circumference (WC), body mass index (BMI), and waist-to-hip ratio (WHR). The relationship between the aforementioned indices and CVD was examined using decision tree (DT) and logistic regression (LR) models. RESULTS A total of 837 individuals were diagnosed with CVD among the 7560 participants. LR analysis showed that BMI, age, WH zinc-copper ratio (Zn/Cu ratio), and serum Zn/Cu ratio were significantly associated the development of CVD in men, and WHR, age, BMI, serum Cu, and Cu/Zn ratio in women. DT analysis showed that, age was the most important predictor of CVD in both genders. 71% of women, older than 49 years, with a WHR≥ 0.89, serum Cu< 75 (µg/dl), BMI≥ 22.93 (kg/m2), and serum Cu≥ 14 (µg/dl), had the highest risk of CVD. In men, among those who were ≥ 53 years, with a WHR≥ 0.98, serum Zn/Cu ratio< 1.69, and BMI≥ 22.30, had the highest risk of CVD. CONCLUSION Among Iranian adult population, BMI, age, and WHR were one of the predictors of CVD for both genders. The Zn/Cu ratio was CVD predictor for men while Cu/Zn ratio was CVD predictor for women.
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Affiliation(s)
- Mohammad Rashidmayvan
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Amin Mansoori
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran; Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Aghasizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Dianati
- Student Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Sama Barati
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Sahranavard
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Rana Kolahi Ahari
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran; Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | | | - Reyhaneh Faridni
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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3
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Escobedo-Monge MF, Bahillo-Curieses P, Parodi-Román J, Escobedo-Monge MA, Alonso-López P, Marugán-Miguelsanz JM. Calcium, Phosphate, and Vitamin D in Children and Adolescents with Chronic Diseases: A Cross-Sectional Study. Nutrients 2024; 16:1349. [PMID: 38732596 PMCID: PMC11085162 DOI: 10.3390/nu16091349] [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: 03/21/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Chronic diseases may affect the nutritional status of children and adolescents. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are crucial nutrients for their growth and development. Proper diagnosis and treatment are critical components of personalized and precision medicine. Hence, we conducted a cross-sectional and comparative study to evaluate Ca, P, and Vit-D levels in their non-skeletal functions and their association with health and nutritional biomarkers in children and adolescents with diverse chronic conditions. We performed anthropometric, body composition, clinical evaluation, biochemical analysis, and dietary survey methods. A total of 78 patients (1-19 years, 43 females, 42 children) took part in this study. Overall, 24, 30, and 24 participants were obese, undernourished, and eutrophic, respectively. Results found that 74% and 35% of individuals had deficient Vit-D and Ca intake, respectively. Most cases were normocalcemic. Results also found that 47% of the subjects had Vit-D deficiency (VDD), 37% were insufficient, and 37% had hypophosphatemia. Of the 46% and 31% of patients with VDD and insufficient levels, 19% and 11% were hypophosphatemic, respectively. Calcium, P, and Vit-D levels were associated with anthropometric parameters, body mass index, body composition, physical activity, diet, growth hormones, and the immune, liver, and kidney systems. These results show the coincident risk of altered Ca, P, and Vit-D metabolism in children and adolescents with chronic diseases.
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Affiliation(s)
- Marlene Fabiola Escobedo-Monge
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
| | - Pilar Bahillo-Curieses
- Section of Pediatric Endocrinology, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain;
| | - Joaquín Parodi-Román
- Science Faculty, University of Cadiz, Paseo de Carlos III, 28, 11003 Cádiz, Spain;
| | | | - Pedro Alonso-López
- Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain (J.M.M.-M.)
| | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
- Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain (J.M.M.-M.)
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Escobedo-Monge MF, Marcos-Temprano M, Parodi-Román J, Escobedo-Monge MA, Alonso-Vicente C, Torres-Hinojal MC, Marugán-Miguelsanz JM. Calcium, Phosphorus, and Vitamin D Levels in a Series of Cystic Fibrosis Patients: A Cross-Sectional Study. Int J Mol Sci 2024; 25:1900. [PMID: 38339178 PMCID: PMC10856093 DOI: 10.3390/ijms25031900] [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: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Cystic fibrosis (CF) is a monogenic disease with different types of mutations that mainly affect the respiratory-digestive system. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are essential nutrients for maintaining adequate growth and development, as well as key components in crucial metabolic pathways. Proper diagnosis, treatment, and response are decisive components of precision medicine. Therefore, we conducted a cross-sectional study to evaluate Ca, P, and Vit-D levels along with health and nutritional indicators, regarding their non-skeletal functions, in a series of CF patients. Anthropometric and clinical evaluation, biochemical analysis, dietary survey, and respiratory and pancreatic status were performed. Even though the results showed that all patients had normal dietary and serum Ca levels, 47% of patients had deficient Vit-D intake, 53% of patients had hypovitaminosis D, 35% had insufficient Vit-D levels, 18% had hypophosphatemia, 76% had elevated alkaline phosphate levels, 29% had hypercalciuria, and 65% had hyperphosphaturia. There were no significant differences between homozygous and compound heterozygous patients. Ca, P, and Vit-D levels were associated with body mass index; body composition; physical activity; diet; growth hormones; and the immune, liver, and kidney systems. We suggest a periodically evaluation of Ca and P losses.
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Affiliation(s)
| | - Marianela Marcos-Temprano
- Castilla y León Cystic Fibrosis Unit, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 3, 47005 Valladolid, Spain;
| | - Joaquín Parodi-Román
- Science Faculty, University of Cadiz, Paseo de Carlos III, 28, 11003 Cádiz, Spain;
| | | | - Carmen Alonso-Vicente
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid; Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (C.A.-V.); (J.M.M.-M.)
| | | | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, University of Valladolid; Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain; (C.A.-V.); (J.M.M.-M.)
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5
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Rabajdová M, Špaková I, Smolko L, Abrahamovská M, Baranovičová B, Birková A, Vašková J, Mareková M. Serum trace element levels and activity of enzymes associated with oxidative stress in endometriosis and endometrial cancer. FEBS Open Bio 2024; 14:148-157. [PMID: 37968795 PMCID: PMC10761925 DOI: 10.1002/2211-5463.13738] [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: 09/18/2023] [Revised: 10/23/2023] [Accepted: 11/13/2023] [Indexed: 11/17/2023] Open
Abstract
Endometriosis and endometrial cancer are closely related to oxidative stress. However, the direct relationship between copper and zinc levels and oxidative stress in the extracellular and intracellular space remains unclear. The presented study is focused on the determination of serum Zn and Cu levels, glutathione concentration and enzyme activity in three groups: patients diagnosed with endometrial cancer (EC), patients diagnosed with endometriosis (EM), and a healthy control group. Spectrophotometric determination of trace elements revealed that levels of zinc and copper were lower in blood plasma of patients with endometriosis as compared with the other groups; however, there were no significant differences in the Cu/Zn ratio. Furthermore, significantly increased blood serum glutathione levels were detected in both EM and EC groups compared with the control group. While the activity of superoxide dismutase (SOD) was similar across the studied groups, we observed differences in the activity of other enzymes associated with oxidative stress, including glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST), between the control group and the EM and EC patients. Additionally, analysis of gene expression based on free circulating mRNA indicated significant differences in the expression of SOD isoenzymes between the patient groups and the control group; expression of GPx isoenzymes was also altered. Obtained results may have potential application in diagnostics as well as monitoring of endometriosis and endometrial cancer.
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Affiliation(s)
- Miroslava Rabajdová
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Ivana Špaková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Lukáš Smolko
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Michaela Abrahamovská
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Barbora Baranovičová
- Department of Gynaecology and Obstetrics, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Anna Birková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Janka Vašková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Mária Mareková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
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6
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Knebusch N, Mansour M, Vazquez S, Coss-Bu JA. Macronutrient and Micronutrient Intake in Children with Lung Disease. Nutrients 2023; 15:4142. [PMID: 37836425 PMCID: PMC10574027 DOI: 10.3390/nu15194142] [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: 08/23/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
This review article aims to summarize the literature findings regarding the role of micronutrients in children with lung disease. The nutritional and respiratory statuses of critically ill children are interrelated, and malnutrition is commonly associated with respiratory failure. The most recent nutrition support guidelines for critically ill children have recommended an adequate macronutrient intake in the first week of admission due to its association with good outcomes. In children with lung disease, it is important not to exceed the proportion of carbohydrates in the diet to avoid increased carbon dioxide production and increased work of breathing, which potentially could delay the weaning of the ventilator. Indirect calorimetry can guide the process of estimating adequate caloric intake and adjusting the proportion of carbohydrates in the diet based on the results of the respiratory quotient. Micronutrients, including vitamins, trace elements, and others, have been shown to play a role in the structure and function of the immune system, antioxidant properties, and the production of antimicrobial proteins supporting the defense mechanisms against infections. Sufficient levels of micronutrients and adequate supplementation have been associated with better outcomes in children with lung diseases, including pneumonia, cystic fibrosis, asthma, bronchiolitis, and acute respiratory failure.
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Affiliation(s)
- Nicole Knebusch
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.); (M.M.); (S.V.)
- Texas Children’s Hospital, Houston, TX 77030, USA
| | - Marwa Mansour
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.); (M.M.); (S.V.)
- Texas Children’s Hospital, Houston, TX 77030, USA
| | - Stephanie Vazquez
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.); (M.M.); (S.V.)
- Texas Children’s Hospital, Houston, TX 77030, USA
| | - Jorge A. Coss-Bu
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (N.K.); (M.M.); (S.V.)
- Texas Children’s Hospital, Houston, TX 77030, USA
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Escobedo-Monge MF, Barrado E, Parodi-Román J, Escobedo-Monge MA, Torres-Hinojal MC, Marugán-Miguelsanz JM. Copper/Zinc Ratio in Childhood and Adolescence: A Review. Metabolites 2023; 13:metabo13010082. [PMID: 36677007 PMCID: PMC9862945 DOI: 10.3390/metabo13010082] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Both copper (Cu) and zinc (Zn) are crucial micronutrients for human growth and development. This literature review covered the last five years of available evidence on the Cu/Zn ratio in children and adolescents. We searched PubMed, Web of Science, Google Scholar, Cochrane Library, and Science Direct for publications between 2017 and 2022, especially in English, although publications in other languages with abstracts in English were included. The main terms used were "copper", "zinc", "copper-zinc", and "zinc-copper" ratios. Cu and Zn determinations made in blood, plasma, or serum were included. This review comprises several cross-sectional and case-control studies with substantial results. The bibliographic search generated a compilation of 19 articles, in which 63.2% of the studies mostly reported a significantly higher Cu/Zn ratio, and 57.9% of them informed significantly lower levels of Zn. We conclude that children and adolescents with acute and chronic conditions are at greater risk of developing elevated Cu/Zn ratios, related to altered nutritional, infectious, and inflammatory status.
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Affiliation(s)
- Marlene Fabiola Escobedo-Monge
- Faculty of Medicine, University of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
- Correspondence: ; Tel.: +34-639-590-467
| | - Enrique Barrado
- Department of Analytical Chemistry, Science Faculty, Campus Miguel Delibes, University of Valladolid, Calle Paseo de Belén, 7, 47011 Valladolid, Spain
| | - Joaquín Parodi-Román
- Science Faculty, University of Cadiz, Paseo de Carlos III, 28, 11003 Cádiz, Spain
| | | | | | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics, Faculty of Medicine, University of Valladolid, Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain
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Liu Y, Tang R, Xu Q, Xu S, Zuo S, Qiu J, Zhong X, Tan R, Liu Y. High Blood Cu/Zn Ratio is Associated with Nutritional Risk in Patients Undergoing Maintenance Hemodialysis. Biol Trace Elem Res 2022; 200:4977-4987. [PMID: 35152373 DOI: 10.1007/s12011-022-03104-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/03/2022] [Indexed: 01/01/2023]
Abstract
Patients undergoing maintenance hemodialysis (MHD) are at risk of an imbalance of copper and zinc homeostasis. We hypothesized that there is an association between the blood copper-zinc (Cu/Zn) ratio and nutritional status in these patients. For this cross-sectional study, blood samples were collected from patients undergoing MHD at Guangzhou Red Cross Hospital in September 2019. Zinc and copper levels were measured using inductively coupled plasma mass spectrometry. The seven-point subjective global assessment (SGA), nutritional risk screening 2002 (NRS2002), and geriatric nutritional risk index (GNRI) were used to evaluate the overall nutritional status. We enrolled 144 MHD patients (men:women = 78:66), with an average age of 64.33 ± 13.39 years and a median dialysis vintage of 33.50 (16.25-57.50) months. Patients with a higher blood Cu/Zn ratio had lower levels of hemoglobin, blood zinc, serum prealbumin, albumin, and creatinine as well as low SGA and GNRI scores, but higher modified Charlson comorbidity index score, serum C-reactive protein level, interleukin-6 level, blood copper level, and NRS2002 score (all p < 0.05). After adjustment for confounding factors in multivariable models, a high blood Cu/Zn ratio was independently associated with nutritional risk defined by all nutritional parameters (SGA, NRS2002, and GNRI). Prospective studies with larger sample sizes are warranted to confirm these results.
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Affiliation(s)
- Yun Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Ruiying Tang
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen City, Guangdong, People's Republic of China
| | - Qingdong Xu
- Department of Nephrology, Jiangmen Central Hospital, Jiangmen City, Guangdong, People's Republic of China
| | - Shilin Xu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - SuJun Zuo
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Jingxian Qiu
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaoshi Zhong
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Rongshao Tan
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Yan Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China.
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China.
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9
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Zuo S, Liu M, Liu Y, Xu S, Zhong X, Qiu J, Qin D, Tan R, Liu Y. Association Between the Blood Copper-Zinc (Cu/Zn) Ratio and Anemia in Patients Undergoing Maintenance Hemodialysis. Biol Trace Elem Res 2022; 200:2629-2638. [PMID: 34480666 DOI: 10.1007/s12011-021-02888-8] [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: 06/15/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
Copper (Cu) and zinc (Zn) imbalances are common in dialysis patients. This study aimed to investigate the relationship between the blood Cu/Zn ratio and anemia in patients undergoing maintenance hemodialysis (MHD) treatment. This cross-sectional study included patients undergoing MHD at our center in September 2019. Clinical and demographic data and blood samples were collected before the hemodialysis sessions, and the blood levels of Zn and Cu were measured by inductively coupled plasma mass spectrometry. Multivariable linear and binary logistic regression analyses were performed to study the relationship between blood Cu/Zn ratio and anemia. A total of 144 MHD patients were enrolled in this study. The patients had a mean age of 64.33 ± 13.39 years, a median dialysis vintage of 33.50 (16.25-57.50) months, with 66 being females (45.8%). The median blood Cu/Zn ratio was 15.55 (interquartile range: 12.47-20.31). Anemia was present in 99 patients (68.8%). Groups with higher hemoglobin levels had decreased blood Cu/Zn ratios (p < 0.05). After adjustments for confounding factors, higher blood Cu/Zn ratios were independently associated with lower hemoglobin levels and anemia in MHD patients based on multivariate linear and multivariate binary logistic regression, respectively, in different models. Our study found that the blood Cu/Zn ratio is independently associated with anemia in MHD patients, but prospective multicenter studies with larger sample sizes are still needed to determine the appropriate cutoff values for blood zinc, blood copper, and blood Cu/Zn levels in this patient population.
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Affiliation(s)
- Sujun Zuo
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Mengmeng Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Yun Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou City, Guangdong province, China
| | - Shilin Xu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Xiaoshi Zhong
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
| | - Jingxian Qiu
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou City, Guangdong province, China
| | - Danping Qin
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China.
| | - Rongshao Tan
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou City, Guangdong province, China
| | - Yan Liu
- Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, China
- Guangzhou Institute of Disease-Oriented Nutritional Research, Guangzhou City, Guangdong province, China
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Pala V, Agnoli C, Cavalleri A, Rinaldi S, Orlandi R, Segrado F, Venturelli E, Vinceti M, Krogh V, Sieri S. Prediagnostic Levels of Copper and Zinc and Breast Cancer Risk in the ORDET Cohort. Cancer Epidemiol Biomarkers Prev 2022; 31:1209-1215. [PMID: 35255128 DOI: 10.1158/1055-9965.epi-21-1252] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/22/2022] [Accepted: 02/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Case-control studies show that copper (Cu) is high and zinc (Zn) low in blood and urine of women with breast cancer compared with controls. METHODS To assess whether prediagnostic Cu and Zn are associated with breast cancer risk, OR of breast cancer according to Cu, Zn, and Cu/Zn ratio in plasma and urine was estimated in a nested case-control study within the ORDET cohort, using conditional logistic regression adjusted for multiple variables: First 496 breast cancer cases and matched controls, diagnosed ≥2 years after recruitment (to eliminate reverse causation) were analyzed. Then all eligible cases/controls were analyzed with stratification into years from recruitment to diagnosis. RESULTS For women diagnosed ≥2 years, compared with lowest tertiles, breast cancer risk was higher in the highest tertile of plasma Cu/Zn ratio (OR, 1.75; 95% CI, 1.21-2.54) and the highest tertile of both plasma and urine Cu/Zn ratio (OR, 2.37; 95% CI, 1.32-4.25). Risk did not vary with ER/PR/HER2 status. For women diagnosed <2 years, high Cu/Zn ratio was strongly associated with breast cancer risk. CONCLUSIONS Our prospective findings suggest that increased Cu/Zn ratio in plasma and urine may be both an early marker of, and a risk factor for, breast cancer development. Further studies are justified to confirm or otherwise our results and to investigate mechanisms. IMPACT Our finding that prediagnostic Cu/Zn ratio is a strong risk factor for breast cancer development deserves further investigation and, if confirmed, might open the way to interventions to reduce breast cancer risk in women with disrupted Cu/Zn homeostasis.
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Affiliation(s)
- Valeria Pala
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Adalberto Cavalleri
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, IARC-WHO, 69372, Lyon Cedex 08, France
| | - Rosaria Orlandi
- Molecular Targeting Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesco Segrado
- Molecular Targeting Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elisabetta Venturelli
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marco Vinceti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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11
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Escobedo-Monge MF, Barrado E, Parodi-Román J, Escobedo-Monge MA, Marcos-Temprano M, Marugán-Miguelsanz JM. Magnesium Status and Calcium/Magnesium Ratios in a Series of Cystic Fibrosis Patients. Nutrients 2022; 14:1793. [PMID: 35565764 PMCID: PMC9104329 DOI: 10.3390/nu14091793] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023] Open
Abstract
Magnesium (Mg) is an essential micronutrient that participates in various enzymatic reactions that regulate vital biological functions. The main aim was to assess the Mg status and its association with nutritional indicators in seventeen cystic fibrosis (CF) patients. The serum Mg and calcium (Ca) levels were determined using standardized methods and the dietary Mg intake by prospective 72 h dietary surveys. The mean serum Ca (2.45 mmol/L) and Mg (0.82 mmol/L) had normal levels, and the mean dietary intake of the Ca (127% DRI: Dietary Reference Intake) and Mg (125% DRI) were high. No patients had an abnormal serum Ca. A total of 47% of the subjects had hypomagnesemia and 12% insufficient Mg consumption. One patient had a serum Mg deficiency and inadequate Mg intake. A total of 47 and 82% of our series had a high serum Ca/Mg ratio of >4.70 (mean 4.89) and a low Ca/Mg intake ratio of <1.70 (mean 1.10), respectively. The likelihood of a high Ca/Mg ratio was 49 times higher in patients with a serum Mg deficiency than in normal serum Mg patients. Both Ca/Mg ratios were associated with the risk of developing cardiovascular disease (CVD), type 2 diabetes (T2D), metabolic syndrome (MetS), and even several cancers. Therefore, 53% of the CF patients were at high risk of a Mg deficiency and developing other chronic diseases.
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Affiliation(s)
- Marlene Fabiola Escobedo-Monge
- Department of Pediatrics of the Faculty of Medicine, Valladolid University, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain;
| | - Enrique Barrado
- Department of Analytical Chemistry, Science Faculty, Campus Miguel Delibes, University of Valladolid, Calle Paseo de Belén, 7, 47011 Valladolid, Spain;
| | | | | | - Marianela Marcos-Temprano
- Pediatric Service, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 3, 47005 Valladolid, Spain;
| | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, Valladolid University, Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain;
- Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 3, 47003 Valladolid, Spain
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12
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Balietti M, Casoli T, Giacconi R, Giuli C. Platelet total PLA2 activity, serum oxidative level and plasma Cu/Zn ratio: a vicious cycle with a potential role to monitor MCI and Alzheimer's disease progression. Rejuvenation Res 2021; 25:16-24. [PMID: 34913745 DOI: 10.1089/rej.2021.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Alzheimer's disease (AD) has no cure, mainly because of late diagnosis. Early diagnostic biomarkers are crucial. Phospholipases A2 (PLA2) are hydrolases with several functions in the brain, nevertheless their deregulation contributes to neurodegeneration. We evaluated platelet total PLA2 activity (ptotPLA2) in healthy elderly subjects (HE, n = 102), patients suffering from Mild Cognitive Impairment (MCI, n = 90) and AD (n = 91). Platelets are considered "circulating neurons" and ptotPLA2 seems to mirror the cerebral activity. ptotPLA2 of the three cohorts was similar, but in MCI the higher ptotPLA2 the worse the global cognitive status (Mini Mental State Examination score, MMSE) and in AD the lower ptotPLA2 the more severe the pathology stage (Clinical Dementia Rating, CDR). Accordingly, MCI with MMSE ≥ 26 overlapped HE, in MCI with MMSE < 26 and in AD with CDR 1 ptotPLA2 increased, in AD with CDR 2 ptotPLA2 decreased. In MCI ptotPLA2 positively correlated with blood oxidation and inflammation, in AD it was the opposite. Finally, Discrimination Index (DI) - calculated multiplying ptotPLA2, oxidative level and Cu/Zn ratio (an inflammation parameter) - differentiated MCI patients who progressed to dementia in the following 24 months and AD patients with the worse pathology development. Summarizing, ptotPLA2 changes during MCI and AD progression, is linked, in opposite way, to oxidative/inflammatory status in MCI and AD and might help, when included in DI, to identify MCI converters to dementia and AD patients with the more severe prognosis. ptotPLA2 may have a diagnostic/prognostic value and be a potential therapeutic target.
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Affiliation(s)
- Marta Balietti
- INRCA, Neurobiology of Aging, Via Birrelli 8, Ancona, Italy, 60121;
| | | | | | - Cinzia Giuli
- INRCA IRCCS Hospital, Unit of Geriatrics, contrada Mossa 2, Fermo, Italy, 63900;
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13
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Meng JB, Hu MH, Zhang M, Hu GP, Zhang W, Hu SJ. The Correlation Between Whole Blood Copper (Cu), Zinc (Zn) Levels and Cu/Zn Ratio and Sepsis-Induced Left Ventricular Systolic Dysfunction (SILVSD) in Patients with Septic Shock: A Single-Center Prospective Observational Study. Int J Gen Med 2021; 14:7219-7234. [PMID: 34737617 PMCID: PMC8558506 DOI: 10.2147/ijgm.s335348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/07/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to explore relationships between whole blood copper (Cu), zinc (Zn) and Cu/Zn ratio and cardiac dysfunction in patients with septic shock. Subjects and Methods Between April 2018 and March 2020, septic shock patients with sepsis-induced left ventricular systolic dysfunction (SILVSD, left ventricular ejection fraction, LVEF<50%) and with no sepsis-induced myocardial dysfunction (non-SIMD, septic shock alone and LVEF>50%) and controls were prospectively enrolled. Whole blood Cu and Zn levels were measured using flame atomic absorption spectrophotometry. Results Eighty-six patients with septic shock including both 41 SILVSD and 45 non-SIMD and 25 controls were studied. Whole blood Cu levels and Cu/Zn ratio were significantly higher and Zn levels were lower in SILVSD compared with non-SIMD and controls (Cu, p=0.009, <0.001; Zn, p=0.029, <0.001; Cu/Zn ratio, p=0.003, <0.001). Both increased whole blood Cu and Cu/Zn ratio and reduced Zn were associated with lower LVEF (all p<0.001) and higher amino-terminal pro-B-type natriuretic peptide (NT-proBNP) (Cu, p=0.002; Zn, p<0.001; Cu/Zn ratio, p<0.001) and had predictive values for SILVSD (Cu, AUC=0.666, p=0.005; Zn, AUC=0.625, p=0.039; Cu/Zn ratio, AUC=0.674, p=0.029). Whole blood Cu levels and Cu/Zn ratio were increased but Zn levels were reduced in non-survivors compared with survivors (Cu, p<0.001; Zn, p<0.001; Cu/Zn ratio, p<0.001). Whole blood Cu and Zn displayed the value of predicting 28-day mortality (Cu, AUC = 0.802, p<0.001; Zn, AUC=0.869, p<0.001; Cu/Zn ratio, AUC=0.902, p<0.001). Conclusion Findings of the study suggest that whole blood Cu levels and Cu/Zn ratio are increased in SILVSD patients and positively correlated with cardiac dysfunction, while whole blood Zn levels are reduced and negatively associated with cardiac dysfunction. Moreover, both whole blood Cu, Zn and Cu/Zn ratio might distinguish between SILVSD and non-SIMD in septic shock patients and predict 28-day mortality. Trial Registration Registered at http://www.chictr.org.cn/ChiCTR1800015709.
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Affiliation(s)
- Jian-Biao Meng
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, People's Republic of China.,Intensive Care Unit, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310012, People's Republic of China
| | - Ma-Hong Hu
- Intensive Care Unit, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310012, People's Republic of China
| | - Ming Zhang
- Intensive Care Unit, Hangzhou Cancer Hospital, Hangzhou, Zhejiang Province, 310002, People's Republic of China
| | - Gong-Pai Hu
- Department of Ultrasonography, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310012, People's Republic of China
| | - Wei Zhang
- Department of Cardiology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang Province, 310012, People's Republic of China
| | - Shen-Jiang Hu
- Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, People's Republic of China
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Escobedo-Monge MF, Barrado E, Parodi-Román J, Escobedo-Monge MA, Torres-Hinojal MC, Marugán-Miguelsanz JM. Copper and Copper/Zn Ratio in a Series of Children with Chronic Diseases: A Cross-Sectional Study. Nutrients 2021; 13:3578. [PMID: 34684579 PMCID: PMC8537994 DOI: 10.3390/nu13103578] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 12/13/2022] Open
Abstract
Copper is an essential micronutrient for humans. A cross-sectional and comparative study was done to assess serum Cu levels and serum copper/zinc (Cu/Zn) ratio and its association with nutritional indicators in a series of children and adolescents with chronic diseases. Anthropometric, biochemical, dietary, body composition, and bone densitometry assessments were carried out. Serum Cu and Zn were measured by atomic absorption spectrophotometry. Seventy-eight patients (55% women) participated. The mean serum Cu in the entire series and by nutritional status through body mass index (BMI) was normal. Serum Cu decreased significantly with age and was meaningfully higher in children than in adolescents. The risk of finding altered Cu levels in children and men was higher than in adolescents and women, respectively. Twenty-two per cent of patients had abnormal serum copper levels, 13 had hypercupremia, and four had hypocupremia. The Cu/Zn ratio was greater than 1.00 for 87% of the patients, which is an indicator of an inflammatory state. All patients with hypozincemia and hypocupremia had deficient Zn intake, but only 65% of the patients with hypercupremia had dietary Zn deficiency. Consequently, the Cu/Zn ratio could indicate an inflammatory state and a high risk of zinc deficiency in this specific child population.
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Affiliation(s)
| | - Enrique Barrado
- Department of Analytical Chemistry, Science Faculty, Valladolid University, Campus Miguel Delibes, Calle Paseo de Belén, 7, 47011 Valladolid, Spain;
| | | | | | | | - José Manuel Marugán-Miguelsanz
- Department of Pediatrics of the Faculty of Medicine, Valladolid University,
Avenida Ramón y Cajal, 7, 47005 Valladolid, Spain;
- Section of Gastroenterology and Pediatric Nutrition, University Clinical Hospital of Valladolid, Avenida Ramón y Cajal, 3, 47003 Valladolid, Spain
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