The relationship between established coronary risk factors and serum copper and zinc concentrations in a large Persian cohort

The biotoxic effects of heavy metals exposure in miners and non-miners

Since little is known about the comparison of the biotoxic effects of heavy metals exposure on biochemical and hematological parameters in miners and non-miners, the current study aimed to compare the effects of arsenic (As), lead (Pb), and copper (Cu) in both groups. Demographic information and blood samples were collected from all participants and measures of As, Pb and Cu were obtained using Atomic Absorption Spectrophotometry. As and Pb mean concentrations in miners and Cu concentration were greater in non-miners. Miners also showed significantly higher level of RBC, HBG and HCT. In the adjusted model, cholesterol showed a positively association with Pb and Cu levels. Triglycerides, GGT, ALP, WBC and PLT positively and HDL-cholesterol negatively were associated with Cu. Creatinine was negatively associated with group variable. In conclusion, miners' high blood heavy metals concentrations can impact biochemical and hematological indices. These observations make monitoring of heavy metals necessary in miners.

Assessment of trace element and mineral levels in students from Turkmenistan in comparison to Iran and Russia

THE OBJECTIVE

Of the present study was to assess essential trace element and mineral levels in serum, hair, and urine of healthy first-year students from Turkmenistan (n = 73) in comparison to students from Iran (n = 78) or Russia (n = 95).

MATERIALS AND METHODS

Examination of foreign students was performed within two days after arrival to Russia during medical examination prior admission to RUDN University. Serum, hair, and urine trace element and mineral levels were assessed with inductively coupled plasma-mass spectrometry (ICP-MS).

RESULTS

The data demonstrate that the levels of trace elements and minerals in students from Turkmenistan share high similarity to elemental profiles of students from Iran. In comparison to students from Russia, subjects originating from Iran and Turkmenistan are characterized by lower serum cobalt (Co), chromium (Cr), copper (Cu), manganese (Mn), molybdenum (Mo), selenium (Se), vanadium (V), zinc (Zn) levels, higher urinary Cr, Cu, Fe, Mn, V, and Zn, lower urinary Co and hair Mo, Se, and Zn content. Concomitantly, students from Turkmenistan were characterized by lower urinary Cr and Cu, serum Cu and V levels, higher circulating Zn concentration, as well as the lower hair Cr, Cu, iodine (I) and magnesium (Mg) content in comparison to Iranian subjects. The discriminant analysis demonstrated that hair, serum, and urinary trace element and mineral levels contributed to complete discrimination between the groups of students from different countries.

CONCLUSIONS

The high similarity of trace element and mineral status of students from Turkmenistan and Iran is expected to be mediated by similar geochemical conditions in the bordering countries.

Prediction of cardiovascular disease risk by serum zinc and copper concentrations and anthropometric measurements

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.

Micronutrients intake and genetic variants associated with premature ovarian insufficiency; MASHAD cohort study

BACKGROUND AND AIM

premature ovarian insufficiency (POI) is defined as the menopause before 40 years of age, and its prevalence is reported to be two-fold higher in Iranian women than the average for woman globally. POI is associated with several cardio/cerebrovascular complications as well as an increased overall mortality. Genetic factors, and serum levels of minerals and vitamin D, have been reported to be related to the prevalence of POI. We have investigated the association between some POI -related genotypes with the serum levels of some important micronutrients.

METHODS

One hundred and seventeen women with POI and 183 controls without any renal, hepatic, and thyroid abnormalities were recruited as part of the MASHAD study. Demographic and anthropometric features were recorded and blood samples were collected and processed. DNA was extracted from the buffy coat of blood samples from all participants and 8 POI-related single nucleotide polymorphisms (SNPs) were determined using ASO-PCR or Tetra ARMS-PCR. Serum minerals and vitamin D concentrations were measured using routine methods.

RESULTS

In women with POI, serum copper, phosphate, and calcium were significantly different for those with rs244715, rs16991615, and rs4806660 genotypes, respectively. In our control population, significant differences were also found in serum copper concentrations between different genotypes of rs4806660, rs7246479, rs1046089, and rs2303369. After adjusting for all confounding factors, the women with POI carrying TC genotype (rs4806660) had a lower risk to have serum copper levels < 80 (µg/dL) than those carrying a TT genotype. Furthermore, women with POI carrying GG genotype (rs244715) had a 6-fold higher risk to have serum copper levels > 155 than those carrying AA genotype.

CONCLUSION

The C and G alleles of the rs4806660 and rs244715 polymorphisms respectively are independently associated with serum copper in women with POI. Further studies are necessary to investigate the association of serum copper and other micronutrients in women and other POI -related polymorphisms.

A novel cuproptosis-related diagnostic gene signature and differential expression validation in atherosclerosis

Atherosclerosis (AS) is a major contributor to morbidity and mortality worldwide. However, the molecular mechanisms and mediator molecules involved remain largely unknown. Copper, which plays an essential role in cardiovascular disease, has been suggested as a potential risk factor. Copper homeostasis is closely related to the occurrence and development of AS. Recently, a new cell death pathway called cuproptosis has been discovered, which is driven by intracellular copper excess. However, no previous studies have reported a relationship between cuproptosis and AS. In this study, we integrated bulk and single-cell sequencing data to screen and identify key cuproptosis-related genes in AS. We used correlation analysis, enrichment analysis, random forest, and other bioinformatics methods to reveal their relationships. Our findings report, for the first time, the involvement of cuproptosis-related genes FDX1, SLC31A1, and GLS in atherogenesis. FDX1 and SLC31A1 were upregulated, while GLS was downregulated in atherosclerotic plaque. Receiver operating characteristic curves demonstrate their potential diagnostic value for AS. Additionally, we confirm that GLS is mainly expressed in vascular smooth muscle cells, and SLC31A1 is mainly localized in macrophages of atherosclerotic lesions in experiments. These findings shed light on the cuproptosis landscape and potential diagnostic biomarkers for AS, providing further evidence about the vital role of cuproptosis in atherosclerosis progression.

Metal mixtures with longitudinal changes in lipid profiles: findings from the manganese-exposed workers healthy cohort

The majority of epidemiological investigations on metal exposures and lipid metabolism employed cross-sectional designs and focused on individual metal. We explored the associations between metal mixture exposures and longitudinal changes in lipid profiles and potential sexual heterogeneity. We recruited 250 men and 73 women, aged 40 years at baseline (2012), and followed them up in 2020, from the manganese-exposed workers healthy cohort. We detected metal concentrations of blood cells at baseline with inductively coupled plasma mass spectrometry. Lipid profiles were repeatedly measured over 8 years of follow-up. We performed sparse partial least squares (sPLS) model to evaluate multi-pollutant associations. Bayesian kernel machine regression was utilized for metal mixtures as well as evaluating their joint impacts on lipid changes. In sPLS models, a positive association was found between manganese and change in total cholesterol (TC) (beta = 0.169), while a negative association was observed between cobalt (beta =  - 0.134) and change in low density lipoprotein cholesterol (LDL-C) (beta =  - 0.178) among overall participants, which were consistent in men. Interestingly, rubidium was positively associated with change in LDL-C (beta = 0.273) in women, while copper was negatively associated with change in TC (beta =  - 0.359) and LDL-C (beta =  - 0.267). Magnesium was negatively associated with change in TC (beta =  - 0.327). We did not observe the significantly cumulative effect of metal mixtures on lipid changes. In comparison to other metals, manganese had a more significant influence on lipid change [group PIP (0.579) and conditional PIP (0.556) for TC change in men]. Furthermore, male rats exposed to manganese (20 mg/kg) had higher levels of LDL-C in plasma and more apparent inflammatory infiltration, vacuolation of liver cells, nuclear pyknosis, and fatty change than the controls. These findings highlight the potential role of metal mixtures in lipid metabolism with sex-dependent heterogeneity. More researches are needed to explore the underlying mechanisms.

Investigation on the Association of Copper and Copper-to-Zinc-Ratio in Hair with Acute Coronary Syndrome Occurrence and Its Risk Factors

The prevalence of coronary artery disease (CAD) increases every year; however, the impact of microelements on its underlying cause—atherosclerosis—is still unclear. Copper plays numerous regulatory roles in cardiovascular health and was suggested to influence the classic risk factors for CAD. The copper-to-zinc-ratio (Cu/Zn-ratio) reflects systemic oxidative stress–one of the factors in the complex pathogenesis of atherosclerosis. Hair incorporates metal ions during its growth; thus, it reflects the metal exposure that occurred over the last 4–8 weeks. The aim of the presented study was to verify the association between Cu and Cu/Zn-ratio content and the occurrence of acute coronary syndrome (ACS) in the hair of 133 patients who underwent coronary angiography due to suspected ACS. Additionally, association between Cu and Cu/Zn-ratio and selected risk factors for CAD was analyzed. Neither Cu nor Cu/Zn-ratio levels were associated with the occurrence of ACS, regardless of its type (UA/NSTEMI/STEMI). We did not find a significant association between Cu content in hair and risk factors for CAD. The Cu/Zn-ratio in hair was significantly correlated only with body mass index. The relationship of Cu content and Cu/Zn-ratio in hair with CAD, its risk factors and ACS appears to be complex and requires further well-designed research.

No Association of Hair Zinc Concentration with Coronary Artery Disease Severity and No Relation with Acute Coronary Syndromes

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Although zinc (Zn) was reported to have antioxidant, anti-inflammatory and protective properties in CVDs, its association with coronary artery disease (CAD) is still unclear. As methods commonly used to assess Zn levels in blood and urine do not show the full picture of the microelement supply, in this study, the nutritional status of Zn in patients with angiographically confirmed CAD was assessed using inductively coupled plasma optical emission spectrometry. We found no association between Zn and the severity of CAD evaluated with the Coronary Artery Surgery Study Score (p = 0.67). There were no statistically significant differences in Zn levels between patients with acute coronary syndrome and those with stable CAD (p = 0.937). A statically significant negative correlation was observed between Zn content and serum triglyceride concentration (p < 0.05). Patients with type 2 diabetes mellitus were found to have a significantly lower hair Zn content compared to non-diabetic individuals (p < 0.01). The role of Zn in the pathogenesis of CAD and its complications need further well-designed research as the moderation and supplementation of Zn dietary intake could be a simple intervention to reduce the CVDs risk.

The Association Between Plasma Copper Concentration and Prevalence of Diabetes in Chinese Adults With Hypertension

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.

Cohort profile: Bandar Kong prospective study of chronic non-communicable diseases

Chronic non-communicable diseases (NCDs), are the leading causes of death among adults worldwide. It is projected that half of the NCDs could be avoided by preventing measures. Under the prospective epidemiological research studies in Iran (PERSIAN), we established a prospective population-based cohort study in southern Iran. The present study was designed to observe changing pattern of lifestyle transition over time and investigate the incidence and prevalence of regional modifiable risk factors as well as their associations with major NCDs. At baseline, 4063 participants aged 35-70 years were recruited on Oct, 2016and planned to get re-evaluated every 5 years along with annual follow-up. Data using validated electronic questionnaire comprising 55 questions and 482 items including general, medical and nutrition queries was collected. Blood, hair, nails, urine specimens and anthropometric measurements were taken. The response rate was 99%. In the results; male and female participants were 42.5% and 57.5%, respectively. Of note, 30.4% of women and 16.1% of men were obese. The prevalence of hypertension in men and women was 14.6% and 21%; however, diabetic men and women were 17.4% and 12.4%, respectively. Living in rural areas increased the odds of having hypertension by 1.33 (AOR = 1.33, 95% CI:1-09, 1.61). Noteworthy, logistic regression displayed that aging could predispose individuals to be more overweight, hypertensive and diabetic. The prevalence of multimorbidity of 3 or more NCDs were 8% (No. 326) and 6% (No.240), respectively. Intake of fruits, vegetables and dairy was less than two servings per day in 9.2%, 13% and 58.3% of the participants. Lower cardiovascular diseases and serum level of FBS and higher HDL level in sailors/fishermen compared to other job groups were significant (p-value <0.001). The second annual follow-up was completed and now at the end of the third wave. Findings of the present study signified the high prevalence of behavioral risk factors and their associations with respective NCDs. Subsequently, it is essential to keep track lifestyle variations, the modifiable risk factors and NCDs trends by prospective population-based cohort studies.

Zinc as a Biomarker of Cardiovascular Health

The importance of zinc (Zn) for cardiovascular health continuously gains recognition. As shown earlier, compromised Zn homeostasis and prolonged inflammation are common features in various cardiovascular diseases (CVDs). Similarly, Zn biochemistry alters several vascular processes, and Zn status is an important feature of cardiovascular health. Zn deficiency contributes to the development of CVDs; thus, Zn manipulations, including Zn supplementation, are beneficial for preventing and treating numerous cardiovascular (CV) disorders. Finally, additional long-term, well-designed studies, performed in various population groups, should be pursued to further clarify significant relationships between Zn and CVDs.

Association of Zinc and Copper Status with Cardiovascular Diseases and their Assessment Methods: A Review Study

Cardiovascular disease (CVD) is the leading cause of mortality, morbidity, and financial losses and has a high prevalence across the world. Several studies have investigated the association between various CVD types with zinc and copper status as the essential minerals for the human body, proposing contradictory and similar results. This narrative review aimed to survey the correlations between zinc and copper status in the human body and some risk factors of CVD, as well as the assessment methods of zinc and copper status in the human body. According to the reviewed articles, zinc and copper deficiency may increase the risk of coronary heart disease, valvular regurgitation, and myocardial lesions, cardiac hypertrophy. Furthermore, it could lead to the expanded mitochondrial compartments of the heart, acute and chronic heart failure, and elevation of inflammation markers, such as interleukin-1 (IL-1) and IL-6. Two methods are primarily used for the assessment of zinc and copper in the human body, including the direct method (measurement of their concentrations) and indirect method (determining the activity of zinc- and copper-containing enzymes). Both these methods are considered reliable for the assessment of the zinc and copper levels in healthy individuals. Serum or plasma levels of these elements are also commonly used for the assessment of the correlation between zinc and copper status and CVD. But, which one is a more accurate indicator in relation to CVD is not yet clear; therefore, further studies are required in this field.

Impact of Micronutrients on Hypertension: Evidence from Clinical Trials with a Special Focus on Meta-Analysis

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.

Copper and Copper/Zinc Ratio in a Series of Cystic Fibrosis Patients

Cystic fibrosis (CF) patients require a stable and sufficient supply of micronutrients. Since copper is an essential micronutrient for human development, a cross-sectional study was carried out to investigate the serum copper levels, serum copper/zinc (Cu/Zn) ratios, and their relationship with nutritional indicators in a group of CF patients. Anthropometric, biochemical, and dietary measurements, an abdominal ultrasound, and respiratory and pancreatic tests were conducted. Seventeen CF patients were studied (10 females, 59%), 76.5% of whom were ∆F580. Their mean serum copper (113 ± 23 μg/dL) was normal, and there was only one teenager with hypocupremia (6%) and two children with hypercupremia (18%). A significant association between serum copper and zinc levels was discovered. The Cu/Zn ratio was higher than 1.00 for 94% of patients, which is an indicator of an inflammation status. There was no significant correlation between the serum copper concentrations and respiratory and pancreatic function, respiratory colonization, and the results of the abdominal ultrasound. Linear regression analysis showed that serum copper had a positive association with both the Z-score body mass index (BMI) and mean bone conduction speed (BCS). Therefore, since 94% of CF patients had a Cu/Zn ratio > 1.00, this factor must alert us to consider the risk of zinc deficiency and high inflammatory response. The measurement of serum zinc alone does not show one’s zinc status. However, the Cu/Zn ratio may be an indicator of zinc deficiency and the inflammatory status of CF patients.

Association of Dietary Inflammatory Index with cardiovascular disease in Kurdish adults: results of a prospective study on Ravansar non-communicable diseases

Background

Various diets and dietary compounds, through their inflammatory properties, are involved in the pathogenesis of chronic diseases including Cardiovascular Diseases (CVDs). Dietary Inflammatory Index (DII) can evaluate the inflammatory properties of diet. The purpose of this study was to determine the association between DII and CVDs in participants of the Ravansar Non-Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran.

Materials

The present cross-sectional study was conducted using the recruitment phase data of the RaNCD cohort study on 6369 participants aged 35 to 65 years. The Food Frequency Questionnaire (FFQ) was used to assess diet. The DII scores were calculated using FFQ data. Participants with a history of myocardial infarction, stroke and coronary artery disease, and/or taking medications for the CVDs were considered as the CVDs patients.

Results

Of the 6369 studied participants, 9% (n = 579) had CVDs history. The mean DII score in this study was − 0.84 ± 1.6. Odds ratio (OR) of CVDs in women was 1.6 times higher than in men (CI 95% = 1.3–1.9), which this association was remained after adjusting for confounding variables (OR = 1.5, CI% = 1.2–1.9). The risk of CVDs in the fourth quartile of DII was 1.4 times higher than the first quartile of DII (OR: 1.4, CI 95% = 1.1–1.8). We found that higher adhere to DII was associated with risk of CVDs.

Conclusion

According to current documents, given the role of diet through inflammatory properties on the risk of CVDs, it is recommended to use DII as an appropriate index to measure the effect of diet on CVDs in Iranian population. In addition, a diet with lower DII may be healthier diet for cardiovascular health.

Comprehensive laboratory reference intervals for routine biochemical markers and pro-oxidant-antioxidant balance (PAB) in male adults

Background

Reference values of biochemical markers are influenced by various parameters including age, sex, region, and lifestyle. Hence, we aimed to determine age‐ and BMI‐specific reference intervals (RIs) for important clinical biomarkers in a healthy adult male population from northeastern Iran. This is also the first study to investigate reference values for pro‐oxidant‐antioxidant balance (PAB).

Methods

Seven hundred and twenty (720) healthy men, aged 20‐60 years, were recruited from Sarakhs in the northeast region of Iran. Reference values for lipid profiles (total cholesterol, triglyceride, HDL‐C and LDL‐C), fasting blood glucose, inflammatory factors (hs‐CRP and PAB), minerals (zinc and copper), uric acid, and blood pressure were measured and statistically analyzed to establish accurate age‐ and BMI‐specific RIs in alignment with CLSI Ep28‐A3 guidelines.

Results

RIs for lipid profiles, inflammatory factors, minerals, and uric acid required no age partitioning with the exception of fasting blood glucose and blood pressure, which demonstrated significantly higher values in subjects aged 50 years and older. Among these biomarkers, only uric acid, blood pressure, and triglycerides demonstrated statistically significant increases in reference value concentrations with increasing BMI.

Conclusion

In this study, age‐ and BMI‐specific RIs for several biochemical markers were determined in healthy adult Iranian men. Partitioning by age and BMI was only required for a few analytes with most demonstrating no statistically significant changes with these covariates. These data can be useful to monitor various diseases in male adults with varying BMI in this region and others.

Association Between Copper, Zinc, Iron, and Selenium Intakes and TC/HDL-C Ratio in US Adults

The trace minerals zinc, copper, iron, and selenium are essential micronutrients, and because of their antioxidant activity, they are hypothesized to improve cardiovascular health. However, their associations with different risk levels for cardiovascular diseases are less clear. Data from the National Health and Nutrition Examination Survey 2007-2014 were used. In this study, the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) was used as a risk marker for cardiovascular disease, and a ratio ≥ 5 was considered to indicate high risk. A total of 7597 adults (3673 men and 3924 women) were included, and 15.9% of the participants had a high risk of cardiovascular disease. Using quantile regression analysis, we found the negative correlation between zinc, copper, iron, and selenium intakes and TC/HDL-C. The effects of copper and zinc were enhanced with increasing quantiles of risk levels. In addition, the difference in the associations of the trace minerals was sex-dependent. The correlation between iron and cardiovascular risk in males was stronger than those in females, while that of copper was weaker than that in females. Moreover, a significant nonlinear relationship between selenium and the TC/HDL-C ratio was only found in females, and this relationship was U-shaped. Our findings suggest that among healthy adults in the US, zinc, copper, iron, and selenium intakes are inversely associated with cardiovascular disease risk, and the effect is enhanced with increasing quantiles of risk levels, with magnitudes differing by sex. Therefore, trace minerals may have the ability to prevent cardiovascular disease.

The association between heavy metal and serum cholesterol levels in the US population: National Health and Nutrition Examination Survey 2009-2012

BACKGROUND

Few studies have examined the relationship between heavy metal and serum cholesterol levels, and no recent study has examined this relationship in the US population.

METHODS AND RESULTS

A total of 19,591 individuals aged 0-80 years were included in the National Health and Nutrition Examination Survey 2009-2012; the current study was composed of survey participants for whom some or all low-density lipoprotein cholesterol (LDL-C), serum triglyceride, high-density lipoprotein cholesterol, total cholesterol, blood lead (Pb), total blood mercury (Hg), and blood cadmium (Cd) levels had been measured. Three tertiles (T1-T3) of heavy metals were used to explore dose-response association between heavy metal exposure and serum cholesterol level. Logistic regression was used to explore the relationship between tertiles of blood heavy metal levels and serum cholesterol levels after adjusting for age, sex, and socioeconomic status. We have shown that the groups with the highest levels of Pb, Hg, and Cd had a 56%, 73%, and 41% chance, respectively, of having a high total cholesterol level. In study subjects with the highest Pb levels, there was also a 22% chance of being in the group with the highest LDL-C level. An increase in total cholesterol and LDL-C levels was observed from the first to the third tertiles of the heavy metals studied.

CONCLUSION

Increasing blood Pb, Hg, and Cd levels were associated with significantly increased odds of high total cholesterol after adjusting for age, sex, and socioeconomic status.

Altered serum Zinc and Copper in Iranian Adults who were of normal weight but metabolically obese

Metabolically obese normal weight (MONW) individuals are potentially at increased risk of developing metabolic syndrome. Serum zinc and copper concentrations were assessed in individuals with MONW to determine whether MONW is associated with altered serum zinc and/or copper status. Normal weight subjects (total n = 2419; 1298 men and 1121 women), were recruited as part of Mashhad Stroke and Heart Association Disorder (MASHAD) Study cohort. They were divided into two groups according to the presence or absence of MetS, defined using IDF criteria. Serum zinc and copper concentrations were determined by atomic absorption. Of the 2419 normal weight adults, 377 had MetS. Of this group, 53.7% and 49.7% had a serum zinc <70 µg/dl (Q1) (p = 0.001) or a serum copper <79 µg/dl (Q1) respectively. Furthermore, 27.3% had a serum copper >131 µg/dl (Q4) (p = 0.034), and 18.8% had a serum zinc >95 µg/dl (Q4). Logistic regression analysis was performed to determine the odds ratio (OR) for an association of serum zinc, copper and zinc to copper ratio with MetS in normal weight subjects. The subjects with a serum zinc >95 µg/dl (Q4) had 0.386 [OR: 0.614(95%CI 0.457–0.823)] lower chance of MetS (p = 0.001) and the subjects with a serum copper >131 (Q4) had OR 1.423 (95% CI: 1.09–1.857) higher chance of MetS (p = 0.009). These data remained significant after adjustment for age and sex, for serum zinc and copper, respectively. Furthermore, our results strongly suggested that zinc and copper were the independent risk factor for metabolic syndrome in normal weight subjects. There is an imbalance between serum copper and zinc concentrations among individuals with MONW when compared with normal BMI individuals without MetS. This may increase the risk of individuals with MONW developing conditions associated with this imbalance, such as diabetes and cardiovascular disease.

Association Between Trace Element Status and Depression in HTLV-1-Infected Patients: a Retrospective Cohort Study

Depression and Anxiety are two important public health problems that are known to be associated with viral infections. The association between the intake of nutrients such as zinc and copper with symptoms of depression has been studied previously. The aim of the current study was to investigate the association between depression with human T cell lymphotropic virus type 1 (HTLV-1) infection and serum content of zinc and copper in a large Iranian population cohort. The study population consisted of 279 HTLV-1-positive patients who were identified after recruitment as part of a large cohort study: the Mashhad Stroke and Heart Association Disorder (MASHAD) study. They were divided into two groups of diagnosed with or without depression based on their symptoms. Serum zinc and copper levels of all subjects were measured using the flame atomic absorption spectrometry. The population sample comprised of 279 individuals infected with HTLV-1 of whom 192 (68.8%) were women. The mean serum zinc in the group with and without depression was 78.69 ± 13.79 μg/dl and 86.87 ± 19.44 μg/dl, respectively (p < 0.001). Also, the serum copper level was higher in the depressive group (116.75 ± 39.56) than in the non-depressive group (104.76 ± 30.77) (p 0.004). The association between serum zinc and copper with depression in HTLV-1-infected patients which was shown in this study could be considered in the treatment strategies in these patients.

Association Between Hypertension in Healthy Participants and Zinc and Copper Status: a Population-Based Study

The prevalence of hypertension (HTN) is increasing globally. It has been shown that there is an association between micronutrient deficiency and HTN. In the current study, we aimed to assess the association between HTN with serum copper and zinc concentrations in a large representative Iranian population. The participants were enrolled into the Mashhad stroke and heart atherosclerotic disorders study (MASHAD study), a cohort study that was initiated in 2010. Anthropometric indices were assessed using standard procedures. Systolic (SBP) and diastolic (DBP) blood pressures were measured using a standard mercury sphygmomanometer. Fasting blood glucose (FBG), lipid profile, uric acid and blood urea nitrogen (BUN), and hs-CRP were measured using routine methods. HTN defined as persons who had SBP ≥ 130 mmHg and/or DBP ≥ 85 mmHg and/or medication use. Flame atomic absorption (Varian AA240FS) was used to measure serum Zn and Cu concentrations. SPSS software was used for all statistical analyses. A total of 9588 participants were recruited into the MASHAD study project. Participants were divided into two groups; 5695 healthy (non-hypertensive) (mean age 45.85 ± 7.5 years) and 3893 hypertensive participants (mean age 51.18 ± 7.67 years). Systolic (p < 0.001) and diastolic blood pressure (p < 0.001) were significantly different for different serum copper quartiles. The participants with serum copper levels < 80 μg/dl had 1.33 times greater risk of an increased blood pressure than other participants. Participants with serum copper levels > 130 μg/dl had a 1.94-fold higher risk of raised blood pressure. Serum zinc was not associated with systolic blood pressure, but individuals in the first quartile level of serum zinc had a diastolic blood pressure that was significantly higher than other quartiles (p = 0.035). Serum copper is associated with blood pressure status in adults in a U-shaped relationship, with a range of serum copper between 80 and 130 μg/dl being associated with normal blood pressure.

Association of serum copper, zinc and selenium levels with risk of metabolic syndrome: A nested case-control study of middle-aged and older Chinese adults

Trace elements, such as copper, zinc and selenium, have been linked to the development of metabolic syndrome. However, previous studies concerning these trace elements in association with metabolic syndrome have presented conflicting results in different countries. The aim of this study was to analyse the association between serum copper, zinc and selenium concentrations and the risk of metabolic syndrome among middle-aged and older Chinese adults. We performed a nested case-control study that included 349 individuals who developed metabolic syndrome (125 males and 224 females) during a 3-year follow-up and 349 controls matched by baseline age (±1 years), sex and area. Serum trace element concentrations were measured using atomic absorption spectrometry. The median serum selenium levels in males and females in the metabolic syndrome group were 82.2 (13.4) μg/L and 82.6 (11.1) μg/L, respectively, which were significantly higher than the serum selenium levels in the control group (p = 0.001 and p < 0.001). After adjusting for potential confounders, the odds ratios of risk for metabolic syndrome in the highest tertile of serum selenium levels were 2.72 [95% confidence interval (CI) 1.43-5.20; p for trend 0.002] for males and 5.30 (95% CI 3.31-8.74; p for trend <0.001) for females, respectively, compared with the lowest tertile. In addition, serum selenium levels were positively correlated with postprandial plasma glucose in both genders (for males: odds ratio 2.42; 95% CI 1.27-4.61; for females: odds ratio 2.11; 95% CI 1.32-3.37) and negatively associated with high-density lipoprotein in only females (odds ratio 3.21; 95% CI 1.75-5.91). These results suggest that higher levels of serum selenium might be an independent risk factor for metabolic syndrome, especially in relation to elevated postprandial plasma glucose and reduced high-density lipoprotein levels. However, we failed to demonstrate an association between copper or zinc status and metabolic syndrome or its components.

Serum Copper Homeostasis in Hypertensive Intracerebral Hemorrhage and its Clinical Significance

This study was to investigate the alterations of serum copper homeostasis after hypertensive intracerebral hemorrhage (ICH), which is not yet clear. We recruited 85 hypertensive ICH patients and determined their serum levels of total copper (TCu), small molecule copper (SMC), and ceruloplasmin (Cp). Sera from 32 healthy persons and 12 primary hypertension patients were collected and analyzed as well. Serum TCu levels in ICH patients were tested at three time points (on admission, day 3, and day 7) and found to be higher than that in hypertension patients (p < 0.05). The serum SMC levels in hypertension patients and ICH patients at three time points were higher than that in healthy controls (p < 0.05). Higher serum SMC levels on days 3 and 7 were associated with death in the hospital. Additionally, higher serum SMC levels on the seventh day were associated with poor outcome at discharge. High serum Cp levels on admission, as well as low serum Cp levels on the seventh day, were associated with death in the hospital (p = 0.002 and p = 0.034, respectively). Our findings indicated that declines in serum Cp and increases in serum SMC are correlated with lethal or poor outcome in hypertensive ICH patients, possibly as a result of contributions to secondary injury of brain after hemorrhage due to impairment of iron transport and enhanced oxidative stress.

Effect of hypotensive therapy combined with modified diet or zinc supplementation on biochemical parameters and mineral status in hypertensive patients

BACKGROUND

Hypotensive therapy leads to a number of trace elements metabolism disturbances. Zinc balance is frequently affected by antihypertensive treatment.

AIM

To evaluate the effect of a hypotensive treatment, modified diet and zinc supplementation on mineral status and selected biochemical parameters in newly diagnosed hypertensive patients on monotherapy.

METHODS

In the first stage, arterial hypertension in ninety-eight human subjects was diagnosed. In the second stage, antihypertensive monopharmacotherapy was implemented. In the third stage, patients were randomized into three groups and continued antihypertensive monotherapy: group D received an optimal-mineral-content diet, group S received zinc supplementation, and group C had no changes in diet or zinc supplementation. Iron, zinc, and copper concentrations in serum, erythrocytes, urine, and hair were determined. Lipids, glucose, ceruloplasmin, ferritin, albumin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α), nitric oxide (NO), superoxide dismutase (SOD) and catalase (CAT) were assayed in serum.

RESULTS

Antihypertensive monotherapy decreased zinc concentration in serum and erythrocytes and increased the level of zinc in urine, decreased CAT and SOD activity, TNF-α concentration in serum, and increased the level of NO in the serum. Zinc supply led to an increase in zinc concentration in serum, erythrocytes, and hair (in group S only). In the groups with higher zinc intake, decreased glucose concentration in the serum was observed. Significant correlation was seen between the zinc and glucose serum concentrations.

CONCLUSION

Hypotensive drugs disturb zinc status in newly diagnosed hypertensive patients. Antihypertensive monotherapy combined with increased zinc supply in the diet or supplementation favorably modify zinc homeostasis and regulate glucose status without blood pressure affecting in patients with hypertension.

Trace minerals intake: Risks and benefits for cardiovascular health

Minerals play a major role in regulating cardiovascular function. Imbalances in electrolyte minerals are frequent and potentially hazardous occurrences that may lead to the development of cardiovascular diseases (CVDs). Transition metals, such as iron, zinc, copper and selenium, play a major role in cell metabolism. However, there is controversy over the effects of dietary and supplemental intake of these metals on cardiovascular risk factors and events. Since their pro-oxidant or antioxidant functions can have different effects on cardiovascular health. While deficiency of these trace elements can cause cardiovascular dysfunction, several studies have also shown a positive association between metal serum levels and cardiovascular risk factors and events. Thus, a J- or U-shaped relationship between the transition minerals and cardiovascular events has been proposed. Given the existing controversies, large, well-designed, long-term, randomized clinical trials are required to better examine the effects of trace mineral intake on cardiovascular events and all-cause mortality in the general population. In this review, we discuss the role of dietary and/or supplemental iron, copper, zinc, and selenium on cardiovascular health. We will also clarify their clinical applications, benefits, and harms in CVDs prevention.

Biomarkers of the metabolic syndrome: Influence of minerals, oligo- and trace elements

Influences of minerals, oligo- and trace elements on the concentration of biomarkers of the metabolic syndrome (MetS) are reviewed. Since food is a complex mixture of caloric compounds and essential non-caloric food components with multiple interactions and varying bioavailability, it is hard to separate or identify the effect of one single component in a total meal or diet. Moreover the diet contains various non-nutritive biologically active components, which may add some beneficial characteristics. Therefore, conclusions on the effect of components on various biomarkers of MetS are sometimes quite contradictory. Reasons therefore are mentioned. Literature data should be studied in detail to conclude whether a component is related to a reduction of MetS-related symptoms or whether its influence is merely affecting a biomarker.

The Prevalence of Metabolic Syndrome in Coronary Artery Disease Patients

BACKGROUND

Metabolic syndrome (MetS) is a worldwide health problem, which is growing in Iranian adults. MetS is associated with risk of type 2 diabetes and coronary artery disease (CAD). In this study, we aimed to investigate the prevalence of MetS and its individual components in CAD patients.

METHODS

This cross-sectional study was performed on 200 CAD patients who had undergone elective coronary angiography at the cardiology department. Anthropometric indices including waist circumference (WC) and body mass index were measured. Blood samples were obtained to determine glucose and lipid profile. MetS components were defined according to the modified Adult Treatment Panel III (ATP III) criteria.

RESULTS

The prevalence of MetS among patients was 49.5% (women: 55.9%; men: 40.2%; P < 0.05). The prevalence increased with age. The low high-density lipoprotein-cholesterol (low HDL-C) (84.8%), high fasting blood glucose (high FBG) (77.8%) and high WC (75.8%) were the most prevalent risk factors in CAD patients with MetS.

CONCLUSIONS

Recent data indicate that the dyslipidemia, hyperglycemia and abdominal obesity are crucial predictors of MetS in CAD patients. Further prospective studies are recommended for more clarification.

Serum Copper and Zinc in a Representative Sample of Bulgarian Population

Copper (Cu) and zinc (Zn) are essential for life. Body Cu and Zn content depends on variety of factors - age, gender, and diet, type of drinking water, geographical location and genetic predisposition. Copper status becomes even more relevant not only in rare genetic disorders such as Wilson disease but in diseases such as cardiovascular ones, impaired glucose tolerance and neuro-degenerative and tumor diseases. The study aimed to examine the distribution of serum Cu and Zn in a representative group of the Bulgarian population and to describe factors which influence metal content. It also aimed to describe the link between serum Cu levels and the frequency of Alzheimer’s disease (AD) in Bulgarians. Cu and Zn in serum were measured in 379 individuals (172 males and 207 females) from 5 different regions in Bulgaria by flame atomic absorption using AAnalyst 400, Perkin Elmer. Statistical analyses were performed by SPSS, 19. Median and inert-quartile range (IQR) for blood Cu were 15.89 (13.87-7.89) μmol/L and for Zn - 13.00 (11.7-14.68) μmol/L in the examined group. Higher Cu levels in females than in males were found (p < 0.001). Decrease of Zn with aging was established (p > 0.05). Significant difference (p < 0.05) was found in serum Cu between young people (< 30 year old) and adults over 61 year old. Statistically significant difference in Cu and Zn was observed (p < 0.05) in respect of residences. Difference without significance was measured between serum lipids and serum Cu (p = 0.541) and Zn (p = 0.741).

Serum Trace Element Concentrations in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a condition that is associated with oxidative stress. Serum trace elements and their related transport proteins, e.g., albumin and ceruloplasmin, play an important role in the antioxidant defense. Trace element status may therefore be involved in the pathogenesis of RA or be affected by the disease activity of this chronic inflammatory condition. The study participants were 110 patients with RA and 100 sex- and age-matched healthy volunteers. Serum concentrations of albumin, ceruloplasmin, selenium, zinc, copper, and zinc/copper ratio were measured in all subjects. The relationship between these parameters and disease activity score was also assessed. Lower concentrations of serum Alb, Zn, and Se were independently related to disease activity index. High concentrations of serum copper were associated with the presence of RA. Serum Cu concentrations were positively related to disease activity as assessed by the disease activity score. Low serum concentrations of Zn and Se, and high serum Cu concentrations may be associated with the presence of RA or be a consequence of this condition. Of the trace elements that were investigated in the present study, only serum Cu was positively correlated with disease activity.

Zinc and copper status in childbearing age Tunisian women: Relation to age, residential area, socioeconomic situation and physiologic characteristics

Plasma zinc and copper status of 1689 non pregnant Tunisian women, aged 20-49 years old, was determined by flame atomic absorption spectrometry. A multiple regression was run to predict plasma trace element concentrations from age, BMI, marital status, menopause, education level, professional activity, economic level and area of living. The mean zinc and copper values were similar to those measured among comparable populations in earlier studies. However, a high prevalence of low plasma zinc and copper concentrations was observed assuming that women at childbearing age are at high risk of zinc and copper deficiencies and specific intervention may be considered. In univariate analysis, the mean values of plasma zinc and copper were associated with sitting areas and professional activity. For only plasma copper levels, there was an increase with BMI and parity, and a decrease with increasing schooling level and economic score. After adjustment for all variables, profession and parity showed a significant relationship between plasma levels copper.

Zinc and copper levels are not correlated with angiographically-defined coronary artery disease in sudanese patients

We investigated zinc and copper levels in angiographically defined obstructive coronary artery disease (CAD) in patients undergoing elective coronary angiography in El-Shaab Hospital, Sudan. We performed a cross-sectional study. One hundred forty-two patients were enrolled. Sociodemographic and medical characteristics were collected using a questionnaire. Glucose, lipid, zinc, and copper levels were measured. Out of 142 patients, 102 (71.8%) had CAD and 40 (28.2%) had patent coronary arteries. There were no significant differences in median (interquartile range) zinc [118.5 (97.2-151.0) vs. 130.0 (106.0-174.0) μg/ml, P = 0.120] and copper [150.6 (125.0-183.0) vs. 158 (132.0-180.0) μg/mL, P = 0.478] levels between patients with CAD and those with patent coronary arteries. In linear regression analysis, there were no associations between CAD and zinc and copper levels. The current study failed to show any significant association between CAD and zinc and copper levels.

Relationship between the concentrations of heavy metals and bioelements in aging men with metabolic syndrome

Heavy metals may exacerbate metabolic syndrome (MS) but abnormal serum concentrations of bioelements may also co-exist with MS. The primary aim of the study was to assess the relationship of blood heavy metal and bioelement concentrations and MS, in men aged 50-75 years. Heavy metals-lead (Pb), cadmium (Cd), mercury (Hg), arsenic (As), tungsten (W), Macroelements-magnesium (Mg) and calcium (Ca), and microelements-iron (Fe), zinc (Zn) copper (Cu), chromium (Cr), molybdenum (Mo), selenium (Se) and manganese (Mn), body mass index (BMI), waist to hip ratio (WHR), abdominal circumference (AC) and blood pressure (BP), total cholesterol (TCh), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), fasting plasma glucose (FPG), insulin, and Homeostasis Model Assessment-Insulin resistance (HOMA-IR). The men with MS showed statistically significant higher Zn and lower Mg concentrations. Those with diabetes had higher Ca concentration and lower Mg concentration. Cr and Mn concentrations were significantly higher in obese men. The participants with hypertension had lower Mg concentration. We found statistically significant positive correlations (W-TCh, W-LDL, Mg-TCh, Mg-LDL, Ca-TCh, Ca-LDL, Ca-insulin, Ca-HOMAR-IR, Zn-TG, Zn-insulin, Zn-HOMA-IR, Cu-BP systolic, Mn-BMI, Mn-AC, Mn-WHR, Mn-insulin, Mn-HOMA-IR, Se-TCh, Se-LDL, Se-TG, Se-insulin, Se-HOMA-IR, Cr-TCh, Cr-HDL, Cr-LDL, Cr-TG) and negative correlations (Cd-insulin, Hg-WHR, W-insulin, W-HOMA-IR, Mg-BMI, Mg-AC, Mg-WHR, Mg-BP systolic, Mo-insulin, Mn-HDL). Tungsten may contribute to lipid disorders. Magnesium appears to play the protective role in the occurrence of metabolic disorders. Microelements Mn, Cr and Se may intensify MS.

Auricular or body acupuncture: which one is more effective in reducing abdominal fat mass in Iranian men with obesity: a randomized clinical trial

BACKGROUND

The prevalence of abdominal obesity is on the rise worldwide. Previous studies have indicated the higher diagnostic value of body fat distribution pattern compared with general body in abdominal obesity assessments. Several non-pharmacological methods have been suggested for obesity management, of which acupuncture has gained a great deal of research interest with promising results. This study aimed to comparatively evaluate the effects of conventional auricular and body electroacupuncture on abdominal fat mass in obese men.

METHODS

The volunteers were randomly divided into four groups, including 2 interventions and 2 controls. This study was conducted on 80 obese volunteer men with Body Mass Index (BMI) range of 30-40 kg/m2.The intervention groups including real body electroacupuncture (A), real auricular acupuncture (C) and the control groups containing sham body electroacupuncture (B), and sham auricular acupuncture (D). All groups were in combination with a low-calorie diet for 6 weeks. BMI, Trunk Fat Mass (TFM), Waist Circumference (WC), and Hip Circumference (HC) were measured pre- and post-intervention.

RESULTS

In group A, respectively a significant reduction was shown in BMI (P < 0.005), TFM (P < 0.005), WC (P < 0.05, P < 0.005) and HC (P < 0.005) when compared with controls (Groups B and D). Interestingly, group C had significant decreases in BMI (P < 0.005), TFM (P < 0.01, P < 0.005), WC (P < 0.005) and HC (P < 0.001) after comparison with the sham. Likewise, WC (P < 0.05) and HC (P < 0.05) were significantly reduced post- intervention when compared with two treatment groups.

CONCLUSIONS

In our study, acupuncture treatment (body or auricular) seemed to have an effect on reducing BMI, TFM, WC and HC. Comparison of the two types of treatment (body and auricular acupuncture) suggests that the two types of acupuncture had similar effects on reducing BMI and TFM, but body electroacupuncture is more effective in reducing WC and auricular in HC. It seems that both auricular and body electro-acupuncture combined with a low-calorie diet are efficient, simple and painless methods to reduce respectively the HC and WC fat in obese men, compared with conventional techniques.

TRIAL REGISTRATION

IRCT201201127117N2.

The associations between serum zinc levels and metabolic syndrome in the Korean population: findings from the 2010 Korean National Health and Nutrition Examination Survey

The prevalence of metabolic syndrome has been increasing rapidly worldwide. The functions of zinc may have a potential association with metabolic syndrome, but such associations have not been investigated extensively. Therefore, we examined the relationship between serum zinc levels and metabolic syndrome or metabolic risk factors among South Korean adults ≥20 years of age. The analysis used data from the Korean National Health and Nutrition Examination Survey, a cross-sectional survey of Korean civilians, conducted from January to December 2010. A total of 1,926 participants were analyzed in this study. Serum zinc levels in men were negatively associated with elevated fasting glucose (adjusted odds ratio [aOR], 0.58; 95% confidence interval [CI], 0.36–0.93) and positively associated with elevated triglycerides (aOR, 1.47; 95% CI, 1.01–2.13). A difference in serum zinc levels was detected in women, depending on the number of metabolic syndrome components (p = 0.002). Furthermore, serum zinc levels showed a decreasing trend with increasing numbers of metabolic syndrome components in women with metabolic syndrome. These findings suggest that serum zinc levels might be associated with metabolic syndrome or metabolic risk factors. Further gender-specific studies are needed to evaluate the effect of dietary or supplemental zinc intake on metabolic syndrome.

The influence of selected antihypertensive drugs on zinc, copper, and iron status in spontaneously hypertensive rats

Mineral homeostasis in hypertensive patients may be affected by hypotensive drugs. The aim of this study was to assess the influence of selected antihypertensive drugs on mineral homeostasis in a rat model of hypertension. Eight-week-old male spontaneously hypertensive rats (SHRs) were treated with perindopril, metoprolol, indapamide, amlodipine, or no drug for 45 days. In another experiment, the SHRs were treated with indapamide or amlodipine in the presence of zinc and copper gluconate supplement. Lipids, glucose, and insulin levels along with superoxide dismutase and catalase activities were assayed in serum. Iron, zinc, and copper concentrations in serum, erythrocytes, and tissues were determined using the flame atomic absorption spectrometry. Blood pressure was measured using a tail-cuff plethysmograph. Treatment with indapamide and amlodipine was found to significantly lower zinc levels in serum, erythrocytes, livers, and spleens of the SHRs, as well as copper levels in the kidneys, compared with the control no-drug group. A markedly higher concentration of glucose was found in the indapamide-treated rats. Supplementing the indapamide-treated SHRs with zinc and copper gluconate resulted in a significant decrease in both systolic and diastolic blood pressure, and also lowered serum glucose and triglyceride concentrations and HOMA (homeostasis model assessment-insulin resistance) values. The results show that indapamide and amlodipine disturb zinc and copper homeostasis in SHRs. Supplementation with zinc and copper restores mineral homeostasis in SHRs treated with indapamide and amlodipine, and also corrects metabolic imbalances while improving the antihypertensive efficiency of indapamide.

Gender differences in the relationship between serum zinc concentration and metabolic syndrome

BACKGROUND

Zinc, a co-factor of antioxidant enzymes, may be involved in the pathophysiology of metabolic syndrome (MetS).

AIM

To determine the association between serum zinc concentration and MetS in a population-based study.

SUBJECTS AND METHODS

In the Tehran Lipid and Glucose Study, serum zinc concentration was measured by flame atomic absorption spectrometry in 2626 adult participants. After removal of outliers, usable data was available for 2401 participants. Dietary zinc was assessed by a validated semi-quantitative food frequency questionnaire.

RESULTS

Compared to those without the MetS, serum zinc concentration was significantly higher in men with syndrome (17.1 ± 4.9 vs 16.5 ± 4.6 μmol/L, p = 0.035); however, values were comparable in females (16.1 ± 4.8 vs 15.8 ± 4.4, p = 0.460). Men in tertile 3 of serum zinc had significantly higher chances of having MetS, even after multivariate adjustment (OR = 1.48, 95% confidence interval (CI) = 1.07-2.06, p = 0.020). Women in tertile 2 of serum zinc had significantly lower chances of having MetS, which remained significant after multivariate adjustment (OR = 0.68, 95% CI = 0.47-0.99, p = 0.046).

CONCLUSION

This study observed a gender difference between serum zinc and MetS, with higher levels being positively associated with MetS in men and having a protective effect in women. Further studies are needed to elucidate the role of zinc status in the development of MetS.

Levels of selenium, zinc, copper, and cardiac troponin I in serum of patients with acute coronary syndrome

The aim of this study was to assess the levels of selenium (Se), zinc (Zn), copper (Cu), and troponin I (TnI) in patients with acute coronary syndrome (ACS) on admission to our emergency department in comparison to healthy control subjects. Patients with diagnosed ACS (n = 100) were included in the study group. Control subjects (n = 100) were selected from healthy volunteers in the same age range. Venous blood samples were obtained to evaluate the levels of Se, Zn, Cu, and TnI (on admission for the ACS group). Serum Se, Zn, and Cu levels were significantly less in the ACS group compared to the control group (p <0.001, p <0.01, and p <0.001, respectively). The serum TnI level was significantly greater in the ACS group compared to the control group (p <0.05). The serum Se level in the ACS group correlated significantly with the TnI level (r = -0.211, p = 0.035). These results indicate that Se, Zn, and Cu deficiencies may be risk factors for ACS, and a decreased serum Se level in patients with ACS might reflect the degree of myocardial necrosis.

Zinc, copper, and blood pressure: Human population studies

Copper and zinc are essential trace biometals that regulate cardiovascular homeostasis, and dysregulation of these metals has been linked to vascular diseases, including hypertension. In this article, we review recent human population studies concerning this topic, focusing on: 1) the relationship between blood pressure and levels of zinc and copper; 2) correlations between trace metals, the renin-angiotensin system, obesity, and hypertension; 3) the relationship between environmental metal pollution and the development of hypertension; and 4) methods commonly employed to assay zinc and copper in human specimens. Moreover, based on the findings of these studies, we suggest the following topics as the basis for future investigations: 1) the potential role of environmental metal pollution as a causal factor for hypertension; 2) metal profiles within specific pathogenic subsets of patients with hypertension; 3) standardizing the experimental design so that the results between different studies are more comparable; and 4) the requirement for animal experiments as complementary approaches to address mechanistic insight that cannot be studied in human populations.

Reference values for serum zinc concentration and prevalence of zinc deficiency in adult Iranian subjects

Zinc, as an essential trace element for health, plays various biological roles in human body functions. Serum zinc reference values are essential for assessing zinc-associated abnormalities and the prevalence of zinc deficiency. This study aims at determining age- and sex-specific reference values for serum zinc concentrations in adult Iranian subjects. Serum zinc concentration was measured by flame atomic absorption spectrometry in 4,698 adult subjects, aged 20-94 years, randomly selected from the population of the Tehran, Lipid, and Glucose Study. After application of exclusion criteria, reference values for serum zinc were determined in 2,632 apparently healthy subjects according to guidelines of the International Federation of Clinical Chemistry (nonparametric method). Dietary zinc was assessed in 2,906 individuals, of which 1,685 were healthy subjects, using a validated semiquantitative food frequency questionnaire. Reference values for serum zinc concentrations ranged between 9.6 and 31.6, 8.9 and 29.9, and 9.3 and 30.8 μmol/L in men, women, and the total population, respectively. Prevalence of serum zinc deficiency was 3.0 and 2.4 % in men and women, respectively (p = 0.267); in men, but not in women, the prevalence increased significantly with age (p for trend <0.001). Of the total participants, 10.3 % (6.5 men and 3.8 % women, p < 0.01) had lower zinc intake compared to dietary reference intakes. The zinc density of the population was 6.3 mg/1,000 kcal. In conclusion, this study presents reference values for serum zinc concentration in adult Iranian subjects for both sexes and different age groups. Prevalence of serum zinc deficiency and dietary zinc inadequacy seems to be lower in Iranians, compared to some other populations.

Effects of auricular acupressure combined with low-calorie diet on the leptin hormone in obese and overweight Iranian individuals

BACKGROUND

Human leptin is a peptide hormone that is released from white adipocytes. The absence of leptin or its receptor leads to uncontrolled food intake, leading to obesity. In the present work, the effects of auricular acupressure combined with low-calorie diet on the leptin hormone level were investigated.

METHODS

Volunteers (n=86) with body mass indices (BMI) between 25 and 45 kg/m² were randomised into a case (n=43) or a control (n=43) group. Participants in each group received a low-calorie diet for 6 weeks. The case group was treated with auricular acupressure and the control group received a sham procedure. Plasma leptin levels, body fat mass, body weight and BMI were measured before and after treatment.

RESULTS

Participants who received auricular acupressure showed significant reductions in their plasma leptin levels (18.57%, p<0.01) as well as in their body fat mass (4%, p<0.05). These changes were not observed in the control group. The reduction in leptin was significantly greater in the acupressure group than the controls.

CONCLUSIONS

Auricular acupressure combined with a low-calorie diet significantly reduced plasma levels of leptin. However, the mechanism of this reduction is not clear.

Gender differences in copper, zinc and selenium status in diabetic-free metabolic syndrome European population - the IMMIDIET study

BACKGROUND AND AIMS

The European 'IMMIDIET' study was designed to evaluate the effect of genetic and dietary habit interactions on cardiovascular disease risk factors in non-diabetic subjects. Copper, zinc and selenium are involved in redox balance and modifications of their homeostasis could be associated with metabolic syndrome. Because few studies have dealt with trace element status in metabolic syndrome with conflicting results, we aimed at investigating the relationships between plasma copper, zinc and selenium concentrations and metabolic syndrome in the IMMIDIET population.

METHODS AND RESULTS

Male-female couples born and living in Abruzzo, Italy (n = 271); Limburg, Belgium (n = 267), southwest part of London, England (n = 263) and 205 Italian-Belgian mixed couples living in Belgium were enrolled. Data on medical history, hypertension and blood lipid profile, medication use, smoking and alcohol habits, physical activity and socioeconomic status were collected using a standardised questionnaire. Anthropometric, blood pressure, glucose, insulin, lipid profile and copper, zinc and selenium measurements were performed. Participants were classified in two groups according to the presence of metabolic syndrome (Yes/No). Comparison between these two groups, performed separately in men and women, indicated no association in men whereas, in women, metabolic syndrome was associated with higher plasma selenium concentrations (odds ratio (OR) = 1.55(1.28-1.89)); this association remained significant after adjustment for age, group, social status, physical activity, energy intake, alcohol consumption, smoking and hormonal status (OR = 1.33 (1.06-1.67)).

CONCLUSION

Our results indicate gender differences in the association between plasma selenium concentration and metabolic syndrome without diabetes and may suggest a sub-clinical deleterious effect of high selenium status in women.

Selenium is significantly depleted among morbidly obese female patients seeking bariatric surgery

BACKGROUND

The aim of this study was to compare serum levels of trace elements in morbidly obese female patients seeking bariatric surgery with those of age-matched females with body mass index (BMI) less than or equal to 30.

METHODS

Blood samples were collected from 66 morbidly obese female patients seeking bariatric surgery prior to undergoing surgery. Blood was collected also from 44 female patients (with BMI less than or equal to 30) prospectively from April 2009 till February 2010. Exclusion criteria in both groups were the presence of any co-morbidities on medication, patients receiving any vitamin supplement or any herbal product intake, smoking, and alcohol consumption. Serum zinc, magnesium, copper, and selenium were measured and compared between the two groups.

RESULTS

The mean age and BMI for morbidly obese female patients was 28.5 years (21.5-35.5) and 45.26 kg/m(2) (40.3-50.22). The control group had a mean age and BMI of 30.75 years (21.35-40.15) and 25.88 kg/m(2) (22.73-29.03). For morbidly obese patients, the serum level of copper, zinc, selenium, and magnesium was 1,623.84, 698.34, 86.08, and 17,830 μg/l, respectively, compared to 1,633.36, 734.82, 101.14, and 18,260 μg/l for the control group. The serum levels of the trace elements were not statistically significantly different between the two groups except for selenium, which was significantly reduced among morbidly obese female patients (p < 0.0001).

CONCLUSIONS

Serum selenium level is significantly reduced among morbidly obese female patients seeking bariatric surgery.

Circulating levels of metals are related to carotid atherosclerosis in elderly

The aim of this study was to investigate if blood levels of trace and/or heavy metals are related to atherosclerosis in a cross-sectional study in elderly. In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (1016 subjects, all aged 70), the prevalence of carotid artery plaques was recorded by ultrasound. The numbers of carotid arteries with plaques (0, 1 or 2) were recorded. Also the thickness (IMT) and gray scale (IM-GSM) of the intima-media complex were measured together with plaque echogenicity. Eleven heavy metals and trace elements were analyzed in whole blood, using inductively coupled plasma-sector field mass spectrometry. Nickel levels were related to the number of carotid arteries with plaques in an inverted U-shaped manner after multiple adjustment for gender, waist circumference, body mass index, fasting blood glucose, systolic and diastolic blood pressure, HDL and LDL cholesterol, serum triglycerides, smoking, antihypertensive treatment and statin use (p=0.026). IM-GSM and plaque echogenicity were both inversely related to chromium in a linear fashion, and to aluminum in an inverted U-shaped manner (both p<0.0001 for IM-GSM). The relationships between metals and IMT were modest. Circulating levels of some metals, like nickel, aluminum and chromium, were related to atherosclerotic plaques or the echogenicity of the IM-GSM and overt plaques independently of cardiovascular risk factors, including lipids.

Gender differences for associations between circulating levels of metals and coronary risk in the elderly

Several studies have pointed out associations between various metals and cardiovascular disease. Since cardiovascular disease prevalence is different between males and females, we investigated whether circulating levels of metals related differently to coronary risk in men and women. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, coronary risk was assessed by the Framingham Risk Score together with circulating blood levels of 11 different trace and heavy metals in 1016 subjects aged 70 years. Circulating levels of cadmium, copper and manganese were significantly higher in women than in men, while mercury, zinc and lead were significantly lower following adjustment for kidney function (measured by glomerular filtration rate, GFR). No significant differences between women and men were seen regarding levels of aluminium, molybdenum, cobalt, chromium and nickel. When all 11 metals were entered as independent variables together with GFR in multiple models in the Framingham Risk Score as the dependent variable, cadmium was the major determinant of the Framingham Risk Score in women (p<0.0001, followed by zinc p=0.03), while copper was the major determinant of the Framingham Risk Score in men (p<0.0001, followed by inverse relations vs. aluminium p=0.01 and nickel p=0.01). There are gender differences in levels of metals and also regarding the association between metals and coronary risk, with cadmium levels being most important for women and copper levels for men in this elderly population.

Copper concentration in a healthy urban adult population of southern Iran

Nutritional deficiencies are important and widespread problems in most developing countries. Preventing and correcting micronutrient deficiencies are important because of the multiple negative consequences of these deficiencies. This study was designed to determine the prevalence of copper deficiency in an adult population in Shiraz, southern Iran. We also determined the association between copper status and other factors such as age, sex, and body mass index (BMI). In this cross-sectional study, 416 adults residing in Shiraz were selected by two-stage sampling. Serum copper was measured by flame-atomic absorption spectrometry. The data were analyzed with SPSS software. Mean age in our sample was 39.33 ± 15.06 years, and mean BMI was 26.17 ± 4.81 kg/m(2). Mean serum copper concentration was 118.15 ± 54.33 μg/dL in the whole sample, 109.74 ± 56.22 μg/dL in men, and 122.15 ± 53.04 μg/dL in women. The overall prevalence of copper deficiency was 24%. The prevalence of copper deficiency differed significantly between men and women but not between different age groups. Serum copper concentration correlated significantly with BMI (p < 0.05). This study is the first to evaluate serum copper status in a healthy population in southern Iran. We show that the mean copper concentrations were higher than those reported for Iranian populations in northern cities and were also higher compared with studies in most other countries. We suggested more detailed studies to identify the etiological determinants of this nutritional deficiency in Iran and elsewhere.

Coronary artery disease and its risk factors status in iran: a review

Background

Coronary artery disease (CAD) is a leading cause of mortality, morbidity, and disability in the world. The high prevalence and morbidity associated with CAD in Iran is one of the most pressing health problems.

Methods

We have reviewed the status of CAD and prevalence of its traditional and novel risk factors based on the published papers in recent years that may have an impact on the rate of CAD in Iran. Evaluation of current impact of metabolic syndrome in Iran was the other aim of this review, as it contributes to pathogenesis of coronary artery disease. We reviewed all PubMed indexed related studies. Some evidences from national articles which were published by the Ministry Of Health and Medical Education Research Council Certified Medical Journals of Islamic Republic of Iran were also included.

Results

The prevalence of CAD, coronary risk factors and metabolic syndrome in Iran is higher than Western countries and similar to some Middle East countries. There are limited data with regard to novel coronary risk factors in Iran.

Conclusion

Primary and secondary prevention of CAD including life style modifications and dietary interventions strongly recommended in Iranian population.