Assessment of serum trace element levels in rheumatic heart disease: A case-control study

Year 2019, , 1 - 5, 15.03.2019

Mehmet Hakan Öncel , Cemal Tuncer

https://doi.org/10.25000/acem.451394

Cited By: 2

Abstract

Aim: Some trace elements play important roles in
various heart diseases. In this study, we aimed to determine the changes in
some trace element concentrations in the serum of patients with rheumatic heart
disease (RHD).

Methods: Sixty-one patients with RHD and 60
healthy subjects were included in the study. Six subgroups were defined in the
study group according to the Wilkins score, the degree of aortic involvement,
and the presence or absence of pulmonary hypertension. Selenium (Se), Zinc (Zn),
and Cupper (Cu) levels were measured, and transthoracic echocardiography was
performed in all participants.

Results: Serum Se and Zn concentrations were
significantly lower in the patients compared to the controls (mean±SD and p 43.08±1.83
µg/dL vs. 60.75±2.44 µg/dL; t=-5.305‎, p=0.001 and 64.65±2.77 µg/dL vs.
87.34±3.33 µg/dL; t=-5.458, p=0.001, respectively). However, the serum Cu
concentration was significantly higher in the patient group than in the control
group (84.50±3.50 µg/dL vs. 74.23±3.08 µg/dL; t=2.309, p=0.023). Similarly, the
Cu/Zn ratio in the patient group was found to be significantly higher than the
control group (1.4±0.09 µg/dL vs. 0.9±0.04 µg/dL; t=5.267, p=0.001). In the
patient group, there was no significant relationship between the Wilkins score,
aortic involvement, pulmonary hypertension, the serum trace element
concentrations, and Cu/Zn ratio (p>0.05 for all).

Conclusions:
We conclude that the changes in the concentrations of the measured trace
elements can predispose ‎to RHD and play a role in the formation of certain
factors that leads to the development of the ‎disease. Besides, serum Cu levels
and Cu/Zn ratio can be used as inflammatory process markers.

Keywords

rheumatic heart disease, trace elements, selenium, zinc, copper

Romatizmal kalp hastalığında serum eser element seviyelerinin değerlendirilmesi: Bir vaka kontrol araştırması

Abstract

Amaç: Değişik kalp
hastalıklarında bazı eser elementlerin önemli olduğu bilinmektedir. Bu
çalışmada Romatizmal Kalp Hastalığı (RKH) olan hastaların serumunda bazı eser
element konsantrasyonlarındaki değişiklikleri belirlemek ve bunun kronik RKH
ve kapak tutulumunun şiddetiyle olan ilişkisinin ortaya konması
amaçlanmıştır.

Metod: RKH olan 61 hasta ve
60 sağlıklı birey çalışma kapsamına alındı. Bu çalışmaya alınan hasta
grup, Wilkins skoruna, aort tutulumunun derecesine ve ayrıca pulmoner
hipertansiyonun varlığı ve yokluğuna göre olmak üzere toplam altı alt gruba
daha ayrıldı. Hastalara ayrıntılı fizik muayene ve laboratuvar incelemesinin
yanında kan Se, Zn ve Cu analizleri yapıldı. Hasta ve kontrol guruplarına
transtorasik ekokardiografi ile ölçümler standart görünümleri üzerinden
yapıldı.

Bulgular: Hasta grubunda
serum Se ve Zn konsantrasyonu kontrol grubuna göre anlamlı ölçüde düşük
bulundu (sırasıyla 43,08±1,83 µg/dL; 60,75±2,44 ‎µg/dL; p<0,001) ve
64,65±2,77‎ µg/dL; 87,34±3,33 µg/dL; p<0.001). Serum Cu konsantrasyonu hasta
grubunda kontrol grubuna göre anlamlı ölçüde yüksek bulunmuştur (84,5±3,5
‎µg/dL’ye karşılık 74,23± 3,08 µg/dL, p<0.05). Benzer şekilde Cu/Zn oranı
hasta grubunda kontrol grubuna göre anlamlı ölçüde yüksek bulunmuştur
(1,4±0,09 µg/dL’ye karşılık 0,9±0,04 µg/dL, p<0.001). Hasta grubunda serum
eser element konsantrasyonları ve Cu/Zn oranı ile hastalığın tutulum
şiddetini gösteren Wilkins skoru, aort tutulumu ve pulmoner hipertansiyon
arasında anlamlı bir ilişki bulunmamıştır (p>0,05).

Sonuç: Eser element
konsantrasyonundaki değişiklikler RKH’nı predispoze edebileceği gibi
hastalığın gelişimine yol açan bazı faktörlerin ortaya çıkmasına da katkı
sağlayabilir. Ek olarak artmış serum Cu seviyesi ve Cu/Zn oranı devam eden
inflamatuvar proçes markırları olarak kullanılabilir.

Keywords

Romatizmal kalp hastalığı, eser element, selenyum, çinko, bakır

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