The Relationship of Trace Element Levels with Obesity and Cardiovascular Health
Year 2024,
Volume: 14 Issue: 3, 752 - 759, 30.09.2024
Doganay Oguz
,
Nur Demirbaş
,
Ruhuşen Kutlu
,
İbrahim Kılınç
Abstract
Objective: One of the most important factors affecting cardiovascular health is obesity. Trace elements, which play a role in every stage of metabolism, are also related to our cardiovascular health. The aim of this study was to determine serum trace element levels in individuals and to examine the relationship between trace elements and cardiovascular risk.
Methods: This cross-sectional study was conducted with individuals who applied to the outpatient clinic between 01.03.2022-31.04.2022. Sociodemographic characteristics, BMI, and Framingham risk score values were recorded. Serum iron, zinc, copper and selenium levels were analyzed in the laboratory.
Results: A total of 180 individuals were included in the study. Of the individuals, 33.3% were overweight and 32.8% were obese. The mean Framingham Risk Score (FRS) was 9.31±7.99 (1-37). FRS values of normal weight individuals (7.84±3.05) were lower than the mean FRS values of overweight (8.80±3.39) and obese (13.39 ± 6.24) groups (p<.001). There was a weak positive correlation between serum copper levels and BMI (r=.176 p=.018). No significant correlation was found between serum iron, zinc and selenium levels and BMI and FRS.
Conclusion: There was a weak positive correlation between copper levels and BMI values, however Se, Zn and Fe levels were not associated with BMI and FRS values. Randomized controlled trials are needed to introduce serum trace element determination in to practice in the diagnosis and follow-up of obesity and cardiovascular disease.
Ethical Statement
This study was approved by Ethics Committee of Necmettin Erbakan University Non-Interventional Research (Number: 2021/3431 Date: 01.10.2021).
Supporting Institution
Scientific Research Project (BAP) support was obtained from Necmettin Erbakan University
Project Number
Project number 221518001
References
- World Health Organization. Regional Office for Europe. (2022). WHO European Regional Obesity Report 2022. World Health Organization. Regional Office for Europe. Access address: https://www.who.int/europe/health-topics/obesity#tab=tab_1 Access date: 11.10.2022
- Aslankoc R, Demirci D, Ummahan I, Yildiz M, Ozturk A, Cetin M, Savran S, Yılmaz B. Role of antioxidant enzymes in oxidative stress-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX). Med J SDU. 2019;26(3):362-369. DOI: 10.17343/sdutfd.566969
- Mehri A. Trace Elements in Human Nutrition (II) - An Update. Int J Prev Med. 2020; 11(2):1-17. DOI: 10.4103/ijpvm.IJPVM_48_19.
- Wan D, Yin Y. Trace elements in nutrition and health: A deep dive into essentiality and mechanism of their biological roles. Sci China Life Sci. 2023;66(9):1949-1951. DOI: 10.1007/s11427-023-2426-3.
- Oakes E, Lyon T, Duncan A, Gray A, Talwar D, O’Reilly D. Acute inflammatory response does not affect erythrocyte concentrations of copper, zinc and selenium. Clin Nutr. 2008;27(1):115-120. DOI: 10.1016/j.clnu.2007.10.003
- Ghayour-Mobarhan M, Shapouri-Moghaddam A, Azimi-Nezhad M, Esmaeili H, Parizadeh SM, Safarian M, Kazemi-Bajestani SM, Khodaei GH, Hosseini SJ, Parizadeh SM, Ferns GA. The relationship between established coronary risk factors and serum copper and zinc concentrations in a large Persian cohort. J Trace Elem Med Biol. 2009;23(3):167-175. DOI: 10.1016/j.jtemb.2009.03.006.
- Chasapis CT, Loutsidou AC, Spiliopoulou CA, Stefanidou ME. Zinc and human health: An update. Arch Toxicol. 2012;86(4):521-534. DOI: 10.1007/s00204-011-0775-1.
- Little PJ, Bhattacharya R, Moreyra AE, Korichneva IL. Zinc and cardiovascular disease. Nutrition. 2010;26(11-12):1050-1057. DOI: 10.1016/j.nut.2010.03.007.
- Foster M, Samman S. Zinc and redox signaling: Perturbations associated with cardiovascular disease and diabetes mellitus. Antioxid Redox Signal. 2010;13(10):1549-1573. DOI: 10.1089/ars.2010.3111.
- Ruz M, Carrasco F, Rojas P, Codoceo J, Inostroza J, Basfi-fer K, Valencia A, Vásquez K, Galgani J, Pérez A, López G, Arredondo M, Perez-Bravo F. Zinc as a potential coadjuvant in therapy for type 2 diabetes. Food Nutr Bull. 2013;34(2):215-221. DOI:10.1177/156482651303400210.
- Costarelli L, Muti E, Malavolta M, Cipriano C, Giacconi R, Tesei S, Piacenza F, Pierpaoli S, Gasparini N, Faloia E, Tirabassi G, Boscaro M, Polito A, Mauro B, Maiani F, Raguzzini A, Marcellini F, Giuli C, Papa R, Emanuelli M, Lattanzio F, Mocchegiani E. Distinctive modulation of inflammatory and metabolic parameters in relation to zinc nutritional status in adult overweight/obese subjects. J Nutr Biochem. 2010;21(5):432-437. DOI: 10.1016/j.jnutbio.2009.02.001.
- De Marchi E, Baldassari F, Bononi A, Wieckowski MR, Pinton P. Oxidative stress in cardiovascular diseases and obesity: Role of p66Shc and protein kinase C. Oxid Med Cell Longev. 2013; 2013:564961. DOI: 10.1155/2013/564961.
- Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164-174.
- Han M, Guan L, Ren Y, Zhao Y, Liu D, Zhang D, Liu L, Liu F, Chen X, Cheng C, Li Q, Guo C, Zhou Q, Tian G, Qie R, Huang S, Wu X, Liu Y, Li H, Sun X, Zhang M, Hu D, Lu J. Dietary iron intake and risk of death due to cardiovascular diseases: A systematic review and dose-response meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr. 2020;29(2):309-321. DOI: 10.6133/apjcn.202007_29(2).0014.
- Zafon C, Lecube A, Simó R. Iron in obesity. An ancient micronutrient for a modern disease. Obes Rev. 2010;11(4):322-328. DOI: 10.1111/j.1467-789X.2009.00638.x.
- Dev S, Babitt JL. Overview of iron metabolism in health and disease. Hemodial Int. 2017;21 Suppl 1(Suppl 1):S6-S20. DOI: 10.1111/hdi.12542.
- Aigner E, Feldman A, Datz C. Obesity as an emerging risk factor for iron deficiency. Nutrients. 2014;6(9):3587-3600. DOI: 10.3390/nu6093587.
- Yanoff LB, Menzie CM, Denkinger B, Sebring NG, McHugh T, Remaley AT, Yanovski JA. Inflammation and iron deficiency in the hypoferremia of obesity. Int J Obes (Lond). 2007;31(9):1412-1419. DOI: 10.1038/sj.ijo.0803625.
- Altarelli M, Ben-Hamouda N, Schneider A, Berger MM. Copper deficiency: Causes, manifestations, and treatment. Nutr Clin Pract. 2019;34(4):504-513. DOI: 10.1002/ncp.10328.
- Kunutsor SK, Dey RS, Laukkanen JA. Circulating Serum Copper Is Associated with atherosclerotic cardiovascular disease, but not venous thromboembolism: A Prospective Cohort Study. Pulse (Basel). 2021;9(3-4):109-115. DOI: 10.1159/000519906.
- Mehdi Y, Hornick JL, Istasse L, Dufrasne I. Selenium in the environment, metabolism and involvement in body functions. Molecules. 2013;18(3):3292-3311. DOI: 10.3390/molecules18033292.
- Tinkov AA, Ajsuvakova OP, Filippini T, Zhou JC, Lei XG, Gatiatulina ER, Michalke B, Skalnaya MG, Vinceti M, Aschner M, Skalny AV. Selenium and selenoproteins in adipose tissue physiology and obesity. Biomolecules. 2020;10(4):658-665. DOI: 10.3390/biom10040658.
- Loscalzo J. Keshan disease, selenium deficiency, and the selenoproteome. N Engl J Med. 2014;370(18):1756-1760. DOI: 10.1056/NEJMcibr1402199.
- Fang C, Wu W, Gu X, Dai S, Zhou Q, Deng H, Shen F, Chen J. 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. J Trace Elem Med Biol. 2019;52:209-215. DOI: 10.1016/j.jtemb.2018.12.017.
- Cetin I, Nalbantcilar MT, Yilmaz B, Tosun K, Nazik A. Correlation of trace element levels in drinking water with body composition of children. Selcuk Med J. 2016;32(4): 75-79.
- Skalnaya MG, Demidov VA. Hair trace element contents in women with obesity and type 2 diabetes. J Trace Elem Med Biol. 2007;21(s1):59-61. DOI: 10.1016/j.jtemb.2007.09.019.
- D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation. 2008;117(6):743-753. DOI: 10.1161/Circulationaha.107.699579.
- Mohammadifard N, Humphries KH, Gotay C, Mena-Sánchez G, Salas-Salvadó J, Esmaillzadeh A, Ignaszewski A, Sarrafzadegan N. Trace minerals intake: Risks and benefits for cardiovascular health. Crit Rev Food Sci Nutr. 2019;59(8):1334-1346. DOI: 10.1080/10408398.2017.1406332.
- Mohammadifard N, Gotay C, Humphries KH, Ignaszewski A, Esmaillzadeh A, Sarrafzadegan N. Electrolyte minerals intake and cardiovascular health. Crit Rev Food Sci Nutr. 2019;59(15):2375-2385. DOI: 10.1080/10408398.2018.1453474.
- Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge MP; American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and cardiovascular disease: A scientific statement from the american heart association. Circulation. 2021;143(21):e984-e1010. DOI:10.1161/CIR.0000000000000973.
- Piché ME, Poirier P, Lemieux I, Després JP. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: An update. Prog Cardiovasc Dis. 2018;61(2):103-113. DOI: 10.1016/j.pcad.2018.06.004.
- Dhaliwal SS, Welborn TA. Central obesity and multivariable cardiovascular risk as assessed by the Framingham prediction scores. Am J Cardiol. 2009;103(10):1403-1407. DOI: 10.1016/j.amjcard.2008.12.048.
- Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, Coutinho T, Jensen MD, Roger VL, Singh P, Lopez-Jimenez F. Normal-Weight central obesity: Implications for total and cardiovascular mortality. Ann Intern Med. 2015;163(11):827-835. DOI: 10.7326/M14-2525.
- Ma X, Jiang S, Yan S, Li M, Wang C, Pan Y, Sun C, Jin L, Yao Y, Li B. Association between copper, zinc, iron, and selenium intakes and TC/HDL-C ratio in US adults. Biol Trace Elem Res. 2020;197(1):43-51. DOI: 10.1007/s12011-019-01979-x.
- Al-Bayati MA, Jamil DA, Al-Aubaidy HA. Cardiovascular effects of copper deficiency on activity of superoxide dismutase in diabetic nephropathy. N Am J Med Sci. 2015;7(2):41-46. DOI: 10.4103/1947-2714.152077.
- Tsuboi A, Terazawa Watanabe M, Kazumi T, Fukuo K. Serum copper, zinc and risk factors for cardiovascular disease in community-living Japanese elderly women. Asia Pac J Clin Nutr. 2014;23(2):239-245. DOI: 10.6133/apjcn.2014.23.2.04.
- Bost M, Houdart S, Oberli M, Kalonji E, Huneau JF, Margaritis I. Dietary copper and human health: Current evidence and unresolved issues. J Trace Elem Med Biol. 2016;35:107-115 DOI: 10.1016/j.jtemb.2016.02.006.
- Saari JT. Copper deficiency and cardiovascular disease: Role of peroxidation, glycation, and nitration. Can J Physiol Pharmacol. 2000;78(10):848-855. DOI: 10.1139/cjpp-78-10-848.
- Song X, Wang W, Li Z, Zhang D. Association between serum copper and serum lipids in adults. Ann Nutr Metab. 2018;73(4):282-289. DOI: 10.1159/000494032.
- Ozyildirim S, Baltaci SB. Cardiovascular Diseases and Zinc. Biol Trace Elem Res 2023; 201:1615–1626. DOI: 10.1007/s12011-022-03292-6
- Cheng BJ, Wang J, Meng XL, Sun L, Hu B, Li HB, Sheng J, Chen GM, Tao FB, Sun YH, Yang LS. The association between essential trace element mixture and cognitive function in Chinese community-dwelling older adults. Ecotoxicol Environ Saf. 2022; 231:113182. DOI: 10.1016/j.ecoenv.2022.113182.
- Ju W, Ji M, Li X, Li Z, Wu G, Fu X, Yang X, Gao X. Relationship between higher serum selenium level and adverse blood lipid profile. Clin Nutr. 2018;37(5):1512-1517. DOI: 10.1016/j.clnu.2017.08.025.
- Lapice E, Masulli M, Vaccaro O. Iron deficiency and cardiovascular disease: An updated review of the evidence. Curr Atheroscler Rep. 2013;15(10):358-365. DOI: 10.1007/s11883-013-0358-0.
- Sullivan JL. Iron in arterial plaque: Modifiable risk factor for atherosclerosis. Biochim Biophys Acta. 2009;1790(7):718-723. DOI: 10.1016/j.bbagen.2008.06.005.
- Eaton CB, Abdul Baki AR, Waring ME, Roberts MB, Lu B. The association of low selenium and renal insufficiency with coronary heart disease and all-cause mortality: NHANES III follow-up study. Atherosclerosis. 2010;212(2):689-694. DOI: 10.1016/j.atherosclerosis.2010.07.008.
- Głąbska D, Włodarek D, Kołota A, Czekajło A, Drozdzowska B, Pluskiewicz W. Assessment of mineral intake in the diets of Polish postmenopausal women in relation to their BMI-the RAC-OST-POL study: Mineral intake in relation to BMI. J Health Popul Nutr. 2016;35(1):23-30. DOI: 10.1186/s41043-016-0061-1.
- Zhan R, Liu L, Yang M, Ren Y, Ge Z, Shi J, Zhou K, Zhang J, Cao H, Yang L, Liu K, Sheng J, Tao F, Wang S. Associations of 10 trace element levels in the whole blood with risk of three types of obesity in the elderly. Environ Geochem Health. 2023;45(12):9787-9806. DOI: 10.1007/s10653-023-01747-w.
- Skalny AV, Korobeinikova TV, Zabroda NN, Chang JS, Chao JC, Aschner M, Paoliello MMB, Burtseva TI, Tinkov AA. Interactive effects of obesity and hypertension on patterns of hair essential trace element and mineral content in adult women. Biol Trace Elem Res. 2023;201(10):4677-4687. DOI: 10.1007/s12011-023-03561-y.
Year 2024,
Volume: 14 Issue: 3, 752 - 759, 30.09.2024
Doganay Oguz
,
Nur Demirbaş
,
Ruhuşen Kutlu
,
İbrahim Kılınç
Project Number
Project number 221518001
References
- World Health Organization. Regional Office for Europe. (2022). WHO European Regional Obesity Report 2022. World Health Organization. Regional Office for Europe. Access address: https://www.who.int/europe/health-topics/obesity#tab=tab_1 Access date: 11.10.2022
- Aslankoc R, Demirci D, Ummahan I, Yildiz M, Ozturk A, Cetin M, Savran S, Yılmaz B. Role of antioxidant enzymes in oxidative stress-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX). Med J SDU. 2019;26(3):362-369. DOI: 10.17343/sdutfd.566969
- Mehri A. Trace Elements in Human Nutrition (II) - An Update. Int J Prev Med. 2020; 11(2):1-17. DOI: 10.4103/ijpvm.IJPVM_48_19.
- Wan D, Yin Y. Trace elements in nutrition and health: A deep dive into essentiality and mechanism of their biological roles. Sci China Life Sci. 2023;66(9):1949-1951. DOI: 10.1007/s11427-023-2426-3.
- Oakes E, Lyon T, Duncan A, Gray A, Talwar D, O’Reilly D. Acute inflammatory response does not affect erythrocyte concentrations of copper, zinc and selenium. Clin Nutr. 2008;27(1):115-120. DOI: 10.1016/j.clnu.2007.10.003
- Ghayour-Mobarhan M, Shapouri-Moghaddam A, Azimi-Nezhad M, Esmaeili H, Parizadeh SM, Safarian M, Kazemi-Bajestani SM, Khodaei GH, Hosseini SJ, Parizadeh SM, Ferns GA. The relationship between established coronary risk factors and serum copper and zinc concentrations in a large Persian cohort. J Trace Elem Med Biol. 2009;23(3):167-175. DOI: 10.1016/j.jtemb.2009.03.006.
- Chasapis CT, Loutsidou AC, Spiliopoulou CA, Stefanidou ME. Zinc and human health: An update. Arch Toxicol. 2012;86(4):521-534. DOI: 10.1007/s00204-011-0775-1.
- Little PJ, Bhattacharya R, Moreyra AE, Korichneva IL. Zinc and cardiovascular disease. Nutrition. 2010;26(11-12):1050-1057. DOI: 10.1016/j.nut.2010.03.007.
- Foster M, Samman S. Zinc and redox signaling: Perturbations associated with cardiovascular disease and diabetes mellitus. Antioxid Redox Signal. 2010;13(10):1549-1573. DOI: 10.1089/ars.2010.3111.
- Ruz M, Carrasco F, Rojas P, Codoceo J, Inostroza J, Basfi-fer K, Valencia A, Vásquez K, Galgani J, Pérez A, López G, Arredondo M, Perez-Bravo F. Zinc as a potential coadjuvant in therapy for type 2 diabetes. Food Nutr Bull. 2013;34(2):215-221. DOI:10.1177/156482651303400210.
- Costarelli L, Muti E, Malavolta M, Cipriano C, Giacconi R, Tesei S, Piacenza F, Pierpaoli S, Gasparini N, Faloia E, Tirabassi G, Boscaro M, Polito A, Mauro B, Maiani F, Raguzzini A, Marcellini F, Giuli C, Papa R, Emanuelli M, Lattanzio F, Mocchegiani E. Distinctive modulation of inflammatory and metabolic parameters in relation to zinc nutritional status in adult overweight/obese subjects. J Nutr Biochem. 2010;21(5):432-437. DOI: 10.1016/j.jnutbio.2009.02.001.
- De Marchi E, Baldassari F, Bononi A, Wieckowski MR, Pinton P. Oxidative stress in cardiovascular diseases and obesity: Role of p66Shc and protein kinase C. Oxid Med Cell Longev. 2013; 2013:564961. DOI: 10.1155/2013/564961.
- Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164-174.
- Han M, Guan L, Ren Y, Zhao Y, Liu D, Zhang D, Liu L, Liu F, Chen X, Cheng C, Li Q, Guo C, Zhou Q, Tian G, Qie R, Huang S, Wu X, Liu Y, Li H, Sun X, Zhang M, Hu D, Lu J. Dietary iron intake and risk of death due to cardiovascular diseases: A systematic review and dose-response meta-analysis of prospective cohort studies. Asia Pac J Clin Nutr. 2020;29(2):309-321. DOI: 10.6133/apjcn.202007_29(2).0014.
- Zafon C, Lecube A, Simó R. Iron in obesity. An ancient micronutrient for a modern disease. Obes Rev. 2010;11(4):322-328. DOI: 10.1111/j.1467-789X.2009.00638.x.
- Dev S, Babitt JL. Overview of iron metabolism in health and disease. Hemodial Int. 2017;21 Suppl 1(Suppl 1):S6-S20. DOI: 10.1111/hdi.12542.
- Aigner E, Feldman A, Datz C. Obesity as an emerging risk factor for iron deficiency. Nutrients. 2014;6(9):3587-3600. DOI: 10.3390/nu6093587.
- Yanoff LB, Menzie CM, Denkinger B, Sebring NG, McHugh T, Remaley AT, Yanovski JA. Inflammation and iron deficiency in the hypoferremia of obesity. Int J Obes (Lond). 2007;31(9):1412-1419. DOI: 10.1038/sj.ijo.0803625.
- Altarelli M, Ben-Hamouda N, Schneider A, Berger MM. Copper deficiency: Causes, manifestations, and treatment. Nutr Clin Pract. 2019;34(4):504-513. DOI: 10.1002/ncp.10328.
- Kunutsor SK, Dey RS, Laukkanen JA. Circulating Serum Copper Is Associated with atherosclerotic cardiovascular disease, but not venous thromboembolism: A Prospective Cohort Study. Pulse (Basel). 2021;9(3-4):109-115. DOI: 10.1159/000519906.
- Mehdi Y, Hornick JL, Istasse L, Dufrasne I. Selenium in the environment, metabolism and involvement in body functions. Molecules. 2013;18(3):3292-3311. DOI: 10.3390/molecules18033292.
- Tinkov AA, Ajsuvakova OP, Filippini T, Zhou JC, Lei XG, Gatiatulina ER, Michalke B, Skalnaya MG, Vinceti M, Aschner M, Skalny AV. Selenium and selenoproteins in adipose tissue physiology and obesity. Biomolecules. 2020;10(4):658-665. DOI: 10.3390/biom10040658.
- Loscalzo J. Keshan disease, selenium deficiency, and the selenoproteome. N Engl J Med. 2014;370(18):1756-1760. DOI: 10.1056/NEJMcibr1402199.
- Fang C, Wu W, Gu X, Dai S, Zhou Q, Deng H, Shen F, Chen J. 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. J Trace Elem Med Biol. 2019;52:209-215. DOI: 10.1016/j.jtemb.2018.12.017.
- Cetin I, Nalbantcilar MT, Yilmaz B, Tosun K, Nazik A. Correlation of trace element levels in drinking water with body composition of children. Selcuk Med J. 2016;32(4): 75-79.
- Skalnaya MG, Demidov VA. Hair trace element contents in women with obesity and type 2 diabetes. J Trace Elem Med Biol. 2007;21(s1):59-61. DOI: 10.1016/j.jtemb.2007.09.019.
- D'Agostino RB Sr, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation. 2008;117(6):743-753. DOI: 10.1161/Circulationaha.107.699579.
- Mohammadifard N, Humphries KH, Gotay C, Mena-Sánchez G, Salas-Salvadó J, Esmaillzadeh A, Ignaszewski A, Sarrafzadegan N. Trace minerals intake: Risks and benefits for cardiovascular health. Crit Rev Food Sci Nutr. 2019;59(8):1334-1346. DOI: 10.1080/10408398.2017.1406332.
- Mohammadifard N, Gotay C, Humphries KH, Ignaszewski A, Esmaillzadeh A, Sarrafzadegan N. Electrolyte minerals intake and cardiovascular health. Crit Rev Food Sci Nutr. 2019;59(15):2375-2385. DOI: 10.1080/10408398.2018.1453474.
- Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon-Larsen P, Lavie CJ, Lear SA, Ndumele CE, Neeland IJ, Sanders P, St-Onge MP; American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and cardiovascular disease: A scientific statement from the american heart association. Circulation. 2021;143(21):e984-e1010. DOI:10.1161/CIR.0000000000000973.
- Piché ME, Poirier P, Lemieux I, Després JP. Overview of epidemiology and contribution of obesity and body fat distribution to cardiovascular disease: An update. Prog Cardiovasc Dis. 2018;61(2):103-113. DOI: 10.1016/j.pcad.2018.06.004.
- Dhaliwal SS, Welborn TA. Central obesity and multivariable cardiovascular risk as assessed by the Framingham prediction scores. Am J Cardiol. 2009;103(10):1403-1407. DOI: 10.1016/j.amjcard.2008.12.048.
- Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, Coutinho T, Jensen MD, Roger VL, Singh P, Lopez-Jimenez F. Normal-Weight central obesity: Implications for total and cardiovascular mortality. Ann Intern Med. 2015;163(11):827-835. DOI: 10.7326/M14-2525.
- Ma X, Jiang S, Yan S, Li M, Wang C, Pan Y, Sun C, Jin L, Yao Y, Li B. Association between copper, zinc, iron, and selenium intakes and TC/HDL-C ratio in US adults. Biol Trace Elem Res. 2020;197(1):43-51. DOI: 10.1007/s12011-019-01979-x.
- Al-Bayati MA, Jamil DA, Al-Aubaidy HA. Cardiovascular effects of copper deficiency on activity of superoxide dismutase in diabetic nephropathy. N Am J Med Sci. 2015;7(2):41-46. DOI: 10.4103/1947-2714.152077.
- Tsuboi A, Terazawa Watanabe M, Kazumi T, Fukuo K. Serum copper, zinc and risk factors for cardiovascular disease in community-living Japanese elderly women. Asia Pac J Clin Nutr. 2014;23(2):239-245. DOI: 10.6133/apjcn.2014.23.2.04.
- Bost M, Houdart S, Oberli M, Kalonji E, Huneau JF, Margaritis I. Dietary copper and human health: Current evidence and unresolved issues. J Trace Elem Med Biol. 2016;35:107-115 DOI: 10.1016/j.jtemb.2016.02.006.
- Saari JT. Copper deficiency and cardiovascular disease: Role of peroxidation, glycation, and nitration. Can J Physiol Pharmacol. 2000;78(10):848-855. DOI: 10.1139/cjpp-78-10-848.
- Song X, Wang W, Li Z, Zhang D. Association between serum copper and serum lipids in adults. Ann Nutr Metab. 2018;73(4):282-289. DOI: 10.1159/000494032.
- Ozyildirim S, Baltaci SB. Cardiovascular Diseases and Zinc. Biol Trace Elem Res 2023; 201:1615–1626. DOI: 10.1007/s12011-022-03292-6
- Cheng BJ, Wang J, Meng XL, Sun L, Hu B, Li HB, Sheng J, Chen GM, Tao FB, Sun YH, Yang LS. The association between essential trace element mixture and cognitive function in Chinese community-dwelling older adults. Ecotoxicol Environ Saf. 2022; 231:113182. DOI: 10.1016/j.ecoenv.2022.113182.
- Ju W, Ji M, Li X, Li Z, Wu G, Fu X, Yang X, Gao X. Relationship between higher serum selenium level and adverse blood lipid profile. Clin Nutr. 2018;37(5):1512-1517. DOI: 10.1016/j.clnu.2017.08.025.
- Lapice E, Masulli M, Vaccaro O. Iron deficiency and cardiovascular disease: An updated review of the evidence. Curr Atheroscler Rep. 2013;15(10):358-365. DOI: 10.1007/s11883-013-0358-0.
- Sullivan JL. Iron in arterial plaque: Modifiable risk factor for atherosclerosis. Biochim Biophys Acta. 2009;1790(7):718-723. DOI: 10.1016/j.bbagen.2008.06.005.
- Eaton CB, Abdul Baki AR, Waring ME, Roberts MB, Lu B. The association of low selenium and renal insufficiency with coronary heart disease and all-cause mortality: NHANES III follow-up study. Atherosclerosis. 2010;212(2):689-694. DOI: 10.1016/j.atherosclerosis.2010.07.008.
- Głąbska D, Włodarek D, Kołota A, Czekajło A, Drozdzowska B, Pluskiewicz W. Assessment of mineral intake in the diets of Polish postmenopausal women in relation to their BMI-the RAC-OST-POL study: Mineral intake in relation to BMI. J Health Popul Nutr. 2016;35(1):23-30. DOI: 10.1186/s41043-016-0061-1.
- Zhan R, Liu L, Yang M, Ren Y, Ge Z, Shi J, Zhou K, Zhang J, Cao H, Yang L, Liu K, Sheng J, Tao F, Wang S. Associations of 10 trace element levels in the whole blood with risk of three types of obesity in the elderly. Environ Geochem Health. 2023;45(12):9787-9806. DOI: 10.1007/s10653-023-01747-w.
- Skalny AV, Korobeinikova TV, Zabroda NN, Chang JS, Chao JC, Aschner M, Paoliello MMB, Burtseva TI, Tinkov AA. Interactive effects of obesity and hypertension on patterns of hair essential trace element and mineral content in adult women. Biol Trace Elem Res. 2023;201(10):4677-4687. DOI: 10.1007/s12011-023-03561-y.