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Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV)

Year 2026, Volume: 16 Issue: 1, 74 - 80, 19.03.2026
https://izlik.org/JA44AY54GW

Abstract

Aim: This study examined the association between serum trace element
concentrations (copper, magnesium, and zinc) and benign
paroxysmal positional vertigo (BPPV), a common cause of vertigo.
Materials and Methods: This retrospective study was conducted
by reviewing laboratory data recorded in the hospital automation
system for patients who presented with vertigo at the Kafkas
University Health Practice and Research Center between January
1, 2022, and April 1, 2024. A total of 119 individuals were included,
comprising 81 (68.07%) patients diagnosed with BPPV and
38 (31.93%) in the control group. Participants had a mean age of
52 years; females accounted for 60.5% of the cohort, while males
comprised 39.5%.
Results: Comparative analyses revealed distinct serum copper,
magnesium, and zinc profiles between the BPPV and control
groups (p<0.05). Higher copper and magnesium concentrations
were observed in individuals with BPPV, whereas zinc levels were
greater in the control group. Among the trace elements examined,
magnesium demonstrated the strongest association with BPPV,
with higher levels corresponding to a 9,709-fold increase in the
odds of the disorder.
Conclusion: Alterations in serum trace element levels, particularly
increased magnesium levels, may be related to the presence of
BPPV. These findings suggest that mineral metabolism may play a
contributory role in vestibular disorders and provide a foundation
for further research in this field.

References

  • 1. Korres S, Luxon L, Vannucchi P, Gibson B. Benign paroxysmal positional vertigo. Int J Otolaryngol. 2011;2011:353865. https://doi.org/10.1155/2011/353865
  • 2. Lawson J, Johnson I, Bamiou DE, Newton JL. Benign paroxysmal positional vertigo: clinical characteristics of dizzy patients referred to a Falls and Syncope Unit. QJM. 2005;98(5):357–364. https://doi.org/10.1093/qjmed/hci057
  • 3. Von Brevern M, Seelig T, Neuhauser H, Lempert T. Benign paroxysmal positional vertigo predominantly affects the right labyrinth. J Neurol Neurosurg Psychiatry. 2004;75(10):1487– 1488. https://doi.org/10.1136/jnnp.2003.031500
  • 4. Von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res. 2015;25(3-4):105–117. https://doi.org/10.3233/ VES-150553
  • 5. Imai T, Ito M, Takeda N, Uno A, Matsunaga T, Sekine K, et al. Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo. Neurology. 2005;64(5):920– 921. https://doi.org/10.1212/01.WNL.0000152890.00170.DA
  • 6. Alolayet H, Murdin L. Benign paroxysmal positional vertigo: a systematic review of the effects of comorbidities. Front Neurol. 2025;16:1595693. https://doi.org/10.3389/fneur.2025.1595693
  • 7. Zang J, Jiang X, Feng S, Zhang H. The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo. Int J Med Sci. 2022;19(8):1227–1234. https://doi.org/10.7150/ijms.73080
  • 8. Lee JM, Lee HJ. Different clinical courses of BPPV according to the medical conditions. Sci Rep. 2024;14(1):12941. https://doi.org/10.1038/s41598-024-63882-3
  • 9. Pham PC, Pham PA, Pham SV, Pham PT, Pham PM, Pham PT, et al. Hypomagnesemia: a clinical perspective. Int J Nephrol Renovasc Dis. 2014;7:219–230. https://doi.org/10.2147/ IJNRD.S42054
  • 10. Al Alawi AM, Majoni SW, Falhammar H. Magnesium and human health: perspectives and research directions. Int J Endocrinol. 2018;2018:9041694. https://doi.org/10.1155/2018/9041694
  • 11. Kükürt A, Gelen V, Başer ÖF, Deveci HA, Karapehlivan M. Thiols: role in oxidative stress-related disorders. In:Accenting Lipid Peroxidation. IntechOpen; 2021. https://doi.org/10.5772/intechopen.96682
  • 12. Kaya İ, Marım F, Parspur ŞE, Tekin ÖF, Erbay ÜT. Can laboratory parameters predict intensive care unit admission in COVID-19?. A focus on magnesium levels. Kafkas J Med Sci. 2026;15(3):288–292. https://doi.org/10.5505/kjms.2025.92603
  • 13. Swain S, Behera IC, Sahu MC. Prevalence of benign paroxysmal positional vertigo: our experiences at a tertiary care hospital of India. Egypt J Ear Nose Throat Allied Sci. 2018;19(3):87–92.https://doi.org/10.21608/ejentas.2018.5246.1040
  • 14. Soto-Varela A, Santos-Perez S, Rossi-Izquierdo M, Sanchez-Sellero I. Are the three canals equally susceptible to benign paroxysmal positional vertigo? Audiol Neurootol. 2013;18(5):327–334. https://doi.org/10.1159/000354649
  • 15. Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169(7):681–693.
  • 16. Lopez-Escámez JA, Gámiz MJ, Fiñana MG, Perez AF, Canet IS. Position in bed is associated with left or right location in benign paroxysmal positional vertigo of the posterior semicircular canal. Am J Otolaryngol. 2002;23(5):263–266. https://doi.org/10.1053/ajot.2002.124199
  • 17. Fu W, He F, Bai Y, An X, Shi Y, Han J, et al. Risk factors of residual dizziness after successful treatment for benign paroxysmal positional vertigo in middle-aged and older adults. Front Neurol. 2022;13:850088. https://doi.org/10.3389/fneur.2022.850088
  • 18. Oh SR, Min SJ, Kim CE, Chang M, Mun SK. The effects of climate on the incidence of benign paroxysmal positional vertigo. Int J Biometeorol. 2020;64(12):2119–2125. https:// doi.org/10.1007/s00484-020-02002-y
  • 19. Barozzi S, Socci M, Ginocchio D, Filipponi E, Martinazzoli MG, Cesarani A. Benign paroxysmal positional vertigo and tinnitus. Int Tinnitus J. 2013;18(1):16–19. https://doi.org/10.5935/0946-5448.20130003
  • 20. Yetiser S. Review of the pathology underlying benign paroxysmal positional vertigo. J Int Med Res. 2020;48(4):0300060519892370. https://doi.org/10.1177/0300060519892370
  • 21. Karlberg M, Hall K, Quickert N, Hinson J, Halmagyi GM. What inner ear diseases cause benign paroxysmal positional vertigo? Acta Otolaryngol. 2000;120(3):380–385. https://doi. org/10.1080/000164800750000603
  • 22. Günizi H, Savaş HB. An evaluation of trace elements and oxidative stress in patients with benign paroxysmal positional vertigo. PLoS One. 2023;18(2):e0277960. https://doi. org/10.1371/journal.pone.0277960
  • 23. Fatima G, Dzupina A, Alhmadi HB, Magomedova A, Siddiqui Z, Mehdi A, et al. Magnesium matters: a comprehensive review of its vital role in health and diseases. Cureus. 2024;16(10):e71392. https://doi.org/10.7759/cureus.71392
  • 24. Walther LE, Wulfes J, Blödow A, Kniep R. Magnesium as an intrinsic component of human otoconia. Acta Otolaryngol. 2018;138(9):775–778. https://doi.org/10.1080/00016489.20 18.1467572
  • 25. Kaya H, Gokdemir MT, Sogut O, Ayan M, Bozkus F, Iynen I, et al. Evaluation of oxidative status and trace elements in patients with benign paroxysmal positional vertigo. HealthMED. 2013;7(1):72–79.
  • 26. Akbarpour M, Jalali MM, Sadeghzadeh N. Blood serum levels of magnesium in patients with benign paroxysmal positional vertigo. Aud Vestib Res. 2024;33(1):40–46. https://doi. org/10.18502/avr.v33i1.14273
  • 27. Rosanoff A, West C, Elin RJ, Micke O, Baniasadi S, Barbagallo M, et al. Recommendation on an updated standardization of serum magnesium reference ranges. Eur J Nutr. 2022;61(7):3697–3706. https://doi.org/10.1007/s00394-022-02916-w
  • 28. Subcommittee on Upper Reference Levels of Nutrients, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Panel on Folate, Other B Vitamins, and Choline. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington (DC): National Academies Press; 2000.
  • 29. Alves CX, de Brito NJ, Vermeulen KM, Dantas Lopes MM, França MC, Bruno SS, et al. Serum zinc reference intervals and their relationship with dietary, functional, and biochemical indicators in 6- to 9-year-old healthy children. Food Nutr Res.2016;60:30157. https://doi.org/10.3402/fnr.v60.30157
  • 30. Cox H, Frith J. Best practice assessment and management of benign paroxysmal positional vertigo in older adults. Age Ageing. 2025;54(8):afaf225. https://doi.org/10.1093/ageing/ afaf225

Year 2026, Volume: 16 Issue: 1, 74 - 80, 19.03.2026
https://izlik.org/JA44AY54GW

Abstract

References

  • 1. Korres S, Luxon L, Vannucchi P, Gibson B. Benign paroxysmal positional vertigo. Int J Otolaryngol. 2011;2011:353865. https://doi.org/10.1155/2011/353865
  • 2. Lawson J, Johnson I, Bamiou DE, Newton JL. Benign paroxysmal positional vertigo: clinical characteristics of dizzy patients referred to a Falls and Syncope Unit. QJM. 2005;98(5):357–364. https://doi.org/10.1093/qjmed/hci057
  • 3. Von Brevern M, Seelig T, Neuhauser H, Lempert T. Benign paroxysmal positional vertigo predominantly affects the right labyrinth. J Neurol Neurosurg Psychiatry. 2004;75(10):1487– 1488. https://doi.org/10.1136/jnnp.2003.031500
  • 4. Von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res. 2015;25(3-4):105–117. https://doi.org/10.3233/ VES-150553
  • 5. Imai T, Ito M, Takeda N, Uno A, Matsunaga T, Sekine K, et al. Natural course of the remission of vertigo in patients with benign paroxysmal positional vertigo. Neurology. 2005;64(5):920– 921. https://doi.org/10.1212/01.WNL.0000152890.00170.DA
  • 6. Alolayet H, Murdin L. Benign paroxysmal positional vertigo: a systematic review of the effects of comorbidities. Front Neurol. 2025;16:1595693. https://doi.org/10.3389/fneur.2025.1595693
  • 7. Zang J, Jiang X, Feng S, Zhang H. The influence of cerebral small vessel diseases on the efficacy of repositioning therapy and prognosis of benign paroxysmal positional vertigo. Int J Med Sci. 2022;19(8):1227–1234. https://doi.org/10.7150/ijms.73080
  • 8. Lee JM, Lee HJ. Different clinical courses of BPPV according to the medical conditions. Sci Rep. 2024;14(1):12941. https://doi.org/10.1038/s41598-024-63882-3
  • 9. Pham PC, Pham PA, Pham SV, Pham PT, Pham PM, Pham PT, et al. Hypomagnesemia: a clinical perspective. Int J Nephrol Renovasc Dis. 2014;7:219–230. https://doi.org/10.2147/ IJNRD.S42054
  • 10. Al Alawi AM, Majoni SW, Falhammar H. Magnesium and human health: perspectives and research directions. Int J Endocrinol. 2018;2018:9041694. https://doi.org/10.1155/2018/9041694
  • 11. Kükürt A, Gelen V, Başer ÖF, Deveci HA, Karapehlivan M. Thiols: role in oxidative stress-related disorders. In:Accenting Lipid Peroxidation. IntechOpen; 2021. https://doi.org/10.5772/intechopen.96682
  • 12. Kaya İ, Marım F, Parspur ŞE, Tekin ÖF, Erbay ÜT. Can laboratory parameters predict intensive care unit admission in COVID-19?. A focus on magnesium levels. Kafkas J Med Sci. 2026;15(3):288–292. https://doi.org/10.5505/kjms.2025.92603
  • 13. Swain S, Behera IC, Sahu MC. Prevalence of benign paroxysmal positional vertigo: our experiences at a tertiary care hospital of India. Egypt J Ear Nose Throat Allied Sci. 2018;19(3):87–92.https://doi.org/10.21608/ejentas.2018.5246.1040
  • 14. Soto-Varela A, Santos-Perez S, Rossi-Izquierdo M, Sanchez-Sellero I. Are the three canals equally susceptible to benign paroxysmal positional vertigo? Audiol Neurootol. 2013;18(5):327–334. https://doi.org/10.1159/000354649
  • 15. Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003;169(7):681–693.
  • 16. Lopez-Escámez JA, Gámiz MJ, Fiñana MG, Perez AF, Canet IS. Position in bed is associated with left or right location in benign paroxysmal positional vertigo of the posterior semicircular canal. Am J Otolaryngol. 2002;23(5):263–266. https://doi.org/10.1053/ajot.2002.124199
  • 17. Fu W, He F, Bai Y, An X, Shi Y, Han J, et al. Risk factors of residual dizziness after successful treatment for benign paroxysmal positional vertigo in middle-aged and older adults. Front Neurol. 2022;13:850088. https://doi.org/10.3389/fneur.2022.850088
  • 18. Oh SR, Min SJ, Kim CE, Chang M, Mun SK. The effects of climate on the incidence of benign paroxysmal positional vertigo. Int J Biometeorol. 2020;64(12):2119–2125. https:// doi.org/10.1007/s00484-020-02002-y
  • 19. Barozzi S, Socci M, Ginocchio D, Filipponi E, Martinazzoli MG, Cesarani A. Benign paroxysmal positional vertigo and tinnitus. Int Tinnitus J. 2013;18(1):16–19. https://doi.org/10.5935/0946-5448.20130003
  • 20. Yetiser S. Review of the pathology underlying benign paroxysmal positional vertigo. J Int Med Res. 2020;48(4):0300060519892370. https://doi.org/10.1177/0300060519892370
  • 21. Karlberg M, Hall K, Quickert N, Hinson J, Halmagyi GM. What inner ear diseases cause benign paroxysmal positional vertigo? Acta Otolaryngol. 2000;120(3):380–385. https://doi. org/10.1080/000164800750000603
  • 22. Günizi H, Savaş HB. An evaluation of trace elements and oxidative stress in patients with benign paroxysmal positional vertigo. PLoS One. 2023;18(2):e0277960. https://doi. org/10.1371/journal.pone.0277960
  • 23. Fatima G, Dzupina A, Alhmadi HB, Magomedova A, Siddiqui Z, Mehdi A, et al. Magnesium matters: a comprehensive review of its vital role in health and diseases. Cureus. 2024;16(10):e71392. https://doi.org/10.7759/cureus.71392
  • 24. Walther LE, Wulfes J, Blödow A, Kniep R. Magnesium as an intrinsic component of human otoconia. Acta Otolaryngol. 2018;138(9):775–778. https://doi.org/10.1080/00016489.20 18.1467572
  • 25. Kaya H, Gokdemir MT, Sogut O, Ayan M, Bozkus F, Iynen I, et al. Evaluation of oxidative status and trace elements in patients with benign paroxysmal positional vertigo. HealthMED. 2013;7(1):72–79.
  • 26. Akbarpour M, Jalali MM, Sadeghzadeh N. Blood serum levels of magnesium in patients with benign paroxysmal positional vertigo. Aud Vestib Res. 2024;33(1):40–46. https://doi. org/10.18502/avr.v33i1.14273
  • 27. Rosanoff A, West C, Elin RJ, Micke O, Baniasadi S, Barbagallo M, et al. Recommendation on an updated standardization of serum magnesium reference ranges. Eur J Nutr. 2022;61(7):3697–3706. https://doi.org/10.1007/s00394-022-02916-w
  • 28. Subcommittee on Upper Reference Levels of Nutrients, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Panel on Folate, Other B Vitamins, and Choline. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington (DC): National Academies Press; 2000.
  • 29. Alves CX, de Brito NJ, Vermeulen KM, Dantas Lopes MM, França MC, Bruno SS, et al. Serum zinc reference intervals and their relationship with dietary, functional, and biochemical indicators in 6- to 9-year-old healthy children. Food Nutr Res.2016;60:30157. https://doi.org/10.3402/fnr.v60.30157
  • 30. Cox H, Frith J. Best practice assessment and management of benign paroxysmal positional vertigo in older adults. Age Ageing. 2025;54(8):afaf225. https://doi.org/10.1093/ageing/ afaf225
There are 30 citations in total.

Details

Primary Language English
Subjects Medical Biochemistry and Metabolomics (Other)
Journal Section Research Article
Authors

Ömer Faruk Demir

Abdulsamed Kükürt This is me

Submission Date January 19, 2026
Acceptance Date February 3, 2026
Publication Date March 19, 2026
IZ https://izlik.org/JA44AY54GW
Published in Issue Year 2026 Volume: 16 Issue: 1

Cite

APA Demir, Ö. F., & Kükürt, A. (2026). Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV). Kafkas Journal of Medical Sciences, 16(1), 74-80. https://izlik.org/JA44AY54GW
AMA 1.Demir ÖF, Kükürt A. Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV). Kafkas Journal of Medical Sciences. 2026;16(1):74-80. https://izlik.org/JA44AY54GW
Chicago Demir, Ömer Faruk, and Abdulsamed Kükürt. 2026. “Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV)”. Kafkas Journal of Medical Sciences 16 (1): 74-80. https://izlik.org/JA44AY54GW.
EndNote Demir ÖF, Kükürt A (March 1, 2026) Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV). Kafkas Journal of Medical Sciences 16 1 74–80.
IEEE [1]Ö. F. Demir and A. Kükürt, “Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV)”, Kafkas Journal of Medical Sciences, vol. 16, no. 1, pp. 74–80, Mar. 2026, [Online]. Available: https://izlik.org/JA44AY54GW
ISNAD Demir, Ömer Faruk - Kükürt, Abdulsamed. “Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV)”. Kafkas Journal of Medical Sciences 16/1 (March 1, 2026): 74-80. https://izlik.org/JA44AY54GW.
JAMA 1.Demir ÖF, Kükürt A. Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV). Kafkas Journal of Medical Sciences. 2026;16:74–80.
MLA Demir, Ömer Faruk, and Abdulsamed Kükürt. “Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV)”. Kafkas Journal of Medical Sciences, vol. 16, no. 1, Mar. 2026, pp. 74-80, https://izlik.org/JA44AY54GW.
Vancouver 1.Ömer Faruk Demir, Abdulsamed Kükürt. Investigation of the Relationship Between Serum Copper, Zinc, and Magnesium Levels and Benign Paroxysmal Positional Vertigo (BPPV). Kafkas Journal of Medical Sciences [Internet]. 2026 Mar. 1;16(1):74-80. Available from: https://izlik.org/JA44AY54GW