The levels of trace elements and homocysteine in arterial hypertension

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Abstract

Abstract. Objective: In this study, we evaluated the levels of zinc, copper, iron, and homocysteine in 50- to 55-year-old male patients with newly diagnosed hypertension, and in patients with a diagnosis of hypertension for at least 3 years to a maximum of 5 years who were not under medication. Materials and methods: We evaluated the levels of zinc, copper, iron, and homocysteine in the groups of hypertension patients and in healthy individuals. The study included 50- to 55-year-old male patients who were admitted to the outpatient cardiology clinic of Kahramanmaras Necip Fazil City Hospital, presenting with chest pain, headache, and dizziness. The determination of zinc and copper levels in serum samples was performed using Perkin Elmer Analyst 800 Flame atomic absorption spectroscopy. Iron was measured using a colorimetric assay (Roche Hitachi Cobas C501 autoanalyzer). Homocysteine level was analyzed using ELISA. Results: The serum levels of zinc and copper in patients with newly diagnosed hypertension (group II) and in patients with a diagnosis of hypertension for 3 – 5 years (group III) were significantly lower compared to the control group (group I) (p < 0.001). Accordingly, the levels of homocysteine and iron in group II and group III were significantly higher compared to the control group (p for all < 0.001). There was no significant difference in the serum levels of iron and copper between the groups with hypertension (group II vs. group III) (p = 0.366; p = 0.295, respectively). Whereas homocysteine levels in group III were significantly higher than in group II (p < 0.001); zinc levels in group III were significantly lower than in group II (p < 0.001). Conclusion: Considering these results, we believe that the levels of iron, copper, homocysteine, and zinc have an effect on hypertension development. In addition, the effects of homocysteine and zinc on hypertension might be continued during disease progression. Thus, we believe that the levels of homocysteine and zinc could be an important parameter in the follow-up of hypertension. Additionally, it is necessary to add elements such as copper and zinc as well as antioxidants in the diet of these patients, and to prevent the increase of iron levels in hypertension. 

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Initial pH, base deficit, lactate, anion gap, strong ion difference, and strong ion gap predict outcome from major vascular injury.

John A. Kellum, Kayla Kaplan (2004)

This study determines whether acid-base data obtained in the emergency department correlate with outcome from major vascular injury. Observational, retrospective record review of trauma patients requiring vascular repair (torso or extremity, January 1988 to December 1997). Data included age, Injury Severity Score, injury mechanism, survival, laboratory profiling, calculated anion gap, strong ion difference, and strong ion gap. Patients were divided into survivors and nonsurvivors with comparison by Student's t-test; significance was assumed for p or = 5 mmol/L, and strong ion gap > or = 5 mEq/L. All of the acid-base descriptors were strongly associated with outcome, but the strong ion gap discriminated most strongly with an area under the receiver operator characteristic of 0.991 (95% confidence interval, 0.972-0.998). The initial emergency department acid-base variables of pH, base deficit, lactate, anion gap, apparent strong ion difference, and strong ion gap discriminate survivors from non-survivors of major vascular injury. The strong ion gap is most strongly predictive of mortality following major vascular trauma.

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Exuberant endothelial cell growth and elements of inflammation are present in plexiform lesions of pulmonary hypertension.

Benjamin Groves, N Voelkel, R Tuder … (1994)

The plexiform lesion in primary pulmonary hypertension is a glomeruloid structure forming channels in branches of the pulmonary artery. These lesions have been considered an abnormal growth of modified smooth muscle cells. We present immunohistochemical evidence in 10 cases of plexogenic pulmonary hypertension that the plexiform channels and the concentric obliterative arteriopathy associated with these channels represent abnormal growth of factor VIII-related antigen-positive endothelial cells. In addition, these cells strongly expressed vimentin, a growth- and differentiation-related intermediate filament. Morphologically and immunohistochemically, the lesions resembled the neovascularization associated with the brain tumor glioblastoma multiform. Furthermore, we noted an exclusively perivascular inflammatory cell infiltrate (but no vasculitis) in seven of the 10 cases with plexogenic arteriopathy composed of T cells, B cells, and macrophages. Our findings indicate that the plexiform lesion may result from a deregulated growth of endothelial cells. The presence of perivascular inflammatory cells suggested that cytokines and growth factors may further influence the development of the plexiform lesion.

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Selenium, selenoproteins and human health: a review.

Nicholas Arthur, Andrew M Brown (2001)

Selenium is of fundamental importance to human health. It is an essential component of several major metabolic pathways, including thyroid hormone metabolism, antioxidant defence systems, and immune function. The decline in blood selenium concentration in the UK and other European Union countries has therefore several potential public health implications, particularly in relation to the chronic disease prevalence of the Western world such as cancer and cardiovascular disease. Ten years have elapsed since recommended dietary intakes of selenium were introduced on the basis of blood glutathione peroxidase activity. Since then 30 new selenoproteins have been identified, of which 15 have been purified to allow characterisation of their biological function. The long term health implications in relation to declining selenium intakes have not yet been thoroughly examined, yet the implicit importance of selenium to human health is recognised universally. Selenium is incorporated as selenocysteine at the active site of a wide range of selenoproteins. The four glutathione peroxidase enzymes (classical GPx1, gastrointestinal GPx2, plasma GPx3, phospholipid hydroperoxide GPx4)) which represent a major class of functionally important selenoproteins, were the first to be characterised. Thioredoxin reductase (TR) is a recently identified seleno-cysteine containing enzyme which catalyzes the NADPH dependent reduction of thioredoxin and therefore plays a regulatory role in its metabolic activity. Approximately 60% of Se in plasma is incorporated in selenoprotein P which contains 10 Se atoms per molecule as selenocysteine, and may serve as a transport protein for Se. However, selenoprotein-P is also expressed in many tissues which suggests that although it may facilitate whole body Se distribution, this may not be its sole function. A second major class of selenoproteins are the iodothyronine deiodinase enzymes which catalyse the 5'5-mono-deiodination of the prohormone thyroxine (T4) to the active thyroid hormone 3,3'5-triiodothyronine (T3). Sperm capsule selenoprotein is localised in the mid-peice portion of spermatozoa where it stabilises the integrity of the sperm flagella. Se intake effects tissue concentrations of selenoprotein W which is reported to be necessary for muscle metabolism. It is of great concern that the health implications of the decline in Se status in the UK over the past two decades have not been systematically investigated. It is well recognised that dietary selenium is important for a healthy immune response. There is also evidence that Se has a protective effect against some forms of cancer; that it may enhance male fertility; decrease cardiovascular disease mortality, and regulate the inflammatory mediators in asthma. The potential influence of Se on these chronic diseases within the European population are important considerations when assessing Se requirement.