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Copper and zinc intake and serum levels in patients with juvenile rheumatoid arthritis

Abstract

Objective: To evaluate the copper and zinc intake and serum levels in patients with juvenile rheumatoid arthritis (JRA), considering the pauci and polyarticular types, the disease activity and duration, the number of inflamed joints and the use of corticosteroids therapy.

Design: Cross-sectional study with control group.

Setting: Outpatients of the pediatric rheumatology public health clinic, of the Universidade Federal de São Paulo/Escola Paulista de Medicina, Brazil.

Subjects: Forty-one patients with JRA were evaluated and 23 patients' brothers, as a control group.

Interventions: Copper and zinc intake evaluation by Food Register method. Copper and zinc serum levels by atomic absorption spectrophotometry.

Results: The disease activity did not determine difference in copper (P=0.624) and zinc (P=0.705) intake, being predominantly below the Recommended Dietary Allowances. The serum copper in relation to control was statistically greater (P=0.018), showing that the number of inflamed joints is statistically significantly related with its variation (P=0.001). The serum zinc was not different either in relation to control (P=0.940) or to the disease characteristics.

Conclusions: The evaluation of copper intake seems to be of fundamental importance. It may influence the efficiency of the organic serum response. More research is needed to indicate, with security, adequate zinc intake.

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References

  • Aaseth, J, Munthe, E, Forre, O & Steinnes, E (1978). Trace elements in serum and urine of patients with rheumatoid arthritis. Scand. J. Rheumatol., 7, (4) 237–240.

    Article  CAS  Google Scholar 

  • Al-Timimi, DJ & Dormandy, TL (1977). Inhibition of lipid autoxidation by human caeruloplasmin. Biochem. J., 168, 283–288.

    Article  CAS  Google Scholar 

  • Bacon, MC, White, PH, Raiten, DJ, Craft, N, Margolis, S, Levander, OA, Taylor, ML, Lipnick, RN & Sami, S (1990). Nutritional status and growth in Juvenile Rheumatoid Arthritis. Semin. Arthritis Rheum., 20, (2) 97–106.

    Article  CAS  Google Scholar 

  • Balogh, Z, El-Ghobarey, AF, Fell, GS, Brown, DH, Dunlop, J & Dick, GS (1980). Plasma zinc and its relationship to clinical symptoms and drug treatment in rheumatoid Arthritis. Ann. Rheum. Dis., 39, 329–332.

    Article  CAS  Google Scholar 

  • Biemond, B, Swaak, AJG & Koster, JF (1984). Protective factors against oxygen free radicals and hydrogen peroxide in rheumatoid arthritis synovial fluid. Arthritis Rheum., 27, 760–777.

    Article  CAS  Google Scholar 

  • Brewer, EJ, Bass, J, Baum, J, Cassidy, JT, Fink, C, Jacobs, J, Hanson, V, Levinson, JE, Schaller, J & Stillman, JS (1977). Current proposed revision of JRA criteria. Arthritis Rheum., 20, 195–199.

    PubMed  Google Scholar 

  • Brown, DH, Buchanan, WW, El-Ghobarey, AF, Smith, WE & Teape, J (1979). Serum copper and its relationship to clinical symptoms in rheumatoid arthritis. Ann. Rheum. Dis., 38, 174–176.

    Article  CAS  Google Scholar 

  • Bussab, WO & Moretin, PA (1987). Estatística básica, 4th edn São Paulo: Atual Editora

    Google Scholar 

  • Cassidy, JE & Petty, RE (1995). Juvenile rheumatoid arthritis. In:Textbook of Pediatric Rheumatology, ed. JE Cassidy & RE Petty, pp133–223, Philadelphia, PA: WB Saunders

    Google Scholar 

  • Chvapil, M (1976). Effect of zinc on cells and biomembrones. In:The Medical Clinics of North America, Vol 60: Symposium on Trace Elements, ed. RE Burch & JE Sullivan, pp789–812, Philadelphia, PA: WB Saunders

    Google Scholar 

  • Chvapil, M, Ryan, JN & Zukoski, CF (1972). The effect of zinc and other metals on the stability of lisossomes. Proc. Soc. Exp. Biol. Med., 40, 642–646.

    Article  Google Scholar 

  • Conforti, A, Franco, L, Menegale, G, Milanino, R, Piemonte, G & Velo, GP (1983). Serum copper and ceruloplasmin levels in Rheumatoid Arthritis and degenerative joint disease and their pharmacological implications. Pharmac. Res. Commun., 15, (9) 859–867.

    Article  CAS  Google Scholar 

  • Ellul-Micallef, R, Galdes, A & Fenich, FF (1976). Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad. Med. J., 52, 148–153.

    Article  CAS  Google Scholar 

  • Gerber, DA (1974). Copper-catalyzed thermal aggregation of human gamma-globulin. Arthritis Rheum., 17, 85–89.

    Article  CAS  Google Scholar 

  • Gibson, RS, Vanderkooy, PD, MacDonald, AC, Goldman, A, Ryan, BA & Berry, M (1989). A growth-limiting, mild zinc-deficiency syndrome on some southern Ontario boys with low height percentiles. Am. J. Clin. Nutr., 49, (6) 1266–1273.

    Article  CAS  Google Scholar 

  • Gomez-Vaquero, C, Nolla, JM, Fiter, J, Ramon, JM, Concustell, R, Valverde, J & Roig-Escofet, D (2001). Nutritional status in patients with rheumatoid arthritis. Joint Bone Spine, 68, (5) 403–409.

    Article  CAS  Google Scholar 

  • Halliwell, B & Gutteridge, JMC (1990). The antioxidants of human extracellular fluids. Arch. Biochem. Biophys., 28, 1–8.

    Article  Google Scholar 

  • Hambidge, KM, Krebs, NF & Walravens, PA (1985). Growth velocity of young children receiving a dietary zinc supplement. Nutr. Res., 1, 306–316.

    Google Scholar 

  • Hannson, L, Hunnan-Seppala, A & Mattila, A (1975). The content of calcium, magnesium, copper, zinc, lead and chromium in the blood of patients with rheumatoid arthritis. Scand. J. Rheumatol., 4, 33–38.

    Article  Google Scholar 

  • Harvey, AR, Pippard, MJ & Ansell, BM (1987). Microcytic anaemia in juvenile chronic arthritis. Scand J. Rheumatol., 16, 53–59.

    CAS  PubMed  Google Scholar 

  • Haugen, MA, Hoyeraal, HM, Larsen, S, Gilboe, IM & Trigg, K (1992). Nutritional intake and nutritional status in children with juvenile chronic arthritis. Scand. J. Rheumatol., 21, 165–170.

    Article  CAS  Google Scholar 

  • Hilario, MOE, Amancio, OMS, Santos, BRM & Naspitz, CK (1991). Effects of nutritional copper deficiency on adult non-pregnant and pregnant rats and their newborns. Arch. Latiam. Nutr., 41, (4) 555–568.

    CAS  Google Scholar 

  • Honkanen, V, Pelkonen, P, Mussalo-Rauhamaa, H, Lehto, J & Westermark, T (1989). Serum trace elements in juvenile chronic arthritis. Clin. Rheumatol., 8, (1) 65–70.

    Article  Google Scholar 

  • Honkanen, V, Konttinen, YT, Sorsa, T, Hukkanen, M, Kemppinen, P, Santavirta, S, Saari, H & Westermarck, T (1991a). Serum zinc, copper and selenium in rheumatoid arthritis. J. Trace Elem. Electrolytes Health Dis., 5, (4) 261–263.

    CAS  PubMed  Google Scholar 

  • Honkanen, V, Lamberg-Allardi, CH, Vesterinen, MK, Lehto, JH, Westermarck, TW, Metsä-Ketelä, TK & Mussalo-Rauhamaa, MH (1991b). Plasma zinc and copper concentrations in rheumatoid arthritis: influence of dietary factors and disease activity. Am. J. Clin. Nutr., 54, 1082–1086.

    Article  CAS  Google Scholar 

  • Karkek, JM (1987). Improving the use of dietary survey methodology. J. Am. Diet. Assoc., 87, (7) 869–871.

    Google Scholar 

  • Kiziltunc, A, Cogalgil, S & Cerrahoglu, L (1998). Camitine and antioxidants levels in patients with rheumatoid arthritis. Scand. J. Rheumatol., 27, 441–445.

    Article  CAS  Google Scholar 

  • Maes, M, Vandoolaeghe, E, Neels, H, Demedts, P, Wauters, A, Meltzer, HY, Altamura, C & Desnyder, R (1997). Lower serum zinc in major depression is a sensitive marker of treatment resistance and of the immune inflammatory response in that ilness. Biol. Psychiat., 42, (5) 349–358.

    Article  CAS  Google Scholar 

  • Makela, A-L, Hyora, H, Vuorinen, K & Nanto, V (1984). Trace elements (Fe, Zn, Cu and Se) in serum rheumatic children living in Western Finland. Scand. J. Rheumatol., 53, (Suppl) 94–101.

    Google Scholar 

  • Matarran-Perez, L, Gonzales-Dominguez, M, Rodriguez-Perez, D, Rodrigo, D, Abellen-Perez, M & Salvatierra-Rios, D (1989). Plasma and intraerythrocytic zinc in rheumatoid arthritis and ankylosing spondylitis. Ann. Intern. Med., 6, 629–632.

    Google Scholar 

  • Milanino, R, Conforti, A, Franco, L, Marella, M & Velo, GP (1985). Review: copper and inflammation—a possible rationale for the pharmacological manipulation of inflammatory disorders. Agents Actions, 16, (6) 504–513.

    Article  CAS  Google Scholar 

  • Milanino, R, Moretti, U, Concari, M, Marrella, M & Velo, GP (1988). Copper and zinc status in adjuvant arthritic rat: studies on blood, liver, kidneys, spleen and inflamed paws. Agents Actions, 24, 365–376.

    Article  CAS  Google Scholar 

  • Milanino, R, Frigo, A, Bambara, LM, Marella, M, Moretti, M, Pasqualicchio, M, Biasi, D, Gasperini, R, Mainetti, L & Velo, GP (1993). Copper and zinc status in Rheumatoid Arthritis: studies on plasma, erythrocytes, and urine, and their relationship with disease activity markers and pharmacological treatment. Clin. Exp. Rheumatol., 11, 271–281.

    CAS  PubMed  Google Scholar 

  • Moretti, U, Frigo, A, Marrella, M, Velo, GP, Tambalo, LM, Bambara, LM & Milanino, R (1988). Copper and zinc in plasma, blood cells and urine of rheumatoid patients. Pharmac. Res. Commun., 20, (Suppl) 19–20.

    Article  Google Scholar 

  • National Research Council (1989). Recommended Dietary Allowances, 10th edn Washington, DC, National Academy Press

  • Naveh, Y, Schapira, D, Ravel, Y, Geller, E & Scharf, Y (1997). Zinc metabolism in rheumatoid arthritis: plasma and urinary zinc and relationship to disease activity. J. Rheumatol., 24, 643–646.

    CAS  PubMed  Google Scholar 

  • Neter, J, Kutner, MH, Nachtsheim, CJ & Wasserman, W (1996). Applied Linear Statistical Models, 4th edn Boston, MA: Irwin

    Google Scholar 

  • Oliva, JC, Castell, M, Queralt, J & Castellone, C (1987). Effect of chronic inflammation on copper and zinc metabolism. Rev. Esp. Fisiol., 43, (1) 25–32.

    CAS  PubMed  Google Scholar 

  • Peretz, A, Neve, J & Famaey, JP (1989). Effects of chronic and acute corticosteroid therapy on zinc and copper status in rheumatoid Arthritis patients. J. Trace Elem. Elect. Heal. Dis., 3, 103–108.

    CAS  Google Scholar 

  • Philippi, ST, Szarfarc, SC & Latterza, CR (1996). Virtual Nutri, Versão 1.0 for Windows, Sistema de Analise Nutricional, Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo

  • Powanda, MC, Cockerell, GL & Pekarek, RS (1973). Amino acid and zinc movement in relation to protein synthesis early in inflammation. Am. J. Physiol., 225, (2) 399–401.

    Article  CAS  Google Scholar 

  • Rosenstein, ED & Caldwell, JR (1999). Trace elements in the treatment of rheumatic conditions. Rheum. Dis. Clin. N. Am., 25, (4) 929–935.

    Article  CAS  Google Scholar 

  • Ross, J, Gibson, RS & Sabry, JH (1986). A study of seasonal trace element intakes and hair trace element concentration in selected households from Wosera, Papua New Guinea. Trop. Geogr. Med., 38, (3) 246–254.

    CAS  PubMed  Google Scholar 

  • Scudder, PR, Al-Timini, D, McMurray, W, White, W, Zoob, BC & Dormandy, TL (1978a). Serum copper and related variables in rheumatoid arthritis. Ann. Rheum. Dis., 37, 67–70.

    Article  CAS  Google Scholar 

  • Scudder, PR, McMurray, W, White, AG & Dormandi, TL (1978b). Synovial fluid copper and related variables in rheumatoid and degenerative arthritis. Ann. Rheum. Dis., 37, (1) 71–72.

    Article  CAS  Google Scholar 

  • Shrimpton, R (1984). Food consumption and dietary adequacy according to income in 1200 families, Manaus, Amazonia, Brazil 1973–1974. Arch. Latinoam. Nutr., 34, (4) 615–629.

    CAS  PubMed  Google Scholar 

  • Soylak, M & Kirnap, M (2001). Serum copper and zinc concentrations of patients with rheumatoid arthritis from Kayseri-Turkey. Fresen. Environ. Bull., 10, (4) 409–410.

    CAS  Google Scholar 

  • Strano, CG, Polito, C, Alessio, M, Servodio Iammarrone, C, Di Toro, A, Todisco, N & Marotta, A (1995). Nutritional status in active juvenile chronic arthritis not treated with steroids. Acta Paediatr., 84, (9) 1010–1013.

    Article  CAS  Google Scholar 

  • Tuncer, S, Kamanli, A, Akçil, E, Kavas, GO, Seckin, B & Atay, MB (1999). Trace element and magnesium levels and superoxide dismutase activity in rheumatoid arthritis. Biol. Trace Elem. Res., 68, (2) 137–142.

    Article  CAS  Google Scholar 

  • Whitehouse, R, Paasad, AS, Rabbani, PI & Cossak, ZT (1982). Zinc in plasma, neutrophils, lynfhocytes and erytrocytes as determined by flameless atomic absorption spectrophotometer. Clin. Chem., 28, (3) 475–480.

    CAS  PubMed  Google Scholar 

  • Winchester, RJ, Agnello, V & Kunkel, HG (1970). Gamma globulin complexes in synovial fluids of patients with rheumatoid arthritis. Clin. Exp. Immunol., 6, 689–673.

    CAS  PubMed  PubMed Central  Google Scholar 

  • World Health Organization (1996). Trace Elements in Human Nutrition and Health, Geneva: WHO

  • Zoli, A, Altomonte, L, Caricchio, R, Galossi, A, Mirone, L, Ruffini, MP & Magaro, M (1998). Serum zinc and copper in active rheumatoid arthritis: correlation with interleukin 1 beta and tumor necrosis factor alpha. Clin. Rheumatol., 17, (5) 378–382.

    Article  CAS  Google Scholar 

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Guarantors: OM Silverio Amancio and MO Esteves Hilário.

Contributors: OMSA, DMAC and MOEH designed and wrote the study. DMAC and MOEH executed the study. OMSA and DMAC carried out biochemical analysis. GY carried out statistical analysis.

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Silverio Amancio, O., Alves Chaud, D., Yanaguibashi, G. et al. Copper and zinc intake and serum levels in patients with juvenile rheumatoid arthritis. Eur J Clin Nutr 57, 706–712 (2003). https://doi.org/10.1038/sj.ejcn.1601601

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