An investigation of the relationship between plasma, erythrocyte and tissue trace element concentrations.
MD thesis, University of Glasgow.
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Introduction. Trace element status may be important in acutely-inflamed patients. Plasma concentrations of trace elements are known to alter during the evolution of the acute phase response, however, erythrocyte trace element concentrations do not. It is not known whether either erythrocyte or plasma concentrations reflect the status of the tissues where trace elements are utilised. Therefore trace element concentrations were examined in tissues and blood from non-inflamed patients, with plasma and erythrocyte concentration changes studied during the evolution of the acute phase response.
Methods: 31 patients undergoing liver resection had liver, rectus muscle, and blood samples obtained pre-operatively, and blood sampling for 3 days post-operatively. Se, Cu and Zn concentrations were obtained by inductively coupled mass spectrometry after nitric acid digestion. Erythrocyte glutathione peroxidase (GPx) was measured by spectrophotometry. C-reactive protein and albumin concentration were measured on each day.
Results: C-reactive protein increased and albumin concentration decreased over the 3 days postoperatively. Plasma Zn and Se concentration changed in the 3 days post-operatively (p<0.001); erythrocyte Cu, Zn and Se concentration, GPx activity and plasma Cu concentration did not change. Preoperatively, liver Cu concentration was associated with erythrocyte Cu concentration (r2 15.9%; p=0.036) but not plasma Cu concentration (r2 4.3%; p=0.264); plasma Zn concentration was associated with liver Zn concentration (r2 14.4%; p=0.046) but erythrocyte Zn concentration was not (r2 0.1%; p=0.896); and liver Se concentration was associated with erythrocyte Se concentration (r2 17.1%; p=0.023), erythrocyte glutathione peroxidase (r2 22.6%; 0.008) and plasma Se concentration (r2 43.1%; p<0.001).
Conclusions: Erythrocyte Cu and Se concentration, and GPx activity are associated with liver Cu and Se concentration respectively, and do not change during the evolution of the acute phase response. They should be considered as potential markers of Cu and Se status. Plasma Zn is associated with liver Zn concentration but the concentration changes during the acute phase response; caution should be taken interpreting results in patients with inflammation, and further work is required to find a suitable alternative marker of Zn status.
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