Serum trace element levels of liver cirrhosis and pancreatic cancer patients

Main Article Content

H Sibel Karapinar*
M Kürşat Türkdoğan
Fevzi Kiliçel

Abstract



The incidence of liver cirrhosis and pancreatic cancer varies between countries and stands out as an important health problem worldwide. Liver cirrhosis is the most advanced stage of chronic liver disease and is a widespread result of chronic liver damage. The etiology of liver cirrhosis and pancreatic cancer, which are major causes of cancer fatalities in developed countries, is poorly understood. Many metabolic and physiological processes in the human body utilize trace elements. The creation and development of many diseases like cancer, cardiovascular, and diabetes mellitus occur with the disruption of trace element metabolism in the body as a result of improper nutrition, environmental, and occupational exposure, and impaired digestion and absorption.


Methods and materials: In this study, copper (Cu), cadmium (Cd), iron (Fe), cobalt (Co), manganese (Mn), magnesium (Mg), nickel (Ni), zinc (Zn), and lead (Pb) concentrations were researched in the serum of liver cirrhosis and Pancreatic Cancer (PC) patients and healthy controls. Analysis of the elements was carried out by flame atomic absorption spectrophotometer.


Results: Fe and Zn serum levels were considerably lower in individuals with liver cirrhosis and pancreatic cancer than in controls (p <0.001). Furthermore, mean serum levels of Cd and Mn in patients with liver cirrhosis and pancreatic Ca were considerably lower than in controls (p <0.01). In addition, when compared to pancreatic cancer, mean serum Cu and Ni levels in liver cirrhosis patients and controls were considerably lower (p <0.05). Mean serum levels of Pb in pancreatic Ca patients were significantly lower compared to liver cirrhosis patients and controls (p <0.05). When comparing all cancer patients to controls, mean serum Co and Mg levels were not substantially different.


Conclusion: Deficiency in four trace elements (Cd, Mn, Fe, and Zn) was determined in patients with liver cirrhosis and pancreatic cancer. In addition, we have determined the deficiency of Cu and Ni trace elements (TEs) in pancreatic cancer patients. TE insufficiencies in cancer patients may be due to excessive consumption of foods and undernourishment. Epidemiological and physiological causes of trace element changes should be investigated further.



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Article Details

Karapinar, H. S., Türkdoğan, M. K., & Kiliçel, F. (2022). Serum trace element levels of liver cirrhosis and pancreatic cancer patients. Archives of Community Medicine and Public Health, 8(2), 055–061. https://doi.org/10.17352/2455-5479.000174
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Copyright (c) 2022 Karapinar HS, et al.

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Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, et al. (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68: 394-424. Link: https://bit.ly/3vikwSs

Ferlay J, Colombet M, Soerjomataram I, Parkin DM, Piñeros M, et al. (2021) Cancer statistics for the year 2020: an overview. Int J Cancer. Link: https://bit.ly/3xYk8u2

Guha IN, Iredale JP (2007) Clinical and diagnostic aspects of cirrhosis. Textbook of Hepatology: From Basic Science to Clinical Practice 604-619.

Nangliya V, Sharma A, Yadav D, Sunder S, Nijhawan S, et al. (2015) Study of trace elements in liver cirrhosis patients and their role in prognosis of disease. Biol Trace Elem Res 165: 35-40. Link: https://bit.ly/3xX2wP7

Grüngreiff K, Reinhold D, Wedemeyer H (2016) The role of zinc in liver cirrhosis. Ann Hepatol 15: 7-16. Link: https://bit.ly/3vic3yE

Kolachi NF, Kazi TG, Afridi HI, Kazi NG, Khan S (2012) Investigation of essential trace and toxic elements in biological samples (blood, serum and scalp hair) of liver cirrhotic/cancer female patients before and after mineral supplementation. Clin Nutr 31: 967-973. Link: https://bit.ly/3KeNXcg

Fu L, Xie H, Huang J, Chen L (2020) Rapid determination of trace elements in serum of hepatocellular carcinoma patients by inductively coupled plasma tandem mass spectrometry. Anal Chim Acta 1112: 1-7. Link: https://bit.ly/3EVxJ70

Himoto T, Masaki T (2020) Current Trends of Essential Trace Elements in Patients with Chronic Liver Diseases. Nutrients 12: 2084. Link: https://bit.ly/3Loz88v

Kazi TG, Kolachi NF, Afridi HI, Kazi NG, Arain SS (2012) Effects of mineral supplementation on liver cirrhotic/cancer male patients. Biol Trace Elem Res 150: 81-90. Link: https://bit.ly/3xW7D25

Gurusamy K (2007) Trace element concentration in primary liver cancers—a systematic review. Biol Trace Elem Res 118: 191-206. Link: https://bit.ly/3vk8M1D

Hu Y, Xiao T, Zhang A (2021) Associations between and risks of trace elements related to skin and liver damage induced by arsenic from coal burning. Ecotoxicology Environmental Safety 208: 111719. Link: https://bit.ly/3Kl7cAQ

Hariharan D, Saied A, Kocher H (2008) Analysis of mortality rates for pancreatic cancer across the world. Hpb 10: 58-62. Link: https://bit.ly/3kjHvWO

Buha A, Wallace D, Matovic V, Schweitzer A, Oluic B, et al. (2017) Cadmium exposure as a putative risk factor for the development of pancreatic cancer: three different lines of evidence. Biomed Res Int. Link: https://bit.ly/3Kk6pQW

Ducreux M, Cuhna AS, Caramella C, Hollebecque A, Burtin P, et al. (2015) Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 26: v56-v68. Link: https://bit.ly/3vj4FTr

Lener MR, Scott RJ, Wiechowska-Kozłowska A, Serrano-Fernández P, Baszuk P, et al. (2016) Serum concentrations of selenium and copper in patients diagnosed with pancreatic cancer. Cancer Res Treat 48: 1056. Link: https://bit.ly/3khxfi4

Camargo J, Pumarega JA, Alguacil J, Sanz-Gallén P, Gasull M, et al. (2019) Toenail concentrations of trace elements and occupational history in pancreatic cancer. Environ Int 127: 216-225. Link: https://bit.ly/3KkVmqB

Goldhaber SB (2003) Trace element risk assessment: essentiality vs. toxicity. Regul Toxicol Pharmacol 38: 232-242. Link: https://bit.ly/3knxHLn

Raouf AA, Radwan GS, Konsowa HA, Sira AM, Ibrahim NL (2013) Serum zinc, copper, and iron in children with chronic liver disease. Egyptian Liver Journal 3: 63-72. Link: https://bit.ly/3kfGQpl

Prystupa A, Błażewicz A, Kiciński P, Sak JJ, Niedziałek J, et al. (2016) Serum concentrations of selected heavy metals in patients with alcoholic liver cirrhosis from the Lublin Region in Eastern Poland. Int J Environ Res Public Health 13: 582. Link: https://bit.ly/3vmG8NG

Maret W (2003) Cellular zinc and redox states converge in the metallothionein/thionein pair. J Nutr 133: 1460S-1462S. Link: https://bit.ly/399R88a

Salgueiro MJ, Zubillaga M, Lysionek A, Sarabia MI, Caro R, et al. (2000) Zinc as an essential micronutrient: a review. Nutrition Research 20: 737-755. Link: https://bit.ly/3LkXpMp

Alguacil J, Porta M, Kauppinen T, Malats N, Kogevinas M, et al. (2003) Occupational exposure to dyes, metals, polycyclic aromatic hydrocarbons and other agents and K‐ras activation in human exocrine pancreatic cancer. Int J Cancer 107: 635-641. Link: https://bit.ly/3kiGUVj

Amaral AF, Porta M, Silverman DT, Milne RL, Kogevinas M, et al. (2012) Pancreatic cancer risk and levels of trace elements. Gut 61: 1583-1588. Link: https://bit.ly/3MxJIKn

Ojajärvi IA, Partanen TJ, Ahlbom A, Boffetta P, Hakulinen T, et al. (2000) Occupational exposures and pancreatic cancer: a meta-analysis. Occup Environ Med 57: 316-324. Link: https://bit.ly/3EPz7YK

Türkdoğan MK, Kilicel F, Kara K, Tuncer I, Uygan I (2003) Heavy metals in soil, vegetables and fruits in the endemic upper gastrointestinal cancer region of Turkey. Environmental toxicology pharmacology 13: 175-179. Link: https://bit.ly/3xWVxph

Cao B, Yan L, Ma J, Jin M, Park C, et al. (2019) Comparison of serum essential trace metals between patients with schizophrenia and healthy controls. J Trace Elements Medicine Biology 51: 79-85. Link: https://bit.ly/3EOB9IB

Morton J, Tan E, Suvarna SK (2017) Multi-elemental analysis of human lung samples using inductively coupled plasma mass spectrometry. J Trace Elements Medicine Biology 43: 63-71. Link: https://bit.ly/3Mv4F8M

Rahelić D, Kujundžić M, Romić Ž, Brkić K, Petrovečki M (2006) Serum concentration of zinc, copper, manganese and magnesium in patients with liver cirrhosis. Coll Antropol 30: 523-528. Link: https://bit.ly/3vN5enF

Ebara M, Fukuda H, Hatano R, Saisho H, Nagato Y, et al. (2000) Relationship between copper, zinc and metallothionein in hepatocellular carcinoma and its surrounding liver parenchyma. J Hepatol 33: 415-422. Link: https://bit.ly/3LyEI84

McMillan DC, Maguire D, Talwar D (2019) Relationship between nutritional status and the systemic inflammatory response: micronutrients. Proc Nutr Soc 78: 56-67. Link: https://bit.ly/3vgLhXo

Oakes EJ, Lyon TD, Duncan A, Gray A, Talwar D, et al. (2008) Acute inflammatory response does not affect erythrocyte concentrations of copper, zinc and selenium. Clin Nutr 27: 115-120. Link: https://bit.ly/3vhqKSz

Bianchi G, Marchesini G, Brizi M, Rossi B, Forlani G, et al. (2000) Nutritional effects of oral zinc supplementation in cirrhosis. Nutrition Research 20:1079-1089. Link: https://bit.ly/3ER4xxH

Arakawa Y, Moriyama M, Arakawa Y (2004) Liver cirrhosis and metabolism (sugar, protein, fat and trace elements). Hepatol Res 30: 46-58. Link: https://bit.ly/37FS589

Friedman SL (2000) Molecular regulation of hepatic fibrosis, an integrated cellular response to tissue injury. J Biol Chem 275: 2247-2250. Link: https://bit.ly/3xXsMcm

Baltaci AK, Dundar TK, Aksoy F, Mogulkoc R (2017) Changes in the serum levels of trace elements before and after the operation in thyroid cancer patients. Biol Trace Elem Res 175: 57-64. Link: https://bit.ly/39mlV1R

Türkdoğan MK, Karapinar HS, Kilicel F (2022) Serum Trace Element Levels of Gastrointestinal Cancer Patients in an Endemic Upper Gastrointestinal Cancer Region. J Trace Elements Medicine Biology 126978. Link: https://bit.ly/3LkFHc0

Gurusamy KS, Farquharson MJ, Craig C, Davidson BR (2008) An evaluation study of trace element content in colorectal liver metastases and surrounding normal livers by X-ray fluorescence. Biometals 21: 373-378. Link: https://bit.ly/39mBFlp

Genchi G, Carocci A, Lauria G, Sinicropi MS, Catalano A (2020) Nickel: Human health and environmental toxicology. Int J Environ Res Public Health 17: 679. Link: https://bit.ly/3ODMy2h

Chiou YH, Wong RH, Chao MR, Chen CY, Liou SH, et al. (2014) Nickel accumulation in lung tissues is associated with increased risk of p53 mutation in lung cancer patients. Environ Mol Mutagen 55: 624-632. Link: https://bit.ly/3OEejb8

McGregor D, Baan R, Partensky C, Rice J, Wilbourn J (2000) Evaluation of the carcinogenic risks to humans associated with surgical implants and other foreign bodies—a report of an IARC Monographs Programme Meeting. Eur J Cancer 36: 307-313. Link: https://bit.ly/3Lg83nP

Choudhury S, Zhang R, Frenkel K, Kawamori T, Chung FL, et al. (2003) Evidence of alterations in base excision repair of oxidative DNA damage during spontaneous hepatocarcinogenesis in Long Evans Cinnamon rats. Cancer Res 63: 7704-7707. Link: https://bit.ly/36Q3Ubc

Irato P, Albergoni V (2005) Interaction between copper and zinc in metal accumulation in rats with particular reference to the synthesis of induced-metallothionein. Chemico-biological interactions 155: 155-164.

Liaw KY, Lee PH, Wu FC, Tsai JS, Lin Shiau SY (1997) Zinc, copper, and superoxide dismutase in hepatocellular carcinoma. Am J Gastroenterol (Springer Nature) 92. Link: https://bit.ly/3rYj71d

Karapınar HS, Kılıçel F (2020) Determination of some toxic element (Cr, Cd, Cu and Pb) levels in cumin and cinnamon aromatic plants frequently used as foodstuff. Bursa Uludağ Üniversitesi Ziraat Fakültesi Dergisi 34: 1-8. Link: https://bit.ly/3ESwJjJ

Filipič M, Fatur T, Vudrag M (2006) Molecular mechanisms of cadmium induced mutagenicity. Hum Exp Toxicol 25: 67-77. Link: https://bit.ly/3xTfAVF

Nawrot T, Plusquin M, Hogervorst J, Roels HA, Celis H, et al. (2006) Environmental exposure to cadmium and risk of cancer: a prospective population-based study. Lancet Oncol 7: 119-126. Link: https://bit.ly/3MCgRVw

Kilicel F, Karapinar HS, Uğuz A (2017) Determination of some heavy metal concentrations of sage tea with FAAS. International J Secondary Metabolite 4: 391-399. Link: https://bit.ly/3xX9fbP

Kovochich M, Monnot A, Kougias DG, More SL, Wilsey JT, et al. (2021) Carcinogenic hazard assessment of cobalt-containing alloys in medical devices: review of in vivo studies. Regul Toxicol Pharmacol 104910. Link: https://bit.ly/39lvSN0

Lin X, Peng L, Xu X, Chen Y, Zhang Y, et al. (2018) Connecting gastrointestinal cancer risk to cadmium and lead exposure in the Chaoshan population of Southeast China. Environ Sci Pollut Res Int 25: 17611-17619. Link: https://bit.ly/3kfMzLR

Abdeen A, Abou-Zaid OA, Abdel-Maksoud HA, Aboubakr M, Abdelkader A, et al. (2019) Cadmium overload modulates piroxicam-regulated oxidative damage and apoptotic pathways. Environ Sci Pollut Res Int 26: 25167-25177. Link: https://bit.ly/3Ksjms0

Awadalla A, Mortada WI, Abol-Enein H, Shokeir AA (2020) Correlation between blood levels of cadmium and lead and the expression of microRNA-21 in Egyptian bladder cancer patients. Heliyon 6: e05642. Link: https://bit.ly/39ev8cl

Ruggeri B, Zhang S, Caamano J, DiRado M, Flynn SD, et al. (1992) Human pancreatic carcinomas and cell lines reveal frequent and multiple alterations in the p53 and Rb-1 tumor-suppressor genes. Oncogene 7: 1503-1511. Link: https://bit.ly/398F7Qn

Person RJ, Tokar EJ, Xu Y, Orihuela R, Ngalame NNO, et al. (2013) Chronic cadmium exposure in vitro induces cancer cell characteristics in human lung cells. Toxicol Appl Pharmacol 273: 281-288. Link: https://bit.ly/3KysSKd

Zhang FL, Fu HW, Casey PJ, Bishop WR (1996) Substitution of cadmium for zinc in farnesyl: protein transferase alters its substrate specificity. Biochemistry 35: 8166-8171. Link: https://bit.ly/3Kkbh8G

Méplan C, Mann K, Hainaut P (1999) Cadmium induces conformational modifications of wild-type p53 and suppresses p53 response to DNA damage in cultured cells. J Biol Chem 274: 31663-31670. Link: https://bit.ly/3y25pyp

Sell S, Ilic Z (1994) Dietary cadmium may enhance the progression of hepatocellular tumors in hepatitis B transgenic mice. Carcinogenesis 15: 2057-2060. Link: https://bit.ly/3LlBWDp

Sohrabi M, Gholami A, Azar MH, Yaghoobi M, Shahi MM, et al. (2018) Trace element and heavy metal levels in colorectal cancer: Comparison between cancerous and non-cancerous tissues. Biol Trace Elem Res 183: 1-8. Link: https://bit.ly/3EPw5DC

Rinaldi L, Barabino G, Klein J-P, Bitounis D, Pourchez J, et al. (2015) Metals distribution in colorectal biopsies: New insight on the elemental fingerprint of tumour tissue. Digestive and Liver Disease 47: 602-607. Link: https://bit.ly/3OFbzdz

Zhang Q, Pan E, Liu L, Hu W, He Y, Xu Q, et al. (2014) Study on the relationship between manganese concentrations in rural drinking water and incidence and mortality caused by cancer in Huai’an City. Biomed Res Int 2014: 645056. Link: https://bit.ly/3LliFSw

Malafa M, Margenthaler J, Webb B, Neitzel L, Christophersen M (2000) MnSOD expression is increased in metastatic gastric cancer. Journal of Surgical Research 88: 130-134. Link: https://bit.ly/3vLec4L

Herceg Z (2007) Epigenetics and cancer: towards an evaluation of the impact of environmental and dietary factors. Mutagenesis 22: 91-103. Link: https://bit.ly/3kjMKps

Sadat N, Hossain I, Hossain K, Reza S, Nahar Z, et al. (2008) Serum trace elements and immunoglobulin profile in lung cancer patients. Journal of Applied Research 8: 24-34. Link: https://bit.ly/38sIdP5

Luckett BG, Su LJ, Rood JC, Fontham ET (2012) Cadmium exposure and pancreatic cancer in south Louisiana. J Environ Public Health 2012: 180186. Link: https://bit.ly/3MvXUDN

Manousos O, Trichopoulos D, Koutselinis A, Papadimitriou C, Polychronopoulou A, et al. (1981) Epidemiologic characteristics and trace elements in pancreatic cancer in Greece. Cancer Detect Prev 4: 439-442. Link: https://bit.ly/3vk2e3f

Farzin L, Moassesi ME, Sajadi F, Ahmadi Faghih MA (2013) Evaluation of trace elements in pancreatic cancer patients in Iran. Middle East Journal of Cancer 4: 79-86. Link: https://bit.ly/3vkdGf5

Saghiri MA, Orangi J, Asatourian A, Sorenson CM, Sheibani N (2016) Functional role of inorganic trace elements in angiogenesis part III:(Ti, Li, Ce, As, Hg, Va, Nb and Pb). Crit Rev Oncol Hematol 98: 290-301. Link: https://bit.ly/3MuYa5W

Castiella A, Múgica F, Zapata E, Zubiaurre L, Iribarren A, et al. (2015) Gender and plasma iron biomarkers, but not HFE gene mutations, increase the risk of colorectal cancer and polyps. Tumor Biol 36: 6959-6963. Link: https://bit.ly/398Fuuf

Sohrabi M, A. Gholami A, Azar MH, Yaghoobi M, Shahi MM, et al. (2018) Trace, element and heavy metal levels in colorectal cancer: comparison between cancerous and non-cancerous tissues. Biol Trace Elem Res 183: 1-8. Link: https://bit.ly/3MuYfqg