|Year : 2016 | Volume
| Issue : 3 | Page : 182-184
Serum copper and zinc levels in preeclamptic Nigerian women
AO Onyegbule1, CC Onah2, BC Iheukwumere1, JN Udo2, CC Atuegbu2, NO Nosakhare2
1 Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Nigeria
2 Department of Chemical Pathology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
|Date of Web Publication||15-Jun-2016|
A O Onyegbule
Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: The exact etiology of preeclampsia remains unknown even though several studies have been done. Some studies have shown that supplementation of zinc (Zn) and copper could ameliorate the effects of preeclampsia while other studies did not establish the beneficial role of these elements in preeclampsia. The objective of this study was to compare the Zn and copper levels in the serum of Nigerian women with or without preeclampsia. Materials and Methods: In this study, serum Zn and copper levels were determined using atomic absorption spectrometry in 54 patients and 48 healthy normotensive pregnant women. The mean, standard deviation, Student's t-test, and Pearson correlation were employed. Results: Serum Zn was significantly lower in patients than controls (8.27 ± 0.60 vs. 12.16 ± 1.83 μmol/l. P <0.001) (t-test). Serum copper was also significantly lower in patients than controls (8.14 ± 1.80 vs. 16.62 ± 3.17 μmol/l, P < 0.001). Conclusion: There was a significant reduction in the levels of Zn and copper in patients with preeclampsia. Dietary supplementation of these trace elements may help to prevent preeclampsia.
Keywords: Atomic absorption spectrometry, copper and zinc, preeclampsia
|How to cite this article:|
Onyegbule A O, Onah C C, Iheukwumere B C, Udo J N, Atuegbu C C, Nosakhare N O. Serum copper and zinc levels in preeclamptic Nigerian women. Niger Med J 2016;57:182-4
|How to cite this URL:|
Onyegbule A O, Onah C C, Iheukwumere B C, Udo J N, Atuegbu C C, Nosakhare N O. Serum copper and zinc levels in preeclamptic Nigerian women. Niger Med J [serial online] 2016 [cited 2023 Mar 29];57:182-4. Available from: https://www.nigeriamedj.com/text.asp?2016/57/3/182/184071
| Introduction|| |
Hypertension associated with pregnancy is the most common medical risk for maternal morbidity and mortality.  The greatest impact is associated with the pregnancy-specific syndrome, preeclampsia.  Preclampsia is the occurrence of hypertension and proteinuria in a pregnant woman after 20 weeks of gestation.  The deficiency of trace elements such as zinc (Zn), copper, magnesium have been implicated in various reproductive events like infertility, congenital anomalies, preeclampsia, low birth weight, and stillbirth. , Therefore, this study was done to compare the levels of Zn and copper in preeclamptic and non- and pre-clamptic women in Nnewi with a view to providing a preliminary data regarding copper and Zn supplementation in pregnancy in our area.
| Materials and methods|| |
This was a case-control study designed to determine the serum levels of copper and Zn in pregnant women with preeclampsia.
Inclusion criteria were women diagnosed with preeclampsia after 20 weeks of pregnancy. The controls were pregnant women in the same age range seen after 20 weeks of pregnancy but not diagnosed with preeclampsia.
Exclusion criteria included patients on any form of Copper and Zinc drugs, patients with medical complications such as diabetes mellitus, renal failure, and heart diseases. A well-designed questionnaire administered by researchers was used to sample the patients and the controls.
A sterile needle and syringe were used to draw blood from the cubital vein, and the blood was put into plain tubes. The blood was allowed to clot undisturbed. Serum was separated by centrifugation for 10 min at 4000 rpm and stored at − 20°C until time of analysis. Copper and Zn levels were determined by atomic absorption spectrophotometry.
The principle is based on the dissolution of the elements (from the flame) from its chemical bonds. This is then placed in unexcited or ground state (neutral atom). Thus, the neutral atom is at a low energy in which it is capable of being absorbing radiation at a very narrow bandwidth corresponding to its own line spectrum. The amount of radiant energy absorbed is proportional to the concentration of copper and Zn in the serum.
The Statistical Package for Social Sciences version 17 (SPSS, Inc., 2008, Chicago) was used for the analysis. Values obtained from the study were expressed as mean and standard deviations. Independent t-test was used to determine the difference between continuous variables while the degree of correlation between variables was measured using Pearson correlation coefficient. The level of significance was set at P < 0.05.
| Results|| |
Of the total 102 pregnant women, 48 were non- and pre-eclamptic while 54 were preeclamptic. The mean age of the patients were 27 ± 7.02 years whereas that of the control was 29 ± 5.35 years. Most of the patients and controls were of 0 and 1 parity. It was noted that among the patients that had preeclampsia (54 women), those <20 years contributed the highest number compared to other ages 15 (27.8%). It was also shown that 33 (61.1%) were nulliparous, greatest number attended secondary education 37 (68.5%) These are shown in [Table 1]. As shown in [Table 2], there was a significant inverse negative correlation between the serum levels of Copper, Zinc and both systolic and diastolic blood pressure. There was an inverse relationship between copper and Zn and diastolic blood pressure (r = −0.808, P < 0.01), r = −0.749, P < 0.01, respectively.
|Table 2: Levels of biochemical parameters in preeclamptic and non- and pre-eclamptic women |
Click here to view
| Discussion|| |
The result obtained from this study showed no statistically significant difference between maternal age and preeclampsia (P = 0.188). This was similar to the findings of Asraf et al.,  but it was, however, different from the findings of Macdonald-Wallis et al. Such difference may be due to the specificity of each population and hospital of the attendant patients.
There was also a significant difference between nulliparity and preeclampsia (P = 0.02), this supported the finding by Odegård et al. , who noted that the risk of preeclampsia was increased by nulliparity and hypertension. This may be explained by the immunologic theory of preeclampsia which was of the view that inadequate blocking antibodies to the paternal antigens increase the incidence of preeclampsia in nullipara.
Lack of formal education has been noted to increase the risk of preeclampsia by a factor of 4.  In our study, women who had at most secondary education were noted to have a higher incidence of preeclampsia, this may be explained by the fact that this group formed the bulk of participants, up to 68.5%.
We observed a significant decrease in the serum level of Zn in preeclamptic women when compared to the non- and pre-eclamptic women. This suggests a possible involvement of Zn, in the development and pathogenesis of preeclampsia. Our data agree with Mahomed et al. and Akinloye et al. ,[ who also noted reduced levels of Zn in women with preeclampsia.
Zn is an important trace element in metabolism, growth, development, and reproduction. It is a constituent of many enzymes. This element plays important roles in nucleic acid metabolism and protein synthesis, as well as membrane structure and function.  Zn deficiency has been associated with complications of pregnancy part of which is preeclampsia. 
Zn is passively transferred from mother to fetus across the placenta, and there is also decreased Zn binding capacity of maternal blood during pregnancy, which facilitates efficient transfer of Zn from mother to fetus.  During pregnancy, there is a decline in circulating Zn and this increases as the pregnancy progresses possibly due to decrease in Zn binding and increased transfer of Zn from the mother to the foetus. 
Zn is essential for proper growth of fetus and the fall in Zn during pregnancy could also be a physiological response to expanded maternal blood volume.  It was reported that an increased incidence of preeclampsia in Zn-deficient regions was corrected by Zn supplementation in those regions. 
Our study also noted the significant difference between the serum copper levels in preeclamptic and non- and pre-eclamptic women. This finding corroborated the finding of Ugwuja  and findings from the earlier workers involved in both epidemiological study  and experimental study. 
Copper has been shown to be involved in the function of several cuproenzymes that are pertinent for life. Copper is a component of ceruloplasmin and superoxide dismutase, which are notable antioxidants. This has made some workers conclude that copper deficiency may increase the risk of cardiovascular diseases. 
Careulopasmin containing copper catalyzes the conversion of Iron from the ferric to the ferrous form, and thus is essential in the absorption of Iron in the gastrointestinal system. It also plays a role in the mobilization of Iron from its tissue stores. 
| Conclusion|| |
Our study showed a significant reduction in the levels of copper and Zn in preeclamptic women when compared with non- and pre-eclamptic women. Dietary supplementation of these trace elements may help to prevent preeclampsia.
We would like to thank all who were involved in the collection, preservation, and processing of the samples.
Financial support and sponsorship:
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ganiyu A, Ayo, Ayodele B, Adijat A, Adebayo A. Serum concentrations of immunoglobulins and acute phase proteins in Nigerian women with preeclampsia. Reprod Biol 2006;6:265.
Roberts J, Bodnar L, Lain K, Hubel C, Markovic N, Ness R. Uric acid is as important as proteinuria in identifying fetal risk in women with gestational hypertension. Hypertension 2005;46:1263-9.
American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Obstet Gynecol 2013;122:1122.
Mohammed K, Williams MA, Woelk GB, Mudzamiri S, Madzime S, King IB, et al
. Leucocyte, Selenium Zinc and copper concentrations in pre-eclampsia and normotensive pregnant women. Biol Trace Elem Res 2004;75:107-118.
Hofmeyr GT, Duley L, Attalah A. Dietary calcium supplememtation for the prevention of preeclampsia and related problems: A systematic review and commentary. Br J Obstet Gynaecol 2007;114:933-43.
Ashraf D, Afra K, Kourosh S. Predictive factors for preeclampsia in pregnant women: A univariate and multivariate logistic regression analysis. Acta Biochimica Polonica 2012;59:673-7.
Macdonald Wallis C, Lawler DA, Heron J, Fraser A, Nelson SM, Tilling KX. Relationship of risk factors for preeclampsia with patterns of occurrence of isolated gestational proteinuria during normal term pregnancy. PLoS 2011;6:e22115.
Odegard RA, Vatten LJ, Alisen ST, Salvessen KA, Austgulen R. Risk factors and clinical manifestations of preeclampsia. BJOG 2007:1410-6.
Akinloye O, Oyewale OJ, Oguntibeju OO. Evaluation of trace elements in pregnant women with pre-eclampsia. Afr J Biotech 2010;9:5196-202.
Norrozi N, Borna S, Hanachi P, Faghihzadeh S, Haghollahi F, Golkhou S. Evaluation of zinc supplementation effect on fetal outcomes in pregnant women with lower than median serum zinc. J Fam Planning Reprod Health Care 2012;6:85-91.
Jain S, Sharma P, Kulshreshtha S, Mohan G, Singh S. The role of serum calcium, magnesium and zinc in preeclampsia. Biol Trace elem Res 2010;133:162-70.
Tamura T, Goldenberg RL, Johnston KE, DuBard M. Maternal plasma zinc concentrations and pregnancy outcome. Am J Clin Nutr 2000;71:109-13.
Chitra U. Serum iron, copper and zinc status in maternal and cord blood. Indian J Clin Biochem 2004;19:48-52.
Adam B, Malatyaliogu E, Alvur M, Talu C. Magnesium, zinc and iron levels in pre-eclampsia. J Matern Foetal Med 2001;10:246-50.
Ugwuja EI, Ejikeme BN, Ugwuja NC, Obeka NC, Akubugwo EI, Obidoa O. Comparison of plasma copper, iron and zinc levels in hypertensive and non-hypertensive pregnant women in Abakaliki, South Eastern Nigeria. Pak J Nutr 2010;9:1136-40.
Leone N, Courbon D, Ducimetiere D, Zureik M. Zinc, cooper and magnesium and risks for all-cause cancer and cardiovascular mortality. Epidemiology 2006;17:308-14.
Rock E, Mazur A, O'connor JM, Bonham MP, Rayssiguier Y, Strain JJ. The effect of copper supplementation on red blood cell oxidizability and plasma antioxidants in middle-aged healthy volunteers. Free Radic Biol Med 2000;28:324-9.
Jones AA, DiSilvestro RA, Coleman M, Wagner TL. Copper supplementation of adult men: Effects on blood copper enzyme activities and indicators of cardiovascular disease risk. Metabolism 1997;46:1380-3.
Ziaei S, Ranjkesh F, Faghihzadeh S. Evaluation of 24 hours urine copper in pre-eclamptic vs. normotensive pregnant and non pregnant women. Int J Fertil Steril 2008;2:9-12.
[Table 1], [Table 2]
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