Determination of plasma and erythrocyte levels of copper, magnesium and zinc by atomic absorption spectrometry in type-2 diabetes mellitus patients with metabolic syndrome

Amin Omidian , Morteza Pourfarzam, Seyed Mostafa Ghanadian, Fouzieh Zadhoush


Background and purpose: Imbalance in blood levels of trace elements is independent risk factor for metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and its complications. This study investigated plasma and erythrocyte levels of copper, magnesium, zinc, and their correlations with biochemical components of the MetS in T2DM patients compared to the healthy controls.

Experimental approach: Forty men recently diagnosed T2DM with MetS without complications and thirty six age-matched healthy controls were enrolled in this cross-sectional study. Plasma and erythrocyte levels of selected elements were measured by graphite furnace atomic absorption spectroscopy.

Findings/Results: The results of the present study showed significantly lower plasma levels of copper, magnesium, and zinc and lower erythrocytes copper in the patients' group compared to the controls; while erythrocyte levels of magnesium and zinc were not significantly different between the two groups. Significant negative correlations were observed between plasma levels of copper with waist and hip circumferences, waist to hip ratio, systolic and diastolic blood pressures, fasting blood glucose, and glycated hemoglobin levels in all subjects; while erythrocyte copper levels showed significant negative correlation with triglyceride, and erythrocyte zinc was positively correlated with diastolic blood pressure and negatively with triglyceride.

Conclusion and implications: Alterations of trace elements may have a significant role in the pathogenesis of MetS and T2DM patients. It is suggested that the body status of copper, magnesium, and zinc might be significantly correlated with components of MetS in T2DM patients; and plasma copper levels may be correlated with complications of type 2 diabetes mellitus.




Keywords: Atomic absorption spectrometry; Copper; Diabetes mellitus; Magnesium; Metabolic syndrome; Zinc.

Full Text:



Ostovar R, Kiani F, Sayehmiri F, Yasemi M, Mohsenzadeh Y, Mohsenzadeh Y. Prevalence of metabolic syndrome in Iran: a meta-analysis. Electron Physician. 2017;9(10):5402-5418.

DOI: 10.19082/5402.

Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137-149.

DOI: 10.1016/j.diabres.2013.11.002.

Hezarkhani S, Aghaei M, Sadat Taheri N, Shahini N, Shahini N. Comparison of glycemic excursion in patients with new onset type II diabetes mellitus before and after treatment with repaglinide. Res Pharm Sci. 2012;7(5):S878.

Samimi F, Baazm M, Eftekhar E, Rajabi S, Goodarzi MT, Jalali Mashayekhi F. Possible antioxidant mechanism of coenzyme Q10 in diabetes: impact on Sirt1/Nrf2 signaling pathways. Res Pharm Sci. 2019;14(6):524-533.

DOI: 10.4103/1735-5362.272561.

Viktorínová A, Toserová E, Krizko M, Duracková Z. Altered metabolism of copper, zinc, and magnesium is associated with increased levels of glycated hemoglobin in patients with diabetes mellitus. Metabolism. 2009;58(10):1477-1482.

DOI: 10.1016/j.metabol.2009.04.035.

Masood N, Baloch GH, Ghori RA, Memon IA, Memon MA, Memon MS. Serum zinc and magnesium in type-2 diabetic patients. J Coll Physicians Surg Pak. 2009;19(8):483-486.

PMID: 19651009.

Basaki M, Saeb M, Nazifi S, Shamsaei HA. Zinc, copper, iron, and chromium concentrations in young patients with type 2 diabetes mellitus. Biol Trace Elem Res. 2012;148(2):161-164.

DOI: 10.1007/s12011-012-9360-6.

Kruse-Jarres JD, Rukgauer M. Trace elements in diabetes mellitus. Peculiarities and clinical validity of determinations in blood cells. J Trace Elem Med Biol. 2000;14(1):21-27.

DOI: 10.1016/S0946-672X(00)80019-X.

Saha-Roy S, Pal S, Bera S, Choudhury K, Bhattacharya A, Sen G, et al. Status of serum magnesium, zinc & copper in patients suffering from type-2 diabetes mellitus. J Drug Deliv Ther. 2014;4(1):70-72.

DOI: 10.22270/jddt.v4i1.754.

Chen MD, Lin PY, Tsou CT, Wang JJ, Lin WH. Selected metals status in patients with noninsulin-dependent diabetes mellitus. Biol Trace Elem Res. 1995;50(2):119-124.

DOI: 10.1007/BF02789414.

Guerrero-Romero F, Rodriguez-Moran M. Hypomagnesemia, oxidative stress, inflammation, and metabolic syndrome. Diabetes Metab Res Rev. 2006;22(6):471-476.

DOI: 10.1002/dmrr.644.

Kazi TG, Afridi HI, Kazi N, Jamali MK, Arain MB, Jalbani N, et al. Copper, chromium, manganese, iron, nickel, and zinc levels in biological samples of diabetes mellitus patients. Biol Trace Elem Res. 2008;122(1):1-18.

DOI: 10.1007/s12011-007-8062-y.

Obeid O, Elfakhani M, Hlais S, Iskandar M, Batal M, Mouneimne Y, et al. Plasma copper, zinc, and selenium levels and correlates with metabolic syndrome components of lebanese adults. Biol Trace Elem Res. 2008;123(1-3):58-65.

DOI: 10.1007/s12011-008-8112-0.

Abolbashari S, Darroudi S, Tayefi M, Khashyarmaneh Z, Zamani P, Haghighi HM, et al. Association between serum zinc and copper levels and antioxidant defense in subjects infected with human T-lymphotropic virus type 1. J Blood Med. 2019;10:29-35.

DOI: 10.2147/JBM.S184913.

Suarez A, Pulido N, Casla A, Casanova B, Arrieta FJ, Rovira A. Impaired tyrosine-kinase activity of muscle insulin receptors from hypomagnesaemic rats. Diabetologia. 1995;38(11):1262-1270.

DOI: 10.1007/BF00401757.

American Diabetes Association. Standards of medical care in diabetes-2019 abridged for primary care providers. Clin Diabetes. 2019;37(1):11-34.

DOI: 10.2337/cd18-0105.

Expert Panel on Detection, Evaluation, and Treatment of high blood cholesterol in adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285(19):2486-2497.

DOI: 10.1001/jama.285.19.2486.

Pourfarzam M, Zadhoush F, Sadeghi M. The difference in correlation between insulin resistance index and chronic inflammation in type 2 diabetes with and without metabolic syndrome. Adv Biomed Res. 2016;5:153.

DOI: 10.4103/2277-9175.188489.

Whitehouse RC, Prasad AS, Rabbani PI, Cossack ZT. Zinc in plasma, neutrophils, lymphocytes, and erythrocytes as determined by flameless atomic absorption spectrophotometry. Clin Chem. 1982;28(3):475-480.

PMID: 7067090.

Rifai N. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Ashwood CA: WB Saunders Co; 2018. pp. 1745-1789.

Prohaska C, Pomazal K, Steffan I. ETAAS method for the determination of Cd, Cr, Cu, Mn and Se in blood fractions and whole blood. Fresenius J Anal Chem. 2000;368(6):627-632.

DOI: 10.1007/s002160000520.

Hulanicki A, Godlewska B, Brzóska M. Determination of total magnesium in biological samples using electrothermal atomic absorption spectrometry. Spectrochim Acta Part B: At Spectrosc. 1995;50(13):1717-1724.

DOI: 10.1016/0584-8547(95)01376-8.

Martin MT, Shapiro R. [28] Atomic absorption spectrometry of magnesium. Methods Enzymol. 1988;158:365-370.

DOI: 10.1016/0076-6879(88)58068-0.

D’Haese PC, Lamberts LV, Vanheule AO, Broe ME. Direct determination of zinc in serum by Zeeman atomic absorption spectrometry with a graphite furnace. Clin Chem. 1993;38:2439-2443.

PMID: 1458581.

Eaton JW, Qian M. Interactions of copper with glycated proteins: possible involvement in the etiology of diabetic neuropathy. Mol Cell Biochem. 2002;234-235(1-2):135-142.

PMID: 12162426.

Galhardi CM, Diniz YS, Faine LA, Rodrigues HG, Burneiko RC, Ribas BO, et al. Toxicity of copper intake: lipid profile, oxidative stress and susceptibility to renal dysfunction. Food Chem Toxicol. 2004;42(12):2053-2060.

DOI: 10.1016/j.fct.2004.07.020.

La SA, Lee JY, Kim DH, Song EL, Park JH, Ju SY. Low magnesium levels in adults with metabolic syndrome: a meta-analysis. Biol Trace Elem Res. 2016;170(1):33-42.

DOI: 10.1007/s12011-015-0446-9.

Burtis CA, Bruns DE. Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. 7th ed. Elsevier-Health Sciences Division; 2014. pp.1756.

Zhang H, Yan C, Yang Z, Zhang W, Niu Y, Li X, et al. Alterations of serum trace elements in patients with type 2 diabetes. J Trace Elem Med Biol. 2017;40:91-96.

DOI: 10.1016/j.jtemb.2016.12.017.

Sobczak AIS, Stefanowicz F, Pitt SJ, Ajjan RA, Stewart AJ. Total plasma magnesium, zinc, copper and selenium concentrations in type-I and type-II diabetes. Biometals. 2019;32(1):123-138.

DOI: 10.1007/s10534-018-00167-z.

Sohrevardi S, Azmandian J, Saie S. Serum levels evaluation of zinc, chromium, copper, selenium and manganese in diabetic and non-diabetic kidney transplant patients. Res Pharm Sci. 2012;7(5):S95.

Ahn BI, Kim MJ, Koo HS, Seo N, Joo NS, Kim YS. Serum zinc concentration is inversely associated with insulin resistance but not related with metabolic syndrome in nondiabetic Korean adults. Biol Trace Elem Res. 2014;160(2):169-175.

DOI: 10.1007/s12011-014-0045-1.

Pizent A, Pavlovic M, Jurasovic J, Dodig S, Pasalic D, Mujagic R. Antioxidants, trace elements and metabolic syndrome in elderly subjects. J Nutr Health Aging. 2010;14(10):866-871.

DOI: 10.1007/s12603-010-0139-1.

Yu Y, Cai Z, Zheng J, Chen J, Zhang X, Huang XF, et al. Serum levels of polyunsaturated fatty acids are low in Chinese men with metabolic syndrome, whereas serum levels of saturated fatty acids, zinc, and magnesium are high. Nutr Res. 2012;32(2):71-77.

DOI: 10.1016/j.nutres.2011.12.004.

Zadhoush F, Sadeghi M, Pourfarzam M. Biochemical changes in blood of type 2 diabetes with and without metabolic syndrome and their association with metabolic syndrome components. J Res Med Sci. 2015;20(8):763-770.

DOI: 10.4103/1735-1995.168383.


  • There are currently no refbacks.

Creative Commons LicenseThis work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.