Comparison of Serum Zinc and Serum Copper
ORIGINAL ARTICLE
Comparison of Serum Zinc and Serum Copper in Hypothyroid Patients with
Normal Subjects
Asha Khubchandani1*, Vijaysinh Parmar2, Viral Solanki3, Janki Jadav 4, Anil Gamit5,
Sagar Gangwani6
1
Associate Professor, 2,3,4,5,6Resident, Department of Biochemistry, B.J. Medical College and Civil Hospital, Asarwa, Ahmedabad (Gujarat)
ABSTRACT
BACKGROUND: The objective of this study is to shed light on the level of trace elements in hypothyroidism. The
content of the trace elements (Zn, Cu) in the serum of patients was determined and compared to that of normal
subjects. MATERIALS AND METHODS: Serum sample of fifty patients of known case of hypothyroidism and
fifty normal subjects were taken. Serum Zinc and serum copper was estimated by colorimeter method in Fully
automated Erba XL-640 Analyser. RESULTS: The results showed that serum zinc level of hypothyroidism patients
was significantly lower as compared to the normal subjects (p value<0.05). There is no significant difference
between the groups in serum copper level. CONCLUSION: Decreased thyroid hormone synthesis and low levels of
circulating thyroid hormones result in biochemical and clinical hypothyroidism. Deficiency of thyroid hormones
causes many metabolic processes to slow down. The results of this study indicates, the role of these trace elements
in many metabolic process either as essential nutrients or as cofactors for different enzymes contributed directly or
indirectly to the hypothyroidism. Consequently, the results of this study suggest that the metabolism of zinc is
abnormal in hypothyroidism disease.
Keywords: Hypothyroidism, Serum Zinc, Serum Copper
INTRODUCTION
The maintenance of optimal health requires an
adequate supply of carbohydrates, proteins, lipids,
macronutrients,
micronutrients,
and
trace
elements.1 Many trace elements play an essential
role in a number of biological processes through
their action as activators or inhibitors of enzymatic
reactions, by competing with other elements and
proteins for binding sites, by influencing the
permeability of cell membranes, or through other
mechanisms. Trace elements are known to influence
hormones action, secretion, activity and binding to
target tissue. Conversely, hormones influence trace
metals metabolism at several levels of action,
including excretion and transport of trace metals.2
Hence, trace elements assay in biological fluids
can be used as diagnostic aid in patients with
different hormonal disturbances along with other
biochemical parameters. Thyroid hormones regulate
the rate of metabolic processes and consequent
development of organism. Deficiency of thyroid
hormones causes many metabolic processes to slow
down. Symptoms of hypothyroidism include
enlargement of thyroid gland or goiter, impairment
of cognition, slowing of mental and
*Corresponding Author
Dr. Asha Khubchandani,
Associate Professor Biochemistry,
11, Vidhi Bunglows, New C.G Road, Chandkheda,
Ahmedabad-382424
Email:- ashakhub@yahoo.com
1
Int J Res Med. 2014; 3(2);1-3
physical performance.3 In the present study the
serum contents of some trace elements Zn and Cu
was determined in hypothyroidism patients and
compared with the normal subjects. Thyroid
hormones play an important role in human body
metabolism. After binding with a specific nuclear
receptor, T3/T4 induces transcription of genetic
code via mRNA and regulates proteosynthesis in
most tissues. Decreased thyroid hormone synthesis
and low levels of circulating thyroid hormones
result
in
biochemical
and/or
clinical
hypothyroidism. This condition occurs more
frequently in women; the overall incidences are
about
3%
of
the
general
population.
Hypothyroidism probably is
initiated
by
autoimmunity against the thyroid gland in addition
to different other causes. The thyroid glands of
most of these patients first have autoimmune
“Thyroiditis”, which means thyroid inflammation.
This causes progressive deterioration and finally
fibrosis of the gland with resultant diminished or
absent secretion of thyroid hormone. Several
other types of hypothyroidism also occur, often
associated with development of enlarged thyroid
glands called thyroid goiter.4
MATERIALS AND METHODS
The cross sectional study was conducted in civil
hospital, ahmedabad during may 2013 to july
2013.Fifty hypothyroidism patients (n=50), their age
range between 19-65 years (39 female and 11 male)
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Comparison of Serum Zinc and Serum Copper
Level of
Trace
Element
Zinc
Copper
2
Normal
Subject
(mean ±SD)
92.17± 6.82
94.75± 7.15
Hypothyroid Patients
(mean ±SD)
49.38± 5.89
93.24± 6.28
Int J Res Med. 2014; 3(2);1-3
P value
< 0.05
> 0.05
Figure 1: Serum Zinc level in Control & Case
92.17
100
Mean
µgm/dl
80
60
SD
49.38
40
20
5.89
6.82
0
CASES
CONTROL
Figure.2 - Serum Copper level in Control & Case
100
Mean
94.75
93.24
SD
80
µgm/dl
participated in this study. The severity of
hypothyroid is mild to moderate and all patients
were on hormone replacement therapy. The mean
age of patients was found to be 41.48±13.17. The
patients were diagnosed depending on the results
of
the
following
examinations:
clinical
examinations, serum hormones level (T3, T4 and
TSH). Fifty normal Controls healthy persons (n=50)
aged 19-65 years (34 female and 16 male) were
used as control. The mean age of control was found
to be 36.86±12.34. Venous blood samples were
collected from patients with Hypothyroidism in
fasting condition and similar conditions were
maintained while taking the blood samples of
controls. About five millilitres of venous blood
from were drawn by utilizing disposable plastic
syringes in the morning and transferred into
sterile test tube. The blood was allowed to clot and
centrifuged at 5000 rpm for 5 minute. Sera were
separated and stored at -4ºC until analysis. The
supernatant blood serum was used for the
analysis of metals copper and zinc by
colorimetric method in Erba XL-640 Fully Auto
Analyser with following principal. Copper, released
from ceruloplasmin in an acidic medium, reacts with
Di-Br-PAESA( 2-(5
bromo-2-pyridylazo)-5-(Npropyl-N-sulfopropylamino) aniline Na salt ) to
form a coloured complex. Intensity of the complex
formed is directly proportional to the amount of
Copper present in the sample.8
Copper + Di-Br-PAESA
Coloured
Complex Zinc in an alkaline medium reacts with
Nitro-PAPS(2-(5-nitro-2-pyridylazo)-5-(N-propylN-sulfopropylamino)phenol
disodium
salt
dehydrate) to form a purple coloured complex.
Intensity of the complex formed is directly
proportional to the amount of Zinc present in the
sample.8 Zinc +Nitro-PAPS
Purple
Coloured Complex and results were analysed with
Graphpad Instat software by using student’s t-test
for statistical significance of 0.05.
RESULTS
Table (1) showed the results of serum trace
elements expressed as mean±standard deviation.
Serum zinc level of hypothyroidism patients are
significantly lower (p<0.05) than the level in
normal subjects. There is no significant difference
between the groups (p>0.05) in serum copper as
shown in Table (1).
Table 1: Level of trace elements in controls &
cases.
60
40
20
6.28
7.15
0
CASES
CONTROL
CONCLUSION
In our study we concluded that there is a significant
decrease in serum zinc level in hypothyroid patients
as compare with normal subject while there is no
significant change in serum copper level between
this two group. Our study correlates well with other
different researches (Iham Amir AL-Juboori et
al.2009; Buchinger et al., 1988; Yoshida et al. 1990;
Zhang et al. 2004). 4,5,6,7 One possible explanation
for these findings, that gastrointestinal absorption of
zinc is severely impaired in hypothyroidism
subjects. An alternative explanation would be a
change in zinc distribution; the low zinc level may
reflect sequestration of zinc by the liver or other
tissues.9 Another explanation is due to the significant
influence of TSH in the variation of the
concentration of iodine, selenium and zinc in
normal and altered human thyroid tissues.10 In one
research, the serum zinc levels in hyperthyroid
patients were clearly higher than in the
hypothyroid patients group.11 Zinc has important
roles in thyroid metabolism and a fundamental role
in protein synthesis. It involves in T3 binding to its
nuclear receptor, and participates in the formation
and mechanism of action of TRH reported in
hypothyroidism patients.2 Hence, the correlation
between hypothyroidism and serum zinc is not a
simple correlation and needs more specific studies.
Furthermore, the overall results of this study
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Comparison of Serum Zinc and Serum Copper
suggest an abnormal metabolism of zinc in
hypothyroidism disease.2 There is no significant
change in serum copper in patients with
hypothyroidism as compared to that of normal
subjects. More investigations are required using
larger sample size and severe hypothyroidism to
be sure about the lack of correlation between the
disease and different copper indexes.
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