Serum copper-to-zinc ratio is associated with heart failure and improves risk prediction in middle-aged and older Caucasian men: A prospective study |
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| Affiliation: | 1. National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK;2. Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK;3. Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland;4. Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK;5. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;6. Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland;1. Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran;2. Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran;3. Consultant Haematologist and Senior Lecturer, Department of Haematology and Blood Transfusion, Faculty of Clinical Science, College of Medicine of the University of Lagos, Nigeria;4. Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran;5. Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine Children''s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;6. Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran;7. Department of Biorepository, Biomedical Research Administration, King Fahad Medical City, Riyadh, Saudi Arabia;8. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia;9. College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA;1. Division of Cardiology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea;2. Division of Hematology & Medical Oncology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea;1. Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C.Heymanslaan 10 - 4K3, 9000 Ghent, Belgium;2. Departments of Public Health Nutrition, Faculty of Public Health, Mulawarman University, Samarinda, East Kalimantan, Indonesia;3. Univ. Lille, Inserm, CHU Lille, CIC 1403 - Centre D''investigation Clinique, F-59000 Lille, France;4. Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE – Institute for Translational Research in Inflammation, F-59000 Lille, France;5. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Science, University of Zaragoza, C/Pedro Cerbuna 12, 50009 Zaragoza, Spain;6. Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Spain;7. Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Spain;8. Instituto de Salud Carlos III, Madrid, Spain |
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| Abstract: | Background and aimsSerum copper (Cu) and zinc (Zn) may play a role in the development of adverse cardiovascular outcomes including heart failure (HF). Serum Cu/Zn-ratio has been shown to be a risk indicator for cardiovascular disease, but its relationship with HF has not been previously investigated. We aimed to assess the association between Cu/Zn-ratio and incident HF risk using a prospective cohort study.Methods and resultsStudy participants were recruited in eastern Finland with baseline examinations carried out between March 1998 and December 2001. Serum levels of Cu and Zn were measured using atomic absorption spectrometry in 1866 men aged 42–61 years without a history of HF at baseline. Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident HF. During 26.5 years median follow-up, 365 HF cases occurred. Restricted cubic splines suggested linear relationships of serum Cu/Zn-ratio, Cu and Zn with HF risk. A unit increase in Cu/Zn-ratio was associated with an increased HF risk in analysis adjusted for several potential confounders including nutritional factors such as total energy intake, intake of fruits, berries and vegetables, and red meat (HR 1.63; 95% CI 1.06–2.51). The corresponding multivariable-adjusted HRs (95% CIs) for serum Cu and Zn were 2.42 (1.32–4.44) and 1.34 (0.50–3.63), respectively. Addition of Cu/Zn-ratio to a HF risk prediction model was associated with improved risk prediction.ConclusionIn middle-aged and older Finnish men, increased serum Cu/Zn-ratio is associated with an increased risk of HF in a linear dose-response fashion and might improve HF risk assessment. |
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| Keywords: | Copper-to-zinc ratio Copper Zinc Heart failure Risk factor Cohort study |
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