Assessment of mineral status (Zn, Cu, Mg and Mn) in rheumatoid arthritis patients in Chandigarh, India

Past studies suggest that the deficiencies of Zn and Cu in patients of rheumatoid arthritis (RA) occur in response to chronic inflammation. However, therapeutic supplementation of Zn or Cu in RA yielded contradictory results. To find out the role of dietary factors, the present epidemiological study was carried out on the mineral status (Zn, Cu, Mg, Mn) in RA patients versus healthy subjects of the Chandigarh, India population where the consumption of Zn from dietary sources is more than its recommended dietary allowance (15-20 mg/day). The results of this study show reduced serum Zn, elevated serum Cu, Mg and Mn levels along with their increased urinary excretions and decreased hair concentrations in RA patients than healthy subjects. The significantly positive correlation (r) between inflammatory markers serum C-reactive protein (CRP), erythrocyte sedimentation rats (ESR) vs. serum Cu, Mg and Mn, and negative with serum Zn {r= 0.973**, 0.978** (Cu), 0.978**, 0.979** (Mg), 0.777**, 0.716** (Mn) and -0.845**, -0.846** (Zn)}, and positive between serum CRP, ESR vs. urine minerals {r = 0.833**, 0.870** (Cu), 0.790**, 0.700** (Zn), 0.874**, 0.830** (Mg), 0.462**, 0.483** (Mn)} and negative between serum CRP, ESR vs. hair minerals {r= -0.961**, -0.970** (Cu), -0.897**, -0.913** (Zn), -0.959**, -0.958** (Mg), -0.535**, -0.484** (Mn), **p<0.0001} were reported. The data suggest that RA patients were unable to retain Zn in their tissues (serum and hair) and experienced excessive loss along with other metals through urinary excretions in spite of higher Zn consumption through the food chain.