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VOLUME 11 , ISSUE 6 ( November-December, 2020 ) > List of Articles


Estimation of Serum Copper and Zinc in Patients of Oral Submucous Fibrosis in Rural Population

Alka Hande, Anand V Bansod, Akhilesh G Agrawal, Amol Gadbail, Amit M Reche

Keywords : Serum copper, Serum zinc,Oral submucous fibrosis

Citation Information : Hande A, Bansod AV, Agrawal AG, Gadbail A, Reche AM. Estimation of Serum Copper and Zinc in Patients of Oral Submucous Fibrosis in Rural Population. World J Dent 2020; 11 (6):478-481.

DOI: 10.5005/jp-journals-10015-1773

License: CC BY-NC 4.0

Published Online: 03-04-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: To estimate the serum levels of copper (Cu) and zinc (Zn) in oral submucous fibrosis (OSMF) patients residing in the rural area. Materials and methods: The current study included 100 participants after receiving their written consent. The participants were broadly divided into group I (OSMF patients) and group II (Control), comprised of 70 and 30 individuals, respectively. The participants in group I were further categorized into three groups based on their clinical severity into group IA, group IB, and group IC corresponding to clinical stage I, stage II, and stage III OSMF, respectively. Intravenous blood was collected under a sterile environment in the plane bulb. Serum was separated and samples were stored at −40°C until use. The samples were returned to room temperature and serum Cu and Zn levels were estimated by a calorimetric test using Dibromo-PAESA method described in the kit manufactured by Centronic GmbH. Results: There were 30 participants in group IA, 25 participants in group IB, and 15 participants in group IC. Serum Cu level was significantly increased in all OSMF patients (mean = 195.305 μg/dL) in comparison with the control group and there was an increase in serum Cu level with an increase in the disease severity. Zinc level was decreased with a mean value of 80.12 μg/dL in comparison with the control group. Besides, the value decreased with an increased disease severity. Conclusion: This study reveals that these trace elements are involved in the pathophysiology of OSMF. Serum Cu and Zn levels can be used as a diagnostic tool for the early diagnosis of OSMF. Clinical significance: Serum Cu and Zn can be used as a marker to assess the OSMF disease severity. Being an important entity in the pathogenic mechanism of OSMF, their estimation may prove to be useful to dental surgeons in planning the treatment to the patients.

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  1. Wollina U, Verma SB, Ali FM, et al. Oral submucous fibrosis: an update. Clin Cosmet Investig Dermatol 2015;8:193–204.
  2. Prabhu SR. Oral diseases in the tropics. Oxford, New York: Oxford University Press; 1992.
  3. Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol 1966;22(6):764–779.
  4. Tekade SA, Chaudhary MS, Tekade SS, et al. Early stage oral submucous fibrosis is characterized by increased vascularity as opposed to advanced stages. J Clin Diagn Res 2017;11(5):ZC92–ZC96.
  5. Gowda BBK, Yathish TR, Sinhasan Sankappa P, et al. The response of oral submucous fibrosis to lycopene – a carotenoid antioxidant, A Clinicopathological Study. Journal of Clinical and Diagnostic Research 2011;5(4):882–888.
  6. Kumar H, Kumar P, Jain S, et al. Analysis of serum copper and iron levels in oral submucous fibrosis patients: a case–control study. Indian J Dent Sci 2016;8(3):145–149.
  7. Sachdev PK, Freeland-Graves J, Beretvas SN, et al. Zinc, copper, and iron in oral submucous fibrosis: a meta-analysis. Int J Dent 2018;2018:3472087.
  8. Yadav S, Verma A, Sachdeva A, et al. Etiopathogenesis and management of oral submucous fibrosis. Internet J Bioengineer 2010;5(1).
  9. Hande AH, Chaudhary MS, Gawande MN, et al. Oral submucous fibrosis: an enigmatic morpho-insight. J Cancer Res Ther 2019;15(3):463–469.
  10. Ali FM, Patil A, Patil K, et al. Oral submucous fibrosis and its dermatological relation. Indian Dermatol Online J 2014;5(3):260–265.
  11. Rajendran R. Oral submucous fibrosis: etiology, pathogenesis, and future research. Bull World Health Organ 1994;72(6):985–996.
  12. Srilekha M. Copper and zinc level in oral submucosal fibrosis (OSMF) patients. J Pharm Sci Res 2015;7(8):573–574.
  13. Trivedy C, Warnakulasuriya KA, Hazarey VK, et al. The upregulation of lysyl oxidase in oral submucous fibrosis and squamous cell carcinoma. J Oral Pathol Med 1999;28(6):246–251.
  14. Prasad AS. Zinc is an antioxidant and anti-inflammatory agent: its role in human health. Front Nutr 2014;1:14.
  15. Pindborg JJ, Murti PR, Bhonsle RB, et al. Oral submucous fibrosis as a precancerous condition. Scand J Dent Res 1984;92(3):224–229.
  16. Lai DR, Chen HR, Lin LM, et al. Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases. J Oral Pathol Med 1995;24(9):402–406.
  17. Hande AH, Chaudhary MS, Gadbail AR, et al. Role of hypoxia in malignant transformation of oral submucous fibrosis. J Datta Meghe Instit Med Sci Univer 2018;13(1):38–43.
  18. Lin CN, Wilson A, Church BB, et al. Pediatric reference intervals for serum copper and zinc. Clin Chim Acta 2012;413(5-6):612–615.
  19. Siddiqui I, Farooqui JQ, Shariff DA, et al. Serum copper levels in various diseases: a local experience at aga khan university hospital, Karachi. Int J Pathol 2006;4(2):101–104.
  20. de Romaña DL, Olivares M, Uauy R, et al. Risks and benefits of copper in light of new insights of copper homeostasis. J Trace Elem Med Biol 2011;25(1):3–13.
  21. Angelova M, Asenova S, Nedkova V, et al. Copper in the human organism. Trakia J Sci 2011;9(1):88–98.
  22. Turnlund JR, Keyes WR, Anderson HL, et al. Copper absorption and retention in young men at three levels of dietary copper by use of the stable isotope 65Cu. Am J Clin Nutr 1989;49(5):870–878.
  23. Prasad AS. Impact of the discovery of human zinc deficiency on health. J Am Coll Nutr 2009;28(3):257–265.
  24. Khanna SS, Karjodkar FR. Circulating immune complexes and trace elements (copper, iron and selenium) as markers in oral precancer and cancer: a randomised, controlled clinical trial. Head Face Med 2006;2:33.
  25. Shetty SR, Babu S, Kumari S, et al. Role of serum trace elements in oral precancer and oral cancer - a biochemical study. J Cancer Res Treat 2013;1(1):1–3.
  26. Yadav A, Kumar L, Misra N, et al. Estimation of serum zinc, copper, and iron in the patients of oral submucous fibrosis. Natl J Maxillofac Surg 2015;6(2):190–193.
  27. Latoo S, Nazir H. Estimation of levels of copper and iron in different stages of OSMF patients. Ann Int Med Den Res 2017;3(5):06–08.
  28. Khan H. Evaluation of serum copper (cu), serum iron (fe) and serum copper (cu)/iron (fe) ration in oral submucous fibrosis in Karachi. J Adv Med Med Res 2018;26(6):1–9.
  29. Nayak AG, Chatra L, Shenai KP. Analysis of copper and zinc levels in the mucosal tissue and serum of oral submucous fibrosis patients. Patil S, ed. World J Dent 2010;1(2):75–78.
  30. Ranganathan K, Devi MU, Joshua E, et al. Oral submucous fibrosis: a case-control study in Chennai, South India. J Oral Pathol Med 2004;33(5):274–277.
  31. Sinor PN, Gupta PC, Murti PR, et al. A case-control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 1990;19(2):94–98.
  32. Kode MA, Karjodkar FR. Estimation of the serum and the salivary trace elements in OSMF patients. J Clin Diagn Res 2013;7(6):1215–1218.
  33. Trivedy C, Meghji S, Warnakulasuriya KA, et al. Copper stimulates human oral fibroblasts in vitro: a role in the pathogenesis of oral submucous fibrosis. J Oral Pathol Med 2001;30(8):465–470.
  34. Tadakamadla J, Kumar S, Mamatha GP. Evaluation of serum copper and iron levels among oral submucous fibrosis patients. Med Oral Patol Oral Cir Bucal 2011;16(7):e870–e873.
  35. Pan Z, Choi S, Ouadid-Ahidouch H, et al. Zinc transporters and dysregulated channels in cancers. Front Biosci (Landmark Ed) 2017;22:623–643.
  36. Alam S, Kelleher SL. Cellular mechanisms of zinc dysregulation: a perspective on zinc homeostasis as an etiological factor in the development and progression of breast cancer. Nutrients 2012;4(8):875–903.
  37. Christudoss P, Selvakumar R, Fleming JJ, et al. Zinc status of patients with benign prostatic hyperplasia and prostate carcinoma. Indian J Urol 2011;27(1):14–18.
  38. Fan Q, Cai Q, Li P, et al. The novel ZIP4 regulation and its role in ovarian cancer. Oncotarget 2017;8(52):90090–90107. DOI: 10.18632/oncotarget.21435.
  39. Barch DH. Esophageal cancer and microelements. J Am Coll Nutr 1989;8(2):99–107.
  40. Issell BF, MacFadyen BV, Gum ET, et al. Serum zinc levels in lung cancer patients. Cancer 1981;47(7):1845–1848.
  41. Paul RR, Chatterjee J, Das AK, et al. Zinc and iron as bioindicators of precancerous nature of oral submucous fibrosis. Biol Trace Elem Res 1996;54(3):213–230.
  42. Ayinampudi BK, Narsimhan M. Salivary copper and zinc levels in oral pre-malignant and malignant lesions. J Oral Maxillofac Pathol 2012;16(2):178–182.
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