Micronutrient concentrations in patients with malignant disease: effect of the inflammatory response

Ann Clin Biochem 2004;41:138-141
© 2004 Association for Clinical Biochemistry


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Original Articles

C Mayland,
K R Allen,
T J Degg and
M Bennet

St Gemmas Hospice, Harrogate Road, Leeds, UK;
Department of Clinical Biochemistry, Leeds Teaching Hospitals, Morley Leeds LS27 0DQ, UK;
Department of Clinical Biochemistry, Leeds Teaching Hospitals, Morley Leeds LS27 0DQ, UK;
St Gemmas Hospice, Harrogate Road, Leeds, UK

Background: Micronutrient deficiencies may occur in patientswith malignancy due to a variety of possible causes, includingunbalanced dietary intake and adverse effects of treatment.In addition, many patients show signs of a chronic inflammatoryresponse, which can affect circulating concentrations of certainvitamins and trace elements. Our aim was to examine the effectof the inflammatory response, as determined by plasma C-reactiveprotein (CRP) concentrations, on a range of micronutrients inpatients with malignancy.

Methods: Blood samples were collected from 50 patients with various malignancies for the measurement of vitamins A, E, C and B1, the trace elements copper, zinc, selenium and manganese and the inflammatory marker CRP. Vitamin A was measured as retinol and vitamin E as -tocopherol. Vitamin C measurement includedboth ascorbic acid and dehydroascorbic acid. The vitamins wereassayed by high-performance liquid chromatography and the traceelements by atomic-absorption spectroscopy.

Results: Concentrations of zinc and selenium below their respective reference ranges and copper and manganese above their respective reference ranges were commonly found in the cancer group. However, none of these elements showed any significant correlation with CRP (P >0.01). Reduced levels of vitamin A, C and B1 were commonly found in the cancer group. Vitamins A and C showed a significant negative correlation with CRP (rs=-0.66, P <0.0001 and rs=-0.53, P = 0.0005, respectively). Vitamin E showed nocorrelation with CRP.

Conclusion: The inflammatory response is a major considerationin the interpretation of vitamin A and C concentrations in patientswith malignancy.

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