Copper to Zinc (Cu/Zn) Ratio, Ceruloplasmin in Type 2 Diabetes Mellitus with Complications

Abstract

Diabetes mellitus is a metabolic disease and associated with vascular, renal, neuropathic and retinal complications. Copper and Zinc may play a role, also may be altered in diabetes mellitus and its complications. The aim of the study is to evaluate copper to zinc 
ratio, ceruloplasmin levels in type 2 diabetes mellitus complications, compare that with healthy individuals(control) and also to correlate these elements with other variables. A cross sectional study consisting of 142 participants (122 type 2 diabetes mellitus patients with and without complications and 20 healthy individuals (controls)).Anthropometric measurements were done according to standard procedures and questionnaire provided to assess information on demographics. Serum copper and zinc were evaluated using atomic absorption spectrometry while ceruloplasmin was determined by ELISA. The copper to zinc ratio was calculated and correlated with clinical variables in both cases and controls. Though serum Cu/Zn ratio was not significantly different between those with complications, without complications and control group (p=0.053, F =2.996) but was lower between diabetes mellitus group and control group (p= 0.009, t = - 2.775). No significant association between Cu/Zn ratio and HbA1c (r =0.006, p=0.948) was found. 
Also, Cu/Zn ratio correlated negatively and significantly with total cholesterol (r = -0.278, p =0.002), high density lipoprotein (r = -0.202, p = 0.027), low density lipoprotein (r = - 0.203, p =0.027) in participants with diabetic complications. However, copper levels was 
significantlyhigherin type 2 diabetesmellitus with complications (p = 0.022, F =3.907) and zinc levels were higher in those with complications, without complications  as compared to the control group but not statistically significant (p=0.167, F= 1.814). Also, 
ceruloplasmin levels of those with complications was higher than the control group but not statistically significant (p =0.604, t =0.552). A negative and no significant correlation between ceruloplasmin and Cu/Zn ratio (r = - 0.113, P =0.341) in diabetic participants with 
complications was observed. In conclusion, Cu/Zn ratio was not significantly different between those with complications, without complications, and control group but correlated negatively and significantly with total cholesterol, high density lipoprotein, 
and low density lipoprotein cholesterol in participants with diabetic complications and may be useful in the pathogenesis and assessing progression in type 2 diabetes complications.