Acute inflammatory response does not affect erythrocyte concentrations of copper, zinc and selenium

Clin Nutr. 2008 Feb;27(1):115-20. doi: 10.1016/j.clnu.2007.10.003. Epub 2007 Nov 26.


Background & aims: Measuring the nutritional status of trace elements in plasma is invalidated in the presence of a systemic inflammatory response. We examined the potential of erythrocytes to assess copper, zinc and selenium status in such situations.

Methods: Venous blood samples were withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h post-operatively from 11 patients (6 males and 5 females) who were admitted for elective knee arthroplasty. C-reactive protein, albumin, copper, zinc, selenium and iron were measured in plasma and erythrocytes.

Results: Plasma zinc and selenium concentrations fell significantly: 95% confidence intervals (CI)=-32% to -44% and -22% to -36%, respectively. Copper concentrations fell transiently and then increased significantly: CI=12-43%. No significant changes were seen in trace element concentrations in erythrocytes expressed either as a ratio of haemoglobin or iron concentration. Erythrocyte iron levels correlated significantly with haemoglobin (r=0.93).

Conclusions: Plasma concentrations of copper, zinc and selenium are unreliable markers of status in patients with an acute inflammatory response. Erythrocyte concentrations of these trace elements may provide a more reliable measure in long-term studies of patients with a chronic systemic inflammatory response. Iron can be used instead of haemoglobin as the denominator when expressing erythrocyte concentrations of trace elements.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee
  • C-Reactive Protein / analysis
  • Copper / analysis
  • Copper / blood
  • Erythrocytes / chemistry*
  • Female
  • Humans
  • Inflammation / blood*
  • Inflammation / physiopathology
  • Iron / analysis
  • Iron / blood
  • Male
  • Middle Aged
  • Nutritional Status*
  • Selenium / analysis
  • Selenium / blood
  • Serum Albumin / analysis
  • Trace Elements / analysis
  • Trace Elements / blood*
  • Zinc / analysis
  • Zinc / blood


  • Serum Albumin
  • Trace Elements
  • Copper
  • C-Reactive Protein
  • Iron
  • Selenium
  • Zinc