Journal of King Saud University: Science (Jan 2023)
Investigation of heavy metal exposure and trace element levels in acute exacerbatıon of COPD
Abstract
Objectives: The study aims to evaluate the levels of trace and heavy metals among chronic obstructive pulmonary disease (COPD) patients with acute exacerbation and their impact on the severity and mortality of the disease. Methods: 100 healthy volunteers and 114 patients with acute exacerbation participated in this work. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, COPD patients are divided into 4 groups. Analysis of heavy metals (lead, cadmium, arsenic, cobalt, nickel, mercury, aluminum, calcium, and manganese) and trace metals (copper, chromium, and zinc) was performed using a plasma mass spectrometer. Results: Body mass index was lower in COPD exacerbation patients (p < 0.05) in comparison to the control. In comparison with the control group, the levels of heavy metals were greater in COPD cases (p < 0.001). Al, Ca, Co, Ni, Cu, As, Cd, and Hg levels of GOLD group 4 were found to be higher compared to GOLD Group 1 (p < 0.001). Likewise, the Mn level was found higher in GOLD Group 1 (p < 0.05). However, the level of Zn was lower in GOLD group 4 in comparison with GOLD 1 cases (p < 0.001). The factors for the prediction of the disease in the COPD patient group were determined using multivariate regression analysis. Al, Ca, Mn, Co, As, and Hg was determined to be independent risk factors in predicting COPD exacerbations (p < 0.05). Al, Co, Pb, Ni, Hg, and Cd levels were higher in COPD exacerbations that resulted in mortality (p < 0.05). Co, Cd, Hg, and Pb were determined to be independent risk factors for mortality in COPD exacerbation cases (p < 0.05). Conclusions: Our study showed that serum heavy metal levels are linked with the harshness and mortality of acute COPD attacks. These findings may indicate that changes in serum heavy metal levels can be used to determine the severity of a COPD exacerbation.
