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. 2023 Mar 16;15(6):1434.
doi: 10.3390/nu15061434.

Disturbed Ratios between Essential and Toxic Trace Elements as Potential Biomarkers of Acute Ischemic Stroke

Anna Mirończuk  1 , Katarzyna Kapica-Topczewska  1 , Katarzyna Socha  2 , Jolanta Soroczyńska  2 , Jacek Jamiołkowski  3 , Monika Chorąży  1 , Agata Czarnowska  1 , Agnieszka Mitrosz  1 , Alina Kułakowska  1 , Jan Kochanowicz  1
Affiliations

Disturbed Ratios between Essential and Toxic Trace Elements as Potential Biomarkers of Acute Ischemic Stroke

Anna Mirończuk et al. Nutrients. .

Abstract

Background: Cadmium (Cd) and lead (Pb) are known to be two of the metal contaminants that pose the greatest potential threat to human health. The purpose of this research study was to compare the levels of toxic metals (Cd, Pb) in patients with acute ischemic stroke (AIS), with a control group in Podlaskie Voivodeship, Poland. The study also aimed to assess the correlations between toxic metals and clinical data in AIS patients, and to assess the potential effect of smoking.

Materials and methods: The levels of mineral components in the collected blood samples were assessed by means of atomic absorption spectrometry (AAS).

Results: The Cd blood concentration was significantly higher in AIS patients as compared to the control group. We found that the molar ratios of Cd/Zn and Cd/Pb were significantly higher (p < 0.001; p < 0.001, respectively), when the molar ratios of Se/Pb, Se/Cd, and Cu/Cd were significantly lower (p = 0.01; p < 0.001; p < 0.001, respectively), in AIS patients as compared to control subjects. However, there were no considerable fluctuations in relation to the blood Pb concentration or molar ratios of Zn/Pb and Cu/Pb between our AIS patients and the control group. We also found that patients with internal carotid artery (ICA) atherosclerosis, particularly those with 20-50% ICA stenosis, had higher concentrations of Cd and Cd/Zn, but lower Cu/Cd and Se/Cd molar ratios. In the course of our analysis, we observed that current smokers among AIS patients had significantly higher blood-Cd concentrations, Cd/Zn and Cd/Pb molar ratios, and hemoglobin levels, but significantly lower HDL-C concentrations, Se/Cd, and Cu/Cd molar ratios.

Conclusions: Our research has shown that the disruption of the metal balance plays a crucial role in the pathogenesis of AIS. Furthermore, our results broaden those of previous studies on the exposure to Cd and Pb as risk factors for AIS. Further investigations are necessary to examine the probable mechanisms of Cd and Pb in the onset of ischemic stroke. The Cd/Zn molar ratio may be a useful biomarker of atherosclerosis in AIS patients. An accurate assessment of changes in the molar ratios of essential and toxic trace elements could serve as a valuable indicator of the nutritional status and levels of oxidative stress in AIS patients. It is critical to investigate the potential role of exposure to metal mixtures in AIS, due to its public health implications.

Keywords: atherosclerosis; cadmium; essential trace elements; heavy metals; ischemic stroke; lead.

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Conflict of interest statement

The authors have no conflict of interest to declare that are relevant to the content of this article.

Figures

Figure 1
Figure 1
Scatter-matrix, histogram, and Spearman rank correlation matrix of essential trace elements, toxic elements and molar-ratio levels of the aforementioned components in patients with acute ischemic stroke. p-values < 0.05 showed statistical validity; * p < 0.05, ** p < 0.01, *** p < 0.001.
Figure 2
Figure 2
Box plot showing the findings regarding the Cd (A) and Cd/Zn (B) molar-ratio levels in acute-ischemic-stroke patients in relation to the stage of ICA atherosclerosis—B-mode ultrasound imaging using a standardized protocol or neck CT angiography. The patients with more advanced stages of ICA atherosclerosis had higher concentrations of the Cd and Cd/Zn molar-ratio levels, particularly those with 20–50% ICA stenosis. Abbreviations: Lead, Pb. Cadmium, Cd. Copper, Cu. Selenium, Se. Zinc, Zn. Internal carotid artery, ICA. Computed tomography, CT. Acute ischemic stroke, AIS. p-values < 0.05 showed statistical validity.
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