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Serum copper concentrations in hospitalized newborns
Ricardo González-Tarancón1, Luisa Calvo-Ruata1, Maite Aramendía2
1Department of Clinical Biochemistry, Hospital Universitario "Miguel Servet", Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain.
Insights
Newborn serum copper (Cu) and ceruloplasmin (Cp) levels are affected by inflammation and prematurity. Healthcare providers should consider these factors, alongside high-sensitivity C-reactive protein (hs-CRP) levels, for accurate interpretation.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Nutrition
Background:
- Low serum copper (Cu) and ceruloplasmin (Cp) in newborns may indicate deficiency or metabolic disorders.
- Interpreting Cu and Cp levels is challenging due to various influencing factors.
- Identifying and stratifying these factors is crucial for accurate assessment.
Purpose of the Study:
- To identify variables affecting serum Cu and Cp concentrations in newborns.
- To stratify Cu and Cp levels based on age, prematurity, feeding, and inflammatory status.
- To improve the interpretation of neonatal Cu status.
Main Methods:
- Analyzed serum Cu and Cp concentrations in 564 hospitalized newborns (0-12 days old).
- Stratified data by age, prematurity (birth weight/gestational age), feeding type, and inflammatory state (hs-CRP).
- Correlated these variables with serum Cu and Cp levels.
Main Results:
- Serum Cu and Cp concentrations were significantly influenced by inflammation (hs-CRP), prematurity, age, and feeding type.
- Higher hs-CRP levels correlated with increased Cu and Cp concentrations.
- Preterm infants typically exhibited very low Cu and Cp levels; modest effects observed for age and feeding.
Conclusions:
- Inflammation and prematurity are the primary factors impacting neonatal serum Cu and Cp levels.
- Assaying hs-CRP alongside Cu status is recommended for accurate interpretation.
- Inflammatory states complicate the interpretation of Cu and Cp concentrations in newborns.
Background:
Low serum Cu and ceruloplasmin (Cp) concentrations in newborns can be the first indication of a severe Cu deficient intake or, alternatively, of genetic diseases affecting Cu metabolism. However, Cu and Cp concentrations can also be influenced by other variables that render their quantitative results difficult to interpret. Therefore, it is necessary to identify these variables and stratify Cu and Cp concentrations according to these altering factors.
Methods:
Serum Cu and Cp concentrations for 564 hospitalized newborns (0-12days of life) are stratified according to their age, prematurity (birth weight or gestational age), type of feeding and inflammatory state (assessed by the serum high sensitivity C-reactive protein (hs-CRP) level) to identify potential correlations.
Results:
Serum Cu and Cp concentrations are influenced by all four variables analyzed, although inflammation is the most significant: the greater the hs-CRP concentration, the greater the serum Cu and Cp concentrations. Prematurity is also an important factor and preterm infants often show very low Cu and Cp concentrations. Age of life and type of feeding have in turn a more modest effect on these magnitudes, being slightly greater at 3-5days of age in breastfed newborns.
Conclusions:
Inflammation and prematurity are the main variables affecting serum Cu and Cp concentrations in newborns. Therefore, hs-CRP should always be assayed in parallel to Cu status. When there is an inflammatory state proper interpretation of these concentrations can be challenging.
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