• Eleanor J C Oakes, Thomas D B Lyon, Andrew Duncan, Andrew Gray, Dinesh Talwar, and O'ReillyDenis St JDS.
• Scottish Trace Element and Micronutrient Reference Laboratory, Royal Infirmary, Glasgow G4 0SF, UK. eleanor.oakes@nhs.net
• Clin Nutr. 2008 Feb 1; 27 (1): 115-20.

Background & AimsMeasuring 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of erythrocytes to assess copper, zinc and selenium status in such situations.MethodsVenous blood samples were withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h post-operatively from 11 patients (6 males and 5 females) who were admitted for elective knee arthroplasty.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.ResultsPlasma 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).ConclusionsPlasma 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.

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