Blood heavy metal and trace element levels in newly diagnosed cases of inflammatory bowel disease

Abstract

Objectives: The relationship between heavy metal and trace element levels in IBD and the clinical course is unclear. The research team evaluated serum levels of heavy metals and trace elements in patients with IBD compared with healthy participants to establish their connection with IBD severity and inflammatory markers.

Methodology: This single-center, retrospective cross-sectional study was conducted at the Department of Gastroenterology, Istanbul Medipol University Faculty of Medicine, Istanbul, Turkey, with stored samples analyzed from 17 October to 17 November 2024. The study included 137 patients with IBD (90 with ulcerative colitis, 47 with Crohn’s disease) and 60 healthy controls. Patients were grouped according to disease severity as mild, moderate, and severe. Serum levels of heavy metals (nickel, aluminum) and trace elements (iron, zinc, selenium, ferritin, vitamin D) were measured. Correlations with C-reactive protein (CRP), sedimentation rate, and fecal calprotectin were examined.

Results: Nickel levels were higher in the IBD group than in controls (1.19±1.04 vs 0.51±0.39 µg/L; median 1.2 [IQR 0.5-1.6] vs 0.4 [0.2-0.7] µg/L; p<0.001). Iron deficiency was present in 54% of patients compared with 16.7% of controls (p<0.001). Zinc and ferritin levels were significantly lower in the patient group (p<0.001). Aluminum strongly correlated with CRP (r=0.69, p<0.001). Multivariate analysis showed a 7.36-fold higher likelihood of IBD associated with elevated nickel levels (OR=7.36; 95% CI: 3.23–16.75; p<0.001).

Conclusion: Nickel accumulation and iron deficiency were associated with IBD severity and may impact pathogenesis. No independent relationship was established for other heavy metals and micronutrients.