Status of selenium and antioxidant enzymes of goitrous children is lower than healthy controls and nongoitrous children with high iodine deficiency

In order to investigate the relations of iodine deficiency and/or goiter with selenium (Se) and antioxidant enzyme (AOE) status, we determined the relevant parameters of goitrous high school children living in an endemic goiter area of Turkey. Subjects were selected by a simple random sampling technique after screening the whole population of the high schools of two towns by neck palpation. The results of the goitrous group (n = 48, aged 15-18 yr) were compared with those of nongoitrous control children (n = 49) from the same populations, and with an outside control group (n = 24) from a lower-goiter-prevalence area. The overall prevalence of goiter was 39.6% in the high school population of the area. Activities of erythrocyte AOE (glutathion peroxidase, catalase, and superoxide dismutase) and concentrations of plasma and erythrocyte Se and urinary iodine were found to be significantly lower in goitrous children than both in-region and out-region of the control groups. When the whole study group was reclassified according to the severity of iodine deficiency, it was found that the AOE and Se status of those control children without goiter but with high iodine deficiency was significantly higher than goitrous children, although they did not differ from nondeficient control group. This might be the result of the possibility that goitrous children are exposed of oxidative stress, which may introduce alterations to the antioxidant defense system and/or the antioxidant status is relatively lower in goitrous children than those children who are highly iodine-deficient but did not develop goiter. The results of this study seem to support the view that the risk of goiter development may be higher in highly iodine-deficient children with lower enzymatic antioxidant and Se status.     

Evaluation of endemic goiter prevalence in Bulgarian schoolchildren

Iodine deficiency is a major health problem worldwide. The environment of the Balkan countries, including Bulgaria, is distinguished for its low iodine content. In 1994, the strategies for the prevention and control of iodine-deficiency disorders were actualized in Bulgaria and universal salt iodization and supplementation for the risk population groups (schoolchildren, pregnant women) were introduced. The aim of this study was to assess the effectiveness of the iodine prophylaxis in schoolchildren, living in an endemic for goiter area after the introduction of salt iodization in Bulgaria. For this purpose, the goiter prevalence and iodine status in 483 schoolchildren (274 boys and 209 girls) aged between 8 and 15 yr, living in an endemic for goiter area in Bulgaria were evaluated. Despite the normalization of iodine supply, mild iodine deficiency on the basis of goiter prevalence (16.15%) and urinary iodine excretion was found. These data indicate the need for reevaluation of the national strategy for prevention of iodine deficiency.     

Endemic goiter, thiocyanate overload, and selenium status in school-age children

Iodine deficiency (ID) and related disorders are still major, yet unresolved health concerns. Recently, in a systematic survey of schoolage children (SAC), we reported severe to moderate ID, in Ankara and three cities from Black Sea region of Turkey. The current study attempted to evaluate selenium (Se) status, thiocyanate (SCN⁻) overload, and their possible contribution to the goiter endemics and thyroid hormone profile observed in these cities. Thyroid ultrasonography was performed and serum Se, SCN⁻, thyroid hormones, sensitive TSH (sTSH) levels, and urinary iodine concentrations (UICs) were determined from 251 SAC (9–11 yr old). Thyroid volumes (TVs) exceeding recommended upper normal limits and median UIC indicated goitre endemics and moderate to severe ID in the areas studied. Mean serum SCN⁻ concentrations were found to be greater than the controls from the literature. The UIC/SCN⁻ ratio was found to be lowest in Bayburt and Trabzon denoting that SCN⁻ overload may contribute to the goiter endemics. Serum Se concentrations represent a marginal deficiency in the four areas studied. No significant correlations between serum Se concentrations and the other parameters studied (i.e., TV, SCN⁻, thyroid hormones, sTSH, UIC) was detected. In conclusion, this study showed that selenium is also marginally deficient in the iodine-deficient endemic areas studied, but this has little or no impact on the thyroid hormone profile and the goiter endemics. SCN⁻ overload may contribute to the endemics, especially for the areas where iodine is severely deficient. An effective iodine supplementation program will not only resolve the goiter endemics but also the consequence of SCN⁻ overload as well in the endemic goiter areas studied.     

Copper,selenium, and zinc concentrations in human milk during the first three weeks of lactation

Human milk samples were analyzed by neutron activation analysis (NAA) for three essential trace elements (Cu, Se, and Zn). Mothers' milk samples were collected from 25 lactating mothers from the Central Hospital, Tripoli, Libya. The average concentration level of Cu, Se, and Zn declined from 0.84 +/- 0.06 mg/L, 104 +/- 9.46 microg/L, and 16.1 +/- 2.67 mg/L at d 0 to 0.39 +/- 0.045 mg/L, 41.8 +/- 6.66 microg/L, and 4.95 +/- 1.3 mg/L, respectively, at d 20 of lactation. Copper and Zn levels in the Libyan mothers' milk were in agreement with reported levels from other countries, whereas Se was at a higher level. The Cu daily intake level is slightly higher than the RDA (Recommended Daily Allowance) value. Selenium and Zn have higher intake levels than the RDA values but within the tolerable upper intake levels.     

History of endemic goiter in Croatia: from severe iodine deficiency to iodine sufficiency

At the time after the Second World War, endemic goiter was present in most parts of Croatia with a prevalence of more than 50% and presence of cretinism. In the village of Rude near Zagreb, goiter was detected in 85% of school children with 2.3% of cretins in the village population. In 1953 the first regulation on obligatory salt iodination, requiring 10 mg of potassium iodide (KI) per kg of salt was established in former Yugoslavia. A three-fold reduction of goiter prevalence, together with disappearance of cretinism was recorded ten years later In 1992, the National Committee for Eradication of Goiter was founded. The survey performed during 1991-1993 exhibited prevalence of goiter among school children between 8% and 35% and urinary iodine excretion under 10 microg/dL in most of the children from continental parts of the country. The new obligatory regulation, requiring 25 mg of KI/kg of salt, was proposed by the National Comittee and finally established in 1996. In 2002 thyroid volumes and medians of urinary iodine excretion were normal according to the ICCIDD criteria. Overall median of urinary iodine excretion for schoolchildren in Croatia was 14 ug/dL. Croatia crossed a path from severe iodine deficiency detected in the 1950's to the period of mild to moderate iodine deficiency during the 1990's, and finally, nowadays, iodine sufficiency has been achieved.     

Serum zinc levels and goiter in Iranian school children

Iodine deficiency has been shown to have high prevalence in Iran despite sufficient iodine supplementation. Zinc deficiency may also contribute to the pathogenesis of endemic goiter. The aim of this study was to compare serum zinc level in Iranian school children with and without goiter. A cross-sectional study was performed among urban children aged 8-12 years in city of Kerman, Iran. A multistage proportional to size cluster sampling method was used to screen 5500 subjects out of 29,787 students. After the screening phase, serum and urine specimens of randomly selected 165 students were evaluated for serum zinc levels and urinary iodine excretion and compared in goiterous and non-goiterous children. Serum zinc level was 149.5±29.4 μg/l in goiterous children and 141.2±52 μg/l in non-goiterous children but no significant difference was found between the groups (p=0.37). But urinary iodine excretion was significantly (p<0.001) lower in goiterous children (207.5 μg/l in goiterous children and 262.5 μg/l in non-goiterous children). This study showed that serum zinc level in goiterous and non-goiterus children is not different and zinc deficiency is not a risk factor for endemic goiter in this population.     

Low serum selenium concentration as a possible factor for persistent goiter in Iranian school children

Selenium deficiency can have adverse effect on thyroid metabolism and response to iodine supplementation. The aim of this study was to determine relationship between prevalence of goiter, thyroid hormone profile, urinary iodine and serum selenium concentrations in Iranian schoolchildren. In a cross- sectional study, 1188 schoolchildren in the age group of 8-13 years were evaluated for goiter prevalence. Urine and serum samples were collected from 500 children and assayed for urinary iodine concentration, thyroid hormone profile and serum selenium concentration. The overall goiter prevalence was 39.6% and the median urinary iodine excretion, indicated to an adequate iodine intake. The mean serum selenium concentration was 119.1 +/- 31 mug/l with significant difference between boys and girls (108.4 +/- 26.2 mug/l vs 127.7 +/- 32.1 mug/l). An increase in free T4 concentration was observed in those with a lower selenium level and there was a significant relationship between the presence or absence of goiter and serum selenium concentration. Selenium supplementation may be an advisable measure to optimize thyroid hormone metabolism and decrease the prevalence of goiter in schoolchildren with low serum selenium concentration.     

Selenium, zinc, and copper concentrations in the blood and milk of lactating women

The aim of the study was to determine Se, Zn, and Cu concentrations in blood plasma and milk of lactating women from central Poland who were in different stages of lactation and to investigate the relationship between the content of trace elements in mothers’ blood and concentrations of microelements in their milk. Se and Zn concentrations in blood plasma of mothers were the lowest and Cu was the highest on the first 4 d of lactation (colostrum, n=43) and were found to be 34.9±11.8 μg/L, 0.51±0.13 mg/L, and 1.70±0.55 mg/L, respectively. The highest plasma level of Se and Zn and the lowest content of Cu could be observed between d 10 and 30 of lactation (mature milk, n=41), and were found to be 54.3±14.6 μg/L for Se (p<0.001), 0.76±0.20 mg/L for Zn (p<0.001), and 1.03±0.30 mg/L (p<0.001) for Cu. The results of Se, Zn, and Cu determination in breast milk samples demonstrate a pattern of decline in their concentration with advancing stages of lactation. We found out that Se, Zn, and Cu concentrations were the highest in colostrum (n=43) and amounted to 24.8±10.1 μg/L, 8.2±2.8 mg/L, and 0.45±0.11 mg/L, respectively. The content of all determined microelements declined significantly during the time of lactation. Statistically significant linear correlation was found between concentrations of Zn in blood plasma and milk in the first stage of lactation. Weak but statistically significant linear correlations were also found between plasma Se content in plasma and in transitional and mature milk of breast-feeding women.     

Significance of serum trace element status in patients with rheumatic heart disease: a prospective study

It is known that certain trace elements can affect various heart diseases. In this study, we aimed to evaluate the changes in concentrations of certain serum trace elements in patients with chronic rheumatic heart disease (RHD). Serum analysis of selenium (Se), zinc (Zn), and copper (Cu) trace elements was assayed by atomic absorption spectrophotometry. RHD patients had significantly lower serum concentrations of Se and Zn than control subjects (p < 0.05 and p < 0.001, respectively). However, the serum Cu concentration was significantly higher in RHD patients than in controls (1.93 +/- 0.59 microg/L vs 1.06 +/- 0.29 microg/L; p < 0.001). Similarly, the Cu/Zn ratio in RHD patients was higher than in control subjects (4.70 +/- 0.92 vs 1.68 +/- 0.45; p < 0.001). Additionally, no significant correlation was found among these trace element concentrations and the functional capacity classes (p > 0.05). RHD patients had decreased serum Se and Zn element concentrations and increased serum Cu element concentration. We suggest that Se and Zn deficiency might be contributory factors in the development of rheumatic heart disease, and a high Cu concentration and a high Cu/Zn ratio might reflect an ongoing inflammatory process in this disease.     

Goiter prevalence,serum selenium,and urine iodine status in a previously iodine-deficient area in Turkey

This study was planned to investigate goiter prevalence and serum selenium and urine iodine status among school-age children in the Ankara region of Turkey. Nine hundred five (905) children were investigated; 847 of them were included in the study. Thyroid ultrasound was performed on children who were suspected of being goitrous at physical examination. Serum TSH, thyroxine, triiodotyronine, thyroid antibody, and urine iodine concentrations (UIC) are also measured. Ultrasound measurements revealed a goiter in 107 (12.6%) of the 847 children. Goiter prevalence was significantly lower among iodized-salt users compared to the noniodized salt using group. UIC and serum selenium levels in the goitrous group were significantly lower compared to the nongoitrous group. Despite legally enforced table salt iodization, the region shows the characteristics of mild iodine deficiency. In addition to lower UIC, goitrous children have lower serum selenium levels compared to the nongoitrous ones. Thus, selenium deficiency plays an important role in goiter endemics in Turkey. It can be postulated that table salt iodization might not be enough for the preventive measures of goiter, but informing people about the correct ways of iodized salt consumption, enforcing the iodization of industrial salts, and, as important as these measures, taking selenium deficiency into consideration are essential for preventing goiters in endemic areas.     

Effects of dietary selenite,copper, and zinc on tissue trace mineral levels in chicks

Studies were conducted to determine whether nutritional selenium (Se) status affects the nutritional status of the chick with respect to other trace elements, particularly copper (Cu) and Zinc (Zn). Severe Se deficiency was produced in chicks by the use of diets that contained exceedingly low contents (less than 0.010 ppm) of Se, but contained adequate amounts of all other known essential nutrients. This diet was based upon corn and soybean meal produced in areas of China with endemic Se deficiency of geobotanical origin. A level of at least 0.10 ppm Se was found to be required to maintain normal Se status of chicks fed this diet, and Se deficiency resulted in decreased levels of Cu, Zn, and molybdenum in the pancreas (liver and plasma levels were not affected). High dietary supplementation of Zn nor Cu did not affect the short-term utilization of Se, as indicated by the 18-h responses of Se-dependent glutathione peroxidase in plasma and liver.     

Selenium Deficiency as a Possible Contributor of Goiter in Schoolchildren of Isfahan, Iran

The prevalence of goiter still remains high in some areas of Iran in spite of iodine supplementation. In the present study, we investigated the role of selenium (Se) deficiency in the etiology of goiter in Isfahan. Two thousand three hundred thirty-one schoolchildren were selected by multistage random sampling. Thyroid size was estimated in each child by inspection and palpation. Urinary iodine concentration (UIC) and plasma Se were measured. Overall, 32.9% of the 2,331 children had goiter. The median UIC was 19.55 µg/dl. Plasma Se was measured in 96 goitrous and 72 nongoitrous children. The mean?±?SD of plasma Se in goitrous and nongoitrous children was 66.86?±?21.82 and 76.67?±?23.33 µg/l, respectively (P?=?0.006). Goitrous girls had lower plasma Se level than nongoitrous girls (65.62?±?21.64 vs. 76.51?±?22.61 µg/dl, P?=?0.02). Goitrous boys had lower plasma Se level than nongoitrous boys (68.45?±?22.21 vs. 76.91?±?24.76 μg/l, P?=?0.14). The prevalence of Se deficiency was significantly higher in goitrous boys and girls than nongoitrous children. Se deficiency is among the contributors of goiter in Isfahan goitrous schoolchildren. However, the role of other micronutrient deficiencies or goitrogens should be investigated in this region.     

Bioelement effects on thyroid gland in children living in iodine-adequate territory

Endemic goitre is a primary pathology of thyroid gland and critical medico social problem in many countries. A dominant cause of endemic goitre is iodine deficiency. However, besides primary iodine deficiency, the goitre may probably develop due to effects of other bioelement imbalances, essential to thyroid function maintenance. Here we studied 44 cases of endemic goitre in prepubertal children (7–10 y.o.) living in iodine-adequate territory. Thyroid volume was estimated by ultrasonometry. Main bioelements (Al, Ca, Cd, Co, Cr, Cu, Fe, Hg, I, Mg, Mn, Pb, Se, Si, Zn) were determined in hair samples by ICP-OES/ICP-MS method. Relationships between hair content of bioelements and thyroid gland size were estimated by multiple regressions. The regression model revealed significant positive relations between thyroid volume and Cr, Si, Mn contents. However, the actual factor of thyroid gland increase was only Si excess in organism. Significant negative relations of thyroid volume were revealed with I, Mg, Zn, Se, Co and Cd. In spite of this, the actual factors of thyroid gland volume increasing were I, Co, Mg and Se deficiency. Total bioelement contribution in thyroid impairment was estimated as 24%. Thus, it was suggested that endemic goitre in iodine-adequate territory can be formed by bioelement imbalances, namely Si excess and Co, Mg, Se shortage as well as endogenous I deficiency in spite of iodine-adequate environment.     

The effect of aging on intestinal absorption and status of calcium, magnesium, zinc, and copper in rats: A stable isotope study

Many investigators have reported changes in mineral status with age but conflicting observations were done concerning mineral absorption. This study was conducted to clarify the effect of aging on intestinal absorption and status of minerals, using a stable isotope approach. To do so, 40 rats of different ages: 9, 22, 44, and 88 weeks were fed with a semi-purified diet for a total of 30 days. At the beginning of the 4th week, the rats received a stable isotope solution containing (44)Ca, (25)Mg, (67)Zn, and (65)Cu. Individual feces and urine were then collected during 4 consecutive days in order to measure stable isotopes by inductively coupled plasma/mass spectrometry (ICP/MS) and blood and tissues were sampled for mineral status determination. Intestinal absorption of (44)Ca and (67)Zn considerably decreased with age, whereas intestinal (25)Mg absorption decreased only moderately and intestinal (65)Cu absorption was unaffected. Plasma and bone calcium (Ca) were not modified with age whereas urinary Ca excretion considerably increased. Plasma and erythrocyte magnesium (Mg) levels were unaffected with age whereas urinary Mg excretion and Mg bone level decreased. Plasma zinc (Zn) level decreased and bone Zn level increased with age whereas red blood cell and liver Zn level and urinary Zn excretion remained unchanged. Plasma Cu level increased with age whereas liver and bone Cu levels and urinary Cu excretion remained unchanged. These results show that the effect of aging on the intestinal mineral absorption and status differ largely according to the mineral considered. Further studies are required under different nutritional conditions to explore the underlying mechanisms during aging and to adjust a better nutrition of the elderly.     

Role of Bamboo-Shoot in the Pathogenesis of Endemic Goiter in Manipur,North East India

ObjectiveEndemic goiter is prevalent in the iodine-sufficient region of Manipur, India. Bamboo shoot (BS), a goitrogenic plant food, are consumed regularly in the area. The objective of this study was to examine the role of BS in the pathogenesis of endemic goiter.MethodsGoiter prevalence, urinary iodine, and thiocyanate (SCN) excretion in school children, iodine content in drinking water, and the household consumption of salt fortified with iodine were measured. To confirm the goitrogenic potential of BS, its progoitrogenic constituents were fed to rats as part of an iodine-sufficient diet, after which the animals' thyroid gland morphology and functional status were assessed.ResultsGoiter prevalence was 31% in 4852 children, and the median urinary I and SCN levels were 176.3 μg/L and 0.962 ± 0.190 mg/dL, respectively. Of the households assessed, 90% consumed salt fortified with adequate iodine. Progoitrogenic constituents were high in BS from Manipur. Increased thyroid weight, hypertrophy and hyperplasia of follicular cells, decreased thyroid peroxidase activity, and low serum thyroxine (T₄) and triiodothyronine (T₃) levels were observed in BS-fed rats.ConclusionNearly one third of the studied participants had palpable goiter, despite a successful salt iodine fortification program. SCN from BS causes goiter in iodine-sufficient experimental animals. Similar ingestion in study participants was confirmed and is the likely cause for the persistence of endemic goiter in the Manipur region. (Endocr Pract. 2013;19:36-45)     

Trace mineral status in post menopausal women: impact of hormonal replacement therapy.

The risks of disturbances in trace mineral nutrition and metabolism are high following menopause. The aim of the study was to investigate the trace mineral status in postmenopausal women and the influence of hormonal replacement therapy on this status. Forty-four healthy postmenopausal women, aged 50-60 years old participated in the study. Eighteen were treated by combined hormonal replacement therapy (HRT) per os for at least two years, and 26 were untreated. Plasma trace mineral levels (Zn, Se, Cr, Mn, Cu), red blood cell antioxidant enzymes (Cu-Zn SOD, Se-GPX, Cu), urinary Zn, Cr, Mg, and Ca excretion were measured. Zinc, selenium and manganese plasma levels, activities of Cu-Zn-SOD and GSH-Px in erythrocytes were not statistically different between the two groups. The percentage of zinc plasma levels below the cut off of 10.7 micromol/L was higher in HRT treated group than in untreated one, whereas zinc excretion was reduced. Plasma copper concentrations were higher in women treated by HRT, whereas erythrocyte copper levels were not modified. Plasma chromium concentrations were significantly higher in women receiving HRT and urinary Cr excretion was decreased. The HRT group also exhibited lower losses of urinary zinc and magnesium than untreated women. These data suggest that hormonal replacement therapy provides beneficial effects on trace mineral status related to menopause.     

Oxidative DNA base damage, antioxidant enzyme activities and selenium status in highly iodine-deficient goitrous children

The objective of this study was to investigate oxidative DNA damage, and the levels of antioxidant enzymes (AOE) and selenium (Se) in relation to iodine deficiency and/or goiter in children. The study was performed in a group of goitrous high school children (15-18 years of age) ( n =14) with severe or moderate iodine deficiency. Thyroid hormones (TSH, FT 4 , TT 4 , FT 3 , TT 3 ), urinary iodine (UI) and plasma Se levels, and erythrocyte glutathione peroxidase (GSHPx), superoxide dismutase (SOD) and catalase (CAT) activities were determined and compared with those of a control group consisting of non-goitrous high school children ( n =14) with normal UI levels or mild iodine deficiency. In the goitrous group, concentrations of FT 4 , TT 4 , plasma Se and UI, and activities of GSHPx and SOD were found to be significantly lower. Six typical hydroxyl radical-induced base lesions in genomic DNA of peripheral blood were identified and quantified by gas chromatography/isotope-dilution mass spectrometry (GC/IDMS), and higher levels of DNA base lesions were observed in the goitrous group. The results suggest that highly iodine-deficient goitrous children may be under oxidative stress, which may lead to greater level of oxidative damage to DNA. This study supports the evidence for the reported relationship between iodine deficiency and the increased incidence of thyroid malignancies.     

Indices of iron and copper status during experimentally induced,marginal zinc deficiency in humans

This study examined the effect of diet-induced, marginal zinc deficiency for 7 wks in 15 men (aged 25.3 +/- 3.3 yrs; mean +/- SD) on selected indices of iron and copper status. The regimen involved low-zinc diets based on egg albumin and soy protein with added phytate and calcium such that mean [phytate]/[Zn] and [phytate] X [Ca]/[Zn] molar ratios were 209 and 4116, respectively, for 1 wk, followed by 70 and 2000, respectively, for 6 wks. Subjects were then repleted with 30 mg Zn/d for 2 wks. Plasma copper, Cu,Zn-superoxide dismutase (Cu,Zn-SOD) activity in plasma and red blood cells (RBC), hemoglobin, hematocrit, and serum ferritin were determined weekly on fasting blood samples. Significant reductions (p less than 0.05) after 7 wks in RBC Cu,Zn-superoxide dismutase (49.5 +/- 7.2 vs 33.6 +/- 6.3 U/mg Hb) and serum ferritin (69.2 +/- 38.7 vs 53.8 +/- 33.7 micrograms/L) occurred; no comparable decline was noted for plasma Cu, hemoglobin, or hematocrit. Significant (p less than 0.05) but less consistent changes were also observed in plasma superoxide dismutase activity. None of the changes were associated with the decreases in plasma, urinary and hair zinc concentrations, and alkaline phosphatase activity in RBC membranes. Results indicate that the biochemical iron and copper status of the subjects was marginally impaired, probably from the dietary regimen that induced marginal zinc deficiency.     

Iodized oil as a complement to iodized salt in schoolchildren in endemic goiter in Romania

OBJECTIVE: To evaluate the long-term efficacy and possible side effects of low doses of iodized oil on iodine nutrition and thyroid function in endemic goiter in Romania. METHODS: Random selection of 214 schoolchildren aged 6-14 years. Serial measurements of urinary iodine, thyroid volume with ultrasound, serum concentrations of thyrotropin, free thyroxine, thyroglobulin and thyroid autoantibodies before and up to 2 years after the oral administration of 200 mg iodine in iodized oil. RESULTS: Urinary iodine concentrations indicated a moderate iodine deficiency before therapy, sharply increased soon after therapy and slowly decreased thereafter but remained within the normal range up to more than 1 year after therapy. The prevalence of goiter was 29% before the administration of iodized oil and 9% 1 year later. Thyroid function tests and autoantibodies were normal before and up to 2 years after therapy. CONCLUSION: A single dose of 200 mg iodine from oral Lipiodol appears adequate and safe for correcting moderate iodine deficiency in children.     

Should chronic obstructive pulmonary disease outpatients be routinely evaluated for trace elements?

We searched for serum concentrations of trace elements and correlated them to malondialdehyde (MDA), which is an indirect marker of oxidative stress, in order to clarify if routine evaluation is necessary in chronic obstructive pulmonary disease (COPD) outpatients. Serum concentrations of copper (Cu), zinc (Zn), and magnesium (Mg) were determined by atomic absorption spectrophotometry and iron (Fe) by a ILLab 1800 autoanalyzer with ILLab test kits. Serum MDA concentrations were detected in terms of TBARS (thiobarbituric acid reactive substances) spectrophotometrically. Serum Cu, Zn, Mg, Fe, and MDA concentrations in patient and control groups were all in the normal reference range. The results respectively were as follows: Cu:123±29.2 and 122.2±23.4 μg/dL; Zn: 87.8±17.8 and 96.9 ± 12.9 μg/dL; Mg: 2.3±0,5 and 2.04±0.28 mg/dL; Fe: 73.8±35.5 and 80.7±51.2 μg/dL; MDA: 1.09±0.11 and 0.95±0.06 nmol/L. MDA was not correlated to Cu, Zn, Mg, or Fe (p>0.05 for all). The serum Zn concentration of COPD group was lower than the control group (p=0.042), whereas the Mg concentration was higher (p=0.021). There was no statistical difference in other study parameters. Oxidative stress was not increased in clinically stable, regularly treated COPD patients. Although there was no deficiency in trace elements (Cu, Fe, Mg, and Zn), serum Zn was close to the lower limit of the reference value. There is no need for routine evaluation of trace elements in clinically stable, regularly treated COPD outpatients.