Evaluation of Serum Copper (Cu), Serum Iron (Fe) and Serum Copper (Cu) / Iron (Fe) Ratio in Oral Submucous Fibrosis in Karachi

Aims: To evaluate serum copper, serum iron, and copper/iron ratio in oral submucous fibrosis disease in Karachi.

Study Design: A cross-sectional study.

Place and Duration of Study: Ziauddin Hospital (Dental OPD), Karachi, Pakistan. In between the period of January 2014 to August 2015.

Methodology: This cross-sectional study included 130 oral submucous fibrosis patients, which were divided into 50 stage 1 OSMF, 50 stage 2 OSMF and 30 healthy individuals between the age range of 6-60 years (91 males and 37 females). Detailed questionnaire followed by sample collection of serum copper and iron from each patient was administered. Colorimetric assay analysed the samples.

Results: Mean age of OSMF patients was 34 years (15- 44 years). Most of them were males (70%), and less were females (30%). The highly affected group was of Muhajirs (Urdu speaking people) with the frequency of 40.8% as compared to other ethnicities. In the present study, the mean serum levels for copper (Cu) and iron (Fe) in healthy individuals were found to be 87 ± 20.2927 µg/dL and 73.7 ± 29.594 µg/dL respectively. In stage 1 OSMF patients, mean serum copper and iron levels were 149.56 µg/dL ± 10.8009 and 28.32 µg/dL ± 3.04 respectively. In stage 2 OSMF patients, mean serum copper and iron levels were 178.58 µg/dL ± 6.60887 and 18.82 µg/dL±2.21. Copper/ Iron ratio was also compared among different stages OSMF patients and healthy individuals. Among healthy individuals, copper/iron ratio was 1.2 which rose to 5.3 in OSMF stage 1, and the highest ratio was found in OSMF stage 2 with 9.5. It showed that the copper/iron ratio significantly increased with the severity of the disease (p < 0.0001).

Conclusion: Copper (Cu) and iron (Fe) could be used as biological markers in oral submucous fibrosis. Serum Cu to Fe ratio could be a helpful tool and a reliable biomarker in the diagnosis and prognosis of OSMF disease.