Biological Trace Element Research

, Volume 189, Issue 2, pp 412–419 | Cite as

Evaluation of Some Trace Elements and Vitamins in Major Depressive Disorder Patients: a Case–Control Study

  • Falah S. Al-FartusieEmail author
  • Hassanain K. Al-Bairmani
  • Zahraa S. Al-Garawi
  • Ahmed H. Yousif


Major depressive disorder (MDD) is a common mental disorder worldwide; however, little is known about its etiology. It is well known that levels of certain trace elements are associated with the pathogenesis of some diseases. Accordingly, this study aims to evaluate the effect of trace elements and vitamins in the etiology of MDD. In this case–control study, sixty men patients with MDD and sixty, age and gender matched, control subjects were examined. Serum levels of Cu, Zn, Ni, Cr, Mn, Mg, and Al were determined by atomic absorption spectrometry as well as serum levels of vitamins E and A were determined using high-performance liquid chromatography. The results revealed that there were significantly higher levels (p < 0.001) of Cu, Cr, and Al in patients sera compared with control. While there were significantly lower levels (p < 0.001) of Zn, Ni, Mn, Mg, vitamin E, and vitamin A in MDD patients as compared with control. In addition, high Cu/Zn ratio (p < 0.05) was observed with the depressive disorder patients. The present study highlights some main indications: a significant relationship between the disturbances of element levels and vitamins (E and A) with MDD. Cu and Zn seemed to have a crucial role in understanding the pathogenesis of depressive disorders, where Cu/Zn ratio could have an important role in the diagnosis and monitoring of MDD. Moreover, the results suggest that the reduction in the antioxidant vitamin E leads to increased risk of MDD. Finally, more studies on using trace element supplementation would be suggested to clarify their effect, in order to improve the therapy of MDD.


Trace elements Vitamins Major depressive disorder Cu Zn 



The authors would like to thank Mustansiriyah University (, Baghdad, Iraq, for its support in the present work.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the research committee of Mustansiriyah University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Owiredu W, Osei O, Amidu N, Appiah-Poku J, Osei Y (2012) Prevalence of metabolic syndrome among psychiatric patients in the Kumasi Metropolis, Ghana. J Med Biomed Sci 1(2):38–49Google Scholar
  2. 2.
    World Health Organisation, Mental disorders (2018) Archived from the original on 18 May 2015Google Scholar
  3. 3.
    Kesslerm RC (1997) The effects of stressful life events on depression. Annu Rev Psychol 48:191–214Google Scholar
  4. 4.
    Post RM (1992) Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 149:999–1010Google Scholar
  5. 5.
    Salim S (2014) Oxidative stress and psychological disorders. Curr Neuropharmacol 12(2):40–147Google Scholar
  6. 6.
    Tsaluchidu S, Cocchi M, Tonello L, Puri BK (2008) Fatty acids and oxidative stress in psychiatric disorders. BMC Psychiatry 8(Suppl 1):S5Google Scholar
  7. 7.
    Sies H (1997) Oxidative stress: oxidants and antioxidants. Exp Physiol 82(2):291–295Google Scholar
  8. 8.
    Hamid AA, Aiyelaagbe OO, Usman LA, Ameen OM, Lawal A (2010) Antioxidants: its medicinal and pharmacological applications. Afr J Pure Appl Chem 4(8):142–151Google Scholar
  9. 9.
    D’Souza B, D’Souza V (2003) Oxidative injury and antioxidant vitamins E and C in schizophrenia. Indian J Clin Biochem 18(1):87–90Google Scholar
  10. 10.
    Raederstorff D, Wyss A, Calder PC, Weber P, Eggersdorfer M (2015) Vitamin E function and requirements in relation to PUFA. Br J Nutr 114(8):1113–1122Google Scholar
  11. 11.
    Al-Fartusie FS, Mohssan SN (2017) Essential trace elements and their vital roles in human body. Indian J Adv Chem Sci 5(3):127–136Google Scholar
  12. 12.
    Aldabagh MA, Kader SI, Ali NM (2011) Serum levels of copper, zinc, iron and magnesium in Iraqis patient with chronic hepatitis C. Karbala J Med 4(10):1146–1150Google Scholar
  13. 13.
    Scheiber IF, Mercer JF, Dringen R (2014) Metabolism and functions of copper in brain. Prog Neurobiol 116:33–57Google Scholar
  14. 14.
    Barrass BC, Coult DB (1972) Interaction of some centrally active drugs with caeruloplasmin. Biochem Pharmacol 21(5):677–685Google Scholar
  15. 15.
    Narang RL, Gupta KR, Narang AP, Singh R (1991) Levels of copper and zinc in depression. Indian J Physiol Pharmacol 35:272–274Google Scholar
  16. 16.
    Bao B, Prasad AS, Beck FW, Fitzgerald JT, Snell D, Bao GW, Singh T, Cardozo LJ (2010) Zinc decreases C-reactive protein, lipid peroxidation, and implication of zinc as an atheroprotective agent. Am J Clin Nutr 91:1634–1641Google Scholar
  17. 17.
    Prasad AS (2014) Zinc is an antioxidant and anti-inflammatory agent: its role in human health. Front Nutr 1:14Google Scholar
  18. 18.
    Michalska-Mosiej M, Socha K, Soroczyńska J, Karpińska E, Łazarczyk B, Borawska MH (2016) Selenium, zinc, copper, and total antioxidant status in the serum of patients with chronic tonsillitis. Biol Trace Elem Res 173:30–34Google Scholar
  19. 19.
    Al-Fartusie FS, Marzook AT, Morad TS (2012) Study of some trace elements and antioxidant vitamins in sera of Iraqi women with toxoplasmosis, Al Mustansiriya. J Science 23(3):199–206Google Scholar
  20. 20.
    Satoshi U, Masashi M, Noriyuki O, Hiroki I, Tatsuya H, Ryosuke T, Kaori I, Ryo I, Kiyonori Y, Kazuma D, Ippei T, Takashi U, Shigeatsu A, Kazuyoshi I, Shigeyuki N (2010) Association between concentration of trace elements in serum and bronchial asthma among Japanese general population. J Trace Elem Med Biol 24:236–242Google Scholar
  21. 21.
    Al-Fartusie FS, Hafudh A, Mustafa N, Al-Bermani H, Majid AY (2017) Levels of some trace elements in sera of patients with lung cancer and in smokers. Indian J Adv Chem Sci 5(4):344–352Google Scholar
  22. 22.
    Onyema-iloh BO, Meludu SC, Iloh E, Nnodim J, Onyegbule O, Myke MB (2014) Biochemical changes in some trace elements, antioxidants vitamins and their therapeutic importance in prostate cancer patients. Asian J Med Sci 6(1):95–97Google Scholar
  23. 23.
    Perkin-Elmer (1996) Analytical methods for atomic absorption spectroscopy. The PerkinElmer Inc, WalthamGoogle Scholar
  24. 24.
    Cetinkaya N, Ozcan H (1991) Investigation of seasonal variation in cow serum retinol and beta-carotene by high performance liquid chromatographic method. Comp Biochem Physiol 100(4):1003–1008Google Scholar
  25. 25.
    Manser WW, Khan MA, Hasan KZ (1989) Trace element studies on Karachi population. Part IV: blood copper, zinc, magnesium and lead levels in psychiatric patients with depression, mental retardation and seizure disorders. J Pak Med Assoc 39:269–274Google Scholar
  26. 26.
    Roger M (2011) The minerals you need. Safe Goods Publishing, USA, p 21Google Scholar
  27. 27.
    Farzin L, Esmail Moassesi E, Fattaneh Sajadi F, Faghih A (2013) Evaluation of trace elements in pancreatic cancer patients in Iran, Middle East. J Cancer 4(2):79–86Google Scholar
  28. 28.
    Islam MR, Islam MR, Shalahuddin Qusar MMA, Islam MS, Kabir MH, Mustafizur Rahman GKM, Islam MS, Hasnat A (2018) Alterations of serum macro-minerals and trace elements are associated with major depressive disorder: a case-control study. BMC Psychiatry 18:94Google Scholar
  29. 29.
    Styczeń K, Sowa-Kućma M, Siwek M, Dudek D, Reczyński W, Misztak P, Szewczyk B, Topór-Mądry R, Opoka W, Nowak G (2016) Study of the serum copper levels in patients with major depressive disorder. Biol Trace Elem Res 174(2):287–293Google Scholar
  30. 30.
    Błażewicz A, Liao K-Y, Liao H-H, Niziński P, Komsta Ł, Momčilović B, Jabłońska-Czapla M, Michalski R, Prystupa A, Sak J, Kocjan R (2017) Alterations of hair and nail content of selected trace elements in nonoccupationally exposed patients with chronic depression from different geographical regions. Biomed Res Int, Hindawi 3178784:1–10Google Scholar
  31. 31.
    Styczeń K, Sowa-Kućma M, Siwek M, Dudek D, Reczyński W, Szewczyk B, Misztak P, Topór-Mądry R, Opoka W, Nowak G (2017) The serum zinc concentration as a potential biological marker in patients with major depressive disorder. Metab Brain Dis 32(1):97–103Google Scholar
  32. 32.
    Grønli O, Kvamme JM, Friborg O, Wynn R (2013) Zinc deficiency is common in several psychiatric disorders. PLoS One 8(12):e82793Google Scholar
  33. 33.
    Wacewicz M, Sochab K, Soroczyńskab J, Niczyporuk M, Aleksiejczukd P, Ostrowskad J, Borawskab MH (2017) Concentration of selenium, zinc, copper, Cu/Zn ratio, total antioxidant status and c-reactive protein in the serum of patients with psoriasis treated by narrow-band ultraviolet B phototherapy: a case-control study. J Trace Elem Med Biol 44:109–114Google Scholar
  34. 34.
    Mezzetti A, Pierdomenico SD, Costantini F, Romano F, De Cesare D, Cuccurullo F, Imbastaro T, Riario-Sforza G, Di Giacomo F, Zuliani G, Fellin R (1998) Copper/zinc ratio and systemic oxidant load: effect of aging and aging-related degenerative diseases. Free Radic Biol Med 25:676–681Google Scholar
  35. 35.
    Bruhl HH, Foni J, Lee YH, Madow A (1987) Plasma concentrations of magnesium, lead, lithium, copper, and zinc in mentally retarded persons. Am J Ment Defic 92(1):103–111Google Scholar
  36. 36.
    Zieba A, Kata R, Dudek D, Schlegel-Zawadzka M, Nowak G (2000) Serum trace elements in animal models and human depression: part III. Magnesium, relationship with copper. Hum Psychopharmacol 15:631–635Google Scholar
  37. 37.
    Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A (2016) Serum magnesium status in patient’s subjects with depression in the City of Yazd in Iran 2013–2014. Biol Trace Elem Res 171:275–282Google Scholar
  38. 38.
    Zheltova AA, Kharitonova MV, Iezhitsa IN, Spasov AA (2016) Magnesium deficiency and oxidative stress: an update. Biomedicine 6(4):20Google Scholar
  39. 39.
    Yao H, Guo L, Jiang BH, Luo J, Shi X (2008) Review oxidative stress and chromium (VI) carcinogenesis. J Environ Pathol Toxicol Oncol 27(2):77–88Google Scholar
  40. 40.
    Jerome R, Silvia P, Michael A (2013) Manganese homeostasis and transport. In Banci L (ed) Metallomics and the Cell. (Chapter 6) Metal Ions in Life Sciences, vol 12. SpringerGoogle Scholar
  41. 41.
    Fukushima T, Tan X, Luo Y, Kanda H (2010) Relationship between blood levels of heavy metals and Parkinson's disease in China. Neuroepidemiology 34(1):18–24Google Scholar
  42. 42.
    Pfeiffer C, LaMola S (1999) Zinc and manganese in the schizophrenias. J Orthomol Med 14:1st QuarterGoogle Scholar
  43. 43.
    Mohssan SN (2018) Comparative study on some hormones, trace elements and antioxidants levels in schizophrenic. MSc Thesis, Mustansiriya University, Baghdad, IraqGoogle Scholar
  44. 44.
    Milanese M, Lkhayat MI, Zatta P (2001) Inhibitory effect of aluminum on dopamine beta-hydroxylase from bovine adrenal gland. J Trace Elem Med Biol 15(2–3):139–141Google Scholar
  45. 45.
    Fatma M, Akmal M, Fadia Z, Abd El Hamid D (2013) Psychiatric evaluation of a group of workers in the aluminium industry. Egypt J Psychiatr 34(1):1–9Google Scholar
  46. 46.
    Moret C, Briley M (2011) The importance of norepinephrine in depression. Neuropsychiatr Dis Treat 7(Suppl 1):9–13Google Scholar
  47. 47.
    Maes M, Vos N, Pioli R, Demedts P, Wauters A, Neels H, Christophe A (2000) Lower serum vitamin E concentration in major depression. Another marker of lowered antioxidant defenses in that illness. J Affect Disord 58:241–146Google Scholar
  48. 48.
    Ghodake SR, Suryakar AN, Kulhalli PM, Padalkar RK, Shaikh AK (2012) A study of oxidative stress and influence of antioxidant vitamins supplementation in patients with major depression. Curr Neurobiol 3:107–111Google Scholar
  49. 49.
    Palta P, Samuel LJ, Miller ER, Szanton SL (2014) Depression and oxidative stress: results from a meta-analysis of observational studies. Psychosom Med 76(1):12–19Google Scholar
  50. 50.
    Ranjbar E, Kasaei MS, Mohammad-Shirazi M, Nasrollahzadeh J, Rashidkhani B, Shams J, Mostafavi S, Mohammadi MR (2013) Effects of zinc supplementation in patients with major depression: a randomized clinical trial. Iran J Psychiatry 8(2):73–79Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Chemistry, College of ScienceMustansiriyah UniversityBaghdadIraq
  2. 2.Kimadia CompanyMinistry of HealthBaghdadIraq

Personalised recommendations