Nutrition and inflammation: The basis for an altered plasma copper to zinc ratio in elderly

As the proportion of older individuals within the population is increasing rapidly in Italy, there is substantial interest in biomarkers capable to predict functional decline and mortality in elderly and to suggest potential preventive strategies. Among the different biomarkers that in these years raised particular scientific interest in gerontological and geriatric research, the plasma copper to zinc ratio seems particularly intriguing. Indeed, high levels of this ratio seem to be strongly associated with mortality in the oldest old and in patients affected by cardiovascular diseases or cancer. It has been hypothesized that a chronic inflammatory status as commonly found in elderly subjects, as well as deleterious changes in dietary habits might contribute to increase the values of this biomarker. In this manuscript we followed-up for 3 years a population of elderly subjects (n.302, age range 60-100) confirming that copper to zinc ratio is a strong predictor of mortality in elderly. Its direct correlation with C reactive protein and inverse correlation with dietary intake of zinc as well as serum albumin suggest that nutritional and inflammatory factors synergically interact to explain the levels of this biomarker. Potential preventive intervention strategies on the basis of these results are discussed.