Human Biomarkers for Assessing Copper Deficiency

Inclusion criteria for Bariatric Surgery Patients: 1) Subject has signed an informed consent; 2) The patient is at least 18 but not more than 65 years of age; 3) subject has a plasma copper level which is in the lowest third and fourth quartiles but not below 80ug/dL for women or below 70 ug/day in men; 4) The patient has a body mass index (BMI) between 18.5 and 55 kg/m2; 4) Patient had RYGB at Emory Bariatric Center between 1999 - 2009; and 6) subject is able to travel to Emory outpatient clinics for blood draw within 3 months of being contacted.

Exclusion criteria for Bariatric Surgery Patients: 1) subject has a plasma copper level which is lower than 80 ug/dL in women or less than 70 ug/dL in men, and/or exhibits significant hematologic or neurologic signs or symptoms (e.g. neutropenia, leukopenia, anemia, paresthesias, gait disturbances, severe weakness, vitamin B12, or thiamine deficiency) requiring further medical evaluation for micronutrient depletion; 2) Patient is pregnant; 3) patient has history of surgical revision or conversion of bariatric procedure; 4) patient has a history of hospitalization for acute illness in the previous 3 months; 5) patient has current active malignant neoplasm; or history of malignancy other than localized basal cell cancer of skin during previous 5 years.

Inclusion and Exclusion Criteria for Normal Controls: Subjects (n = 10) will have normal blood levels of copper. Criteria will be similar to that for the bariatric surgery cohort except that subjects should be normal weight [BMI between 20 - 30 kg/m2, to avoid the effects of obesity on copper status(15)] and should not have abdominal surgery or history of gastrointestinal disease.

Inclusion and Exclusion Criteria for Aim 2 Patients:

Subjects in Aim 2 will be identified from the Emory Bariatric Clinic population or from those subjects in Aim 1 whose plasma copper concentrations are in the deficient range (< 80 ug/dL for women and 70 ug/dL for men). Subjects will be notified about the study and their eligibility will be determined.

Inclusion criteria: 1) Subject has signed an informed consent for Aim 2; 2) subject has a plasma copper level determined in Aim 1 which is below 80 ug/dL for women and below 70 ug/dL for men; 3) subject is at least 18 but not more than 65 years of age; 4) Patient had RYGB at Emory Bariatric Center between 1999 - 2009; and 5) subject is able to travel to Emory outpatient clinics for blood draw within 3 months of being contacted.

Exclusion criteria: 1) subject exhibits significant neurologic signs or symptoms (e.g. paresthesias, gait disturbances, severe weakness; 2) subject exhibits deficiencies in vitamins B12, vitamin B6 or B1; 3) subject is pregnant; 4) subject has history of surgical revision or conversion of bariatric procedure; 5) subject has a history of hospitalization for acute illness in the previous 3 months; 6) subject has current active malignant neoplasm; or history of malignancy other than localized basal cell cancer of skin during previous 5 years; 7) subject has type 1 or type 2 diabetes mellitus.