Nutritional Status and Plasma Trace Elements in Peripartum Cardiomyopathy. a Comparative Study in Niger

Abstract

BACKGROUND: Peripartum cardiomyopathy is a frequent condition of unknown origin in Sahelian West Africa. OBJECTIVE: To identify the nutritional and trace-elements status, plasma concentrations of albumin, pre-albumin (trans-thyretin), retinol binding protein, copper, selenium and zinc were assayed in 35 African women living in a Sahelian area, hospitalized in the Hôpital national, Niamey (Republic of Niger) with peripartum cardiac failure due to peripartum cardiomyopathy. METHODS: Plasma albumin was assayed by an automatic method; pre-albumin and retinol binding protein by radial immunodiffusion (Mancini's method); and plasma copper, selenium and zinc by neutron activation and particle-induced X-ray emission. The results were compared with those for a control group of African women living under the same conditions but without peripartum cardiac failure. RESULTS: Plasma albumin and pre-albumin were lower in patients with peripartum cardiomyopathy than they were in controls (P < 0.001). For retinol binding protein, the difference was not statistically significant. The plasma concentrations of selenium and zinc were lower in patients than they were in controls (48 +/- 25 versus 77 +/- 16 ng/ml and 0.90 +/- 0.21 versus 1.17 +/- 0.25 micrograms/ml, respectively, P < 0.001) whereas that of copper was higher (2.03 +/- 0.37 versus 1.23 +/- 0.20 micrograms/ml, P < 0.001). The mean zinc: copper ratio was lower in patients than it was in controls (0.44 versus 0.95). CONCLUSION: Such differences may be aetiological factors or biological consequences of the peripartum cardiac failure due to cardiomyopathy. Nutritional abnormalities may play a role in the pathophysiology of the disease.