Serum Copper Is Decreased in Premature Newborns and Increased in Newborns with Hemolytic Jaundice

Copper is an active component of several enzyme systems, including cytochrome c oxidase and superoxide dismutase (1), and is essential for the prevention of anemia and leucopenia. It is important for the maturation of collagen and the maintenance of skeletal and vascular integrity because of its involvement in the lysyl oxidase enzyme system (2). Deficiency of copper is associated with an increased incidence of infection, as seen in patients with Menke kinky-hair disease, an inherited disease with low copper concentrations (3). The mechanism by which high copper concentrations interact with genetic control systems, leading to liver damage, is still unknown (4). The normal term infant is born with a generous liver copper store, and copper deficiency in neonates is a rare event (5). Copper deficiency has been associated with anemia, neutropenia, and bone demineralization in both preterm and full-term infants (6)(7)(8). Ceruloplasmin, the major serum copper-transporting protein, is synthesized in the liver, but its precise role in copper metabolism is unclear. Neonatal hepatic ceruloplasmin synthesis occurs after birth and is associated with a gradual increase in plasma concentrations (9). We report the concentrations of copper in healthy and jaundiced full-term and premature infants and their correlations with hemoglobin, bilirubin, and liver enzymes. The study was approved by the Greek Ethical Committee, and parental consent was obtained. The study comprised 303 neonates (full-term and premature). Newborns with obstructive jaundice or with infections or inflammatory process were excluded. All patients underwent routine laboratory tests to determine the etiology of their jaundice (see Table 1 in the Data Supplement that accompanies the online version of this Technical Brief at http://www.clinchem.org/content/vol50/issue7/) (10)(11). Patients were divided into the following groups (Table 1⇓ ). View this table: Table 1. Copper concentrations and hemolysis related biochemical tests in full-term and premature newborns with …