The value of copper and zinc levels in hernia formation


Suleyman Ozdemir, MD, Department of Surgery, Ufuk University Medical School, 31.Sokak 5/12 Bahcelievler, 06490 Ankara, Turkey. Tel.: 0090 533 3232502; fax: 0090 312 2044055; e-mail:


Eur J Clin Invest 2011; 41 (3): 285–290


Background  A defect in collagen metabolism is suspected to be one of the factors responsible for hernia formation. Lysyl oxidase is a copper-dependent enzyme in the process that provides for the structural integrity of collagen molecules, while zinc is essential for tissue maintenance.

Materials and methods  In a prospective fashion, copper and zinc levels were measured in plasma and tissue specimens obtained from indirect (n = 23), direct (n = 20) and incisional hernia patients (n = 19) and from healthy controls (laparoscopic cholecystectomy patients, n = 15) by enzymatic colorimetric analysis.

Results  Groups were similar in age, comorbid diseases and body mass index. Whereas plasma levels of Cu and Zn in hernia and control patients were similar, and tissue levels were significantly lower in all hernia groups (especially the incisional hernia group) compared to controls (P < 0·001). The incisional hernia group had significantly lower tissue copper levels than direct hernia patients and lower zinc levels than indirect hernia patients.

Conclusions  Patients with all types of hernia, especially those with incisional hernias, have significantly lower tissue copper and zinc levels than control patients, despite having similar plasma levels. This finding might reflect excessive consumption or dysfunction of lysyl oxidase as playing a role in the aetiology of hernias.