The role of heavy metal levels in blood and hair samples in patients followed BY multiple sclerosis diagnosis

The aim of this study is to determine heavy metal levels in hair and blood samples of a group of MS patients. The study was carried out on 100 patients with Multiple Sclerosis (MS) who were followed up at the Fırat University Faculty of Medicine Neurology Clinic between January and December 2019. This is a cross-sectional study. 29 different heavy metal levels from hair samples and 16 from blood samples were studied. Blood and hair metal levels were examined according to reference values, MS type and some environmental factors. One Sample T, Student T, Mann Whitney U, Kruskal Wallis, One Way Anova Test were used in the analyzes p <0.05 was considered statistically significant. The mean age of the patients was 37.51 ± 11.98 years. 79% of the patients were women. 73% are under 45 years of age, 60% are at upper secondary level, 76% live in the city. 51% of the patients were RRMS (Relapsing Remitting Multiple Sclerosis), 15% were PPMS (Primary Progressive Multiple Sclerosis), 18% were SPMS (Secondary Progressive Multiple Sclerosis), 16% were newly diagnosed MS. According to MS subtypes, only iodine element levels in hair samples were higher in SPMS group compared to RRMS group; there was no difference in terms of blood samples. When the heavy metal levels in the hair samples of the patients are compared with the reference values, the results of lithium, aluminum, cobalt, zinc, arsenic metals are not significant; magnesium, calcium, strontium and barium elements were found to be higher than the reference values. In blood samples, manganese and nickel levels were observed to be at reference values but other elements remained significantly below the reference values. When hair samples were compared in terms of place of residence, the antimony element was found to be significantly higher in those living in the city, and there was no difference in blood samples. In this cross-sectional study, two separate groups were created for patients who consumed drinking water from natural sources and mains water. Lead and zinc levels were found to be relatively high in mains water drinkers. Lithium is high in hair samples in patients over 20 years old; it was determined that lithium, magnesium, zinc, arsenic, cadmium and thallium elements are high in blood samples. There was no increase in mercury levels in blood and hair samples in patients with amalgam tooth filling. Acute toxicity was not observed in relapsed applications. In patients with chronic MS, increased blood platinum levels and hair cadmium levels were observed compared to those with acute MS. Key words: Heavy metals, Multiple Sclerosis, hair