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. 2025 Dec;203(12):6327-6336.
doi: 10.1007/s12011-025-04643-9. Epub 2025 May 5.

Investigation of the Relationship Between Serum Trace Elements and MSFC Levels in Multiple Sclerosis: A Cross-sectional Case-Control Study

Cihat Ozguncu  1 , Serefnur Ozturk  2 , Haluk Gumus  2 , Gokhan Ozdemir  2 , Bahadır Ozturk  3 , Ilkay Guzel  3 , Gozde Ongun  4
Affiliations

Investigation of the Relationship Between Serum Trace Elements and MSFC Levels in Multiple Sclerosis: A Cross-sectional Case-Control Study

Cihat Ozguncu et al. Biol Trace Elem Res. 2025 Dec.

Abstract

The effects of trace elements have been investigated in multiple sclerosis (MS) etiology for years. However, common results have yet to be obtained in previous studies. Therefore, as a cross-sectional case-control study, we aimed to examine the relationship between trace elements and MS in the Konya province, where air pollution is intense. Study participants with MS were investigated regarding the expanded disability status (EDSS) and multiple sclerosis functional composite (MSFC) scales. All study participants were also evaluated concerning the Beck Depression Inventory (BDI), Facit Fatigue Scale (FFS), Fatigue Severity Scale (FSS), and levels of blood chromium (Cr), manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), cadmium (Cd), and lead (Pb). While there were 49 people in the MS group, 51 individuals constituted the controls. Mn, Zn, Cd, and Pb levels were significantly higher in controls. There was no significant difference between MS and control groups regarding depression and fatigue scores. MSFC parameters, depression, and fatigue scale scores were statistically higher with increasing EDSS in MS patients. A significant correlation was also observed between the scores of the timed 25-foot walk (T25FW) and dominant hand 9-hole peg test (9HPT) and Cr levels (p = 0.014, 0.004). A relationship was also observed between Mn levels and T25FW (p = 0.047). Trace element levels can be seen at different levels in MS patients. While a correlation was observed between some MSFC parameters and Cr and Mn levels, no relationship was observed between trace element levels, depression, fatigue, and EDSS.

Keywords: Chromium; Depression; Fatigue; Manganese; Multiple sclerosis; Trace element.

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Conflict of interest statement

Declarations. Ethics Approval: The study involving human participants was carried out under the principles of the 1964 Declaration of Helsinki and its later amendments. The study protocol was also reviewed and approved by the Local Ethics Committee for Clinical Research of Selcuk University (Approval number: 2019/81). Conflict of Interest: The authors declare that the research was conducted without commercial or financial relationships construed as a potential conflict of interest.

Figures

Fig. 1
Fig. 1
Participant flow diagram
See this image and copyright information in PMC

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