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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Copper and zinc function synergistically as cofactors for copper-zinc superoxide dismutase and other critical metalloenzymes that govern antioxidant defense and erythropoiesis. Deficiency in either trace element precipitates a cascade of pathophysiological consequences: anemia, immunosuppression, and elevated cardiovascular risk. Yet herein lies a therapeutic paradox, zinc supplementation can trigger competitive inhibition of copper absorption, potentially exchanging one micronutrient deficit for another.This raises a key question: Does the ratio between these minerals predict anemia better than individual levels? We examined whether the copper-to-zinc ratio (Cu/Zn) forecasts anemia risk in nearly 6,000 adults from NHANES 2011–2012, particularly those with declining kidney function.
We analyzed 5,972 individuals (mean age 60 ± 7 years) with complete data on kidney function, serum copper and zinc, hemoglobin, and chronic disease history. Anemia was defined by WHO criteria, and kidney function assessed using the updated 2021 CKD-EPI equation. We divided participants into Cu/Zn ratio tertiles and examined associations with hemoglobin levels (linear regression) and anemia prevalence (logistic regression), adjusting for age, sex, race, eGFR, heart failure, coronary disease, stroke, cancer, and COPD.
The higher the Cu/Zn ratio, the lower the hemoglobin, a relationship that intensified in participants with altered renal function. Rising Cu/Zn tertiles correlated with escalating anemia risk. Compared to the lowest tertile (Cu/Zn 0.353–1.22), the middle tertile showed modest but significant risk elevation (OR 1.03, 95% CI 1.01–1.07). The top tertile revealed an even starker picture: 10% higher anemia odds (OR 1.10, 95% CI 1.07–1.18).
Copper-to-zinc imbalance emerges as a significant anemia risk factor, suggesting copper's potentially harmful influence when it outpaces zinc. These findings highlight a critical clinical insight: in hematologic health, trace metal balance may matter as much as absolute levels. For older adults with declining kidney function, who already face elevated anemia risk, monitoring the Cu/Zn ratio could offer a new lens for risk assessment and targeted intervention. The mechanisms behind this metallic tug-of-war warrant deeper investigation.
