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Role of drinking water copper in pathogenesis of oral submucous fibrosis: a prospective case control study.
[oral submucous fibrosis]
Although
oral
submucous
fibrosis
(
OSMF
)
is
thought
to
be
multifactorial
in
origin
,
the
chewing
of
areca
nut
is
thought
to
be
the
main
cause
.
Alkaloids
and
tannins
in
areca
nut
are
responsible
for
fibrosis
,
but
recent
evidence
has
suggested
that
copper
ions
are
also
an
important
mediator
,
and
in
a
small
pilot
study
we
recently
found
that
OSMF
was
significantly
associated
with
a
raised
concentration
of
copper
in
drinking
water
.
We
have
further
investigated
this
association
in
a
heterogeneous
population
in
Hyderabad
-
Karnataka
,
India
,
a
region
with
a
high
incidence
of
the
condition
.
We
evaluated
3
groups
,
each
of
100
patients
:
those
with
OSMF
who
chewed
gutkha
,
those
who
chewed
gutkha
but
did
not
have
OSMF
,
and
healthy
controls
who
did
not
chew
gutkha
.
The
difference
between
the
groups
in
the
mean
concentration
of
copper
in
water
measured
by
atomic
absorption
spectrometry
was
significant
(
p
<
0
.
001
)
.
There
were
also
significant
differences
between
the
groups
in
mean
concentrations
of
serum
copper
,
salivary
copper
,
and
ceruloplasmin
(
p
<
0
.
001
)
.
Our
results
confirm
that
copper
in
drinking
water
contributes
to
the
pathogenesis
of
OSMF
,
but
ingestion
of
copper
is
unlikely
to
be
the
sole
cause
.
Diseases
Validation
Diseases presenting
"high incidence of the condition"
symptom
oral submucous fibrosis
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