Trace Elements in Medicine (Moscow)
2019, 20(1): 4-12
TOPICAL PAPERS

DEFICIENCIES OF TRACE ELEMENTS AND THE PROBLEM OF COMORBIDITY

A.M. Vasilenko¹, M.M. Sharipova²

¹ National Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of the Russian Federation; New Arbat, 32, Moscow, 121099, Russia
² A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Delegatskaya st., 20, str. 1, Moscow, 127473, Russia

10.19112/2413-6174-2019-20-1-4-12 

ABSTRACT. Comorbidity is considered as one of the actual unsolved problem of modern medicine. Over the past thirty years both the amount of patients with more than one chronical disease and with comorbid diseases have been increasing worldwide. Ac-cording to the essence of comorbidity, approaches to its prevention and treatment should be based on methods aimed at correcting the general etiopathogenetic mechanisms of the components of the disease, such as deficiency of essential microelements. Popular studies indicate wide and increasing prevalence of microelementosis and their connection with morbidity. Microelementosis can be considered both as a cause and as a result of a patient's disease. However, only a few studies are devoted to the etiological role of essential microelements deficiency per se. The dilemma of the cause-effect relationship of microelementosis and comorbidity is proposed to be solved in the context of evolutionary medicine and biogeochemistry by V.I. Vernadsky. The concept of evolutionary medicine defines the etiology and pathogenesis of modern human diseases from the standpoint of their inconsistency with the adaptation mechanisms established in the evolutionary process and contributes to the emergence of new views on the etiology and pathogenesis of various nosological forms. The study of the chemical compound of biological objects conducted by V.I. Vernadsky showed that, the most of the elements of the periodic table are part of living matter, and the changes in their distribution in the biosphere are one of the most important factors in the formation of living systems. Based on the paradigm of evolutionary medicine and the logic of biogeochemistry, microelements deficiency should be considered as a cause, not as a consequence of the disease in most cases. The lack of microelements is a common premorbid background of a wide range of diseases. It accompanies all stages of disease pathogenesis, and, therefore, and becomes the reason of comorbidity. This is due to the pluripotent biological role of a number of microelements, their involvement in the regulation of several vital processes. Zinc, copper, magnesium and iron are characterized by wide spectra of pluripotent action. Based on the analysis of data on the pandemic of microelementosis, the pluripotent role of essential microelements in vital processes, the cause-effect relationships of microelementosis and various diseases, from the standpoint of evolutionary medicine and biogeochemical concept, a hypothesis is put forward on the etiological role of the deficiency of essential microelements in the development of comorbidity.

KEYWORDS: comorbidity, trace elements, essential trace elements, biogeochemical concept, evolutionary medicine