The Exchangeable Copper-Zinc Ratio Links Sex Hormones, Tumor Burden, and Epithelial Remodeling in Colorectal Cancer.

In females, CRC patients showed higher total serum Cu and lower Zn levels than controls, resulting in a significantly elevated Cu:Zn ratio (all p ≤ 0.01) and a markedly increased exCu:Zn ratio compared with controls ( p = 0.0011), whereas differences in exCu alone did not reach statistical significance after age adjustment.

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In sensitivity analyses that included hemoglobin as an additional covariate in age-adjusted models, the marked differences between male CRC patients and controls remained highly significant and in the same direction, primarily among men.

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