İNTİHAR VAKALARINDA KAN ÖRNEKLERİNDE AĞIR METAL VE ELEMENT DÜZEYLERİNİN DEĞERLENDİRİLMESİ
Erkman, Fatma Tuğba
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Suicide attempt and death as a result of suicide are frequently encountered in forensic medicine practices. Although suicidal behavior tends to decrease in developed countries in recent years, it continues to be a global health problem. For this reason, many studies have been conducted on the pathophysiology of suicide. In some studies, it has been stated that there is a relationship between suicidal behavior and pathologies that may lead to suicidal behavior and genetic, toxicological, acquired and neurobiological causes. In this study, it was aimed to determine whether there is a relationship between heavy and essential metals, which cause inflammation by acting on neurobiological mechanisms and play a role in the pathogenesis of many diseases, and suicidal behavior, and to determine whether postmortem blood heavy metal level can be used as a predictor factor. In this context, autopsies were performed in 2016-2017; among the witness samples at the stage of destruction; Cases older than 18 years of age, showing signs of Stage II and above decay, and cases of conquered graves were excluded from the sample group; and 45 cases with demographic and postmortem staging characteristics matched with the study group were included in the study. Blood samples in purple capped and red capped tubes were used separately for each case. Chromium (Cr), manganese (Mn), cadmium (Cd), antimony (Sb), lead (Pb), copper (Cu), zinc (Zn), selenium (Se), molybdenum in blood and plasma samples using ICP-MS device (Mo), cobalt (Co), arsenic (As), nickel (Ni), mercury (Hg) metal levels were evaluated. The findings show that in all individuals included in the study, people living in the city center are exposed to higher levels of heavy metals, cadmium and mercury values are significantly higher than those living in rural areas, and in the analysis results of the cases determined to have died by suicide, Cu, Zn, Mo, Co. showed that As values were significantly higher. In the literature, mostly case reports indicate that there is a relationship between many heavy metals and psychiatric diseases that cause suicidal behavior, but in our study, Cu, Zn, Mo, Co and As levels were found to be significantly higher in suicide cases. In this context, it indicates that postmortem blood heavy metal levels can be used as a secondary indicator/predictor in cases with problems in determining the origin of suicide. It has been evaluated that a larger number of case series studies with an expanded variable pool are needed in order to clearly demonstrate the relationship between blood heavy metal levels and suicide.