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We next examined the serum concentration of trace elements/minerals in dSSc patients with or without pulmonary fibrosis. The result revealed that the serum concentration of Cu in dSSc patients with pulmonary fibrosis was significantly lower than that in patents without pulmonary fibrosis. Our study provided evidence that serum concentrations of K, Ca, P, Cu, and Mg were changed significantly in dSSc patients, and lower serum concentration of Cu was associated with pulmonary fibrosis.Metabolic alterations and inflammation are regarded as