Effect of zinc supplementation on body mass index and serum levels of zinc and leptin in pediatric hemodialysis patients

Effects of zinc supplementation on serum zinc and leptin levels, BMI, and body composition in hemodialysis patients

This study was carried out to evaluate the relationship between dietary and serum zinc and leptin levels with protein-energy wasting (PEW) in haemodialysis patients. The study was conducted on 80 volunteer patients aged 19-65years who received haemodialysis treatment three times a week for at least 1year. Anthropometric measurements and body composition analyses were performed. Blood samples were collected for serum zinc and leptin and other biochemical parameters. Food consumption of the patients was recorded for 3 days. Malnutrition-inflammation score (MIS) was calculated for all patients. PEW was assessed according to the criteria recommended by the International Society of Renal Nutrition and Metabolism (ISRNM). According to the ISRNM criteria, 38.1% of male patients and 36.8% of female patients were diagnosed with PEW. The median serum leptin levels of patients with PEW [9.0 (16.9) ng/mL] were significantly lower than those without PEW [20.7 (38.5) ng/mL] (p < 0.05). Dietary zinc intake in patients with PEW was significantly lower than that in patients without PEW (p < 0.05). However, there was no significant difference in serum zinc levels between the patients with and without PEW. In the multivariate analyses, dietary and serum zinc and leptin was associated with PEW. After controlling for several confounding factors these associations disappeared. Dietary zinc intake and serum leptin levels were inversely correlated with MİS. There was no relationship between serum leptin and dietary and serum zinc in these patients. Dietary zinc intake and serum zinc and leptin concentration were not associated with PEW. Low serum leptin levels might be the outcome rather than the cause of PEW in haemodialysis patients.

Objective The aim of this study was to determine the effect of zinc supplementation on serum levels of zinc and leptin in pediatric patients on hemodialysis (HD). Background Zinc is an essential trace element for human nutrition, and its deficiency which could result in anorexia, poor nutritional status, high rates of infections, and growth retardation. Many patients on maintenance HD exhibit zinc deficiency. Leptin may offer a tool for making clear the physiology of zinc deficiency–induced anorexia based on a relationship between zinc and leptin levels. Patient and methods The study was carried out on 42 children divided into two groups: group I included 22 children on HD who received 50-mg zinc gluconate twice daily for 90 days, and group II included healthy children as controls. Anthropometric measurements were taken, and serum zinc and leptin levels were determined the day before supplementation and at day 90 of the study. Results Serum level of zinc is decreased and serum leptin level is increased in children on regular HD. There is an increase in zinc level and a decrease in serum leptin level after zinc supplementation. Conclusion Zinc supplementation increased serum zinc level and decreased serum leptin level among males and females in the studied patients. Enhancement of serum zinc level improves appetite and stimulate food intake.

Objective Patients hospitalized in the intensive care unit are usually under stress due to severe diseases and infections, which may lead to a decrease in the level of micronutrients in them. Among micronutrients, the assessment of serum selenium and zinc status in critically ill patients is of great importance, because these two minerals play a vital role in maintaining health and immune system function. Therefore, this study examines the status of serum zinc and selenium in adults hospitalized in the special care department of Baath Hospital in 2024. Material and Methods This cross-sectional study was conducted in Besat Hospital, Hamadan, during 2024 after approval by the Ethics Committee of Hamadan University of Medical Sciences. 72 patients hospitalized in the intensive care unit of Besat Hospital were selected through convenience sampling. Inclusion criteria for the study included being over 18 years of age and having been hospitalized in the ICU for one week. Written informed consent was obtained from patients or their companions for sample collection. Serum zinc and zinc levels and other laboratory factors were measured. Also, demographic and hospital information of the patient including name, age, and sex of the patient, date of hospitalization, cause of hospitalization, severity of the disease, nutritional method, duration of nutritional interruption, and outcome of the disease were recorded in the checklist. Analyses were performed using the nonparametric Mann-Whitney test, analysis of variance, and Spearman correlation test using Stata 17.0 software at a significance level of 0.05. Results According to the results, 70.8% of the patients were male and 29.2% were female, and the mean age of the patients was 54.90 years. 80.6% of the patients were on enteral nutrition (EN) and 15.3% were on oral nutrition. According to the results, 52.8% of the patients admitted to the ICU were discharged and 47.2% died. The mean serum zinc level was 15.74 micrograms/dL, of which 3.40% were zinc deficient. The mean serum selenium level was 19.97 nanograms/mL, and it was normal in 6.98% of the patients. Also, there was no statistically significant relationship between disease severity, hospital outcome, feeding interruption, feeding method, serum zinc and selenium levels in patients admitted to the ICU (p &gt; 0.05). The mean serum zinc level based on the APACHE score showed that patients in the more severe stage of the disease had lower serum zinc levels. The mean serum zinc level in patients with APACHE score 20–30 was 71.56 micrograms/dL. The mean serum zinc level in enteral feeding patients was 74.38 and in oral feeding patients was 75.36 micrograms/dL. Also, the mean serum selenium level in enteral feeding patients was 97.25 and in oral feeding patients was 97.71 nanograms/mL. Conclusion The present study shows that zinc deficiency is significant in patients hospitalized to the intensive care unit but is not associated with disease severity, type of nutrition, interruption of nutrition, and final patient outcome. However, further studies with a larger sample size of patients are needed to draw definitive conclusions.

Objective: Patients hospitalized in the intensive care unit are usually under stress due to severe diseases and infections, which may lead to a decrease in the level of micronutrients in them. Among micronutrients, the assessment of serum selenium and zinc status in critically ill patients is of great importance, because these two minerals play a vital role in maintaining health and immune system function. Therefore, this study examines the status of serum zinc and selenium in adults hospitalized in the special care department of Baath Hospital in 2024. Material and Methods: This cross-sectional study was conducted in Besat Hospital, Hamadan, during 2024 after approval by the Ethics Committee of Hamadan University of Medical Sciences. 72 patients hospitalized in the intensive care unit of Besat Hospital were selected through convenience sampling. Inclusion criteria for the study included being over 18 years of age and having been hospitalized in the ICU for one week. Written informed consent was obtained from patients or their companions for sample collection. Serum zinc and zinc levels and other laboratory factors were measured. Also, demographic and hospital information of the patient including name, age, and sex of the patient, date of hospitalization, cause of hospitalization, severity of the disease, nutritional method, duration of nutritional interruption, and outcome of the disease were recorded in the checklist. Analyses were performed using the nonparametric Mann-Whitney test, analysis of variance, and Spearman correlation test using Stata 17.0 software at a significance level of 0.05. Results: According to the results, 70.8% of the patients were male and 29.2% were female, and the mean age of the patients was 54.90 years. 80.6% of the patients were on enteral nutrition (EN) and 15.3% were on oral nutrition. According to the results, 52.8% of the patients admitted to the ICU were discharged and 47.2% died. The mean serum zinc level was 15.74 micrograms/dL, of which 3.40% were zinc deficient. The mean serum selenium level was 19.97 nanograms/mL, and it was normal in 6.98% of the patients. Also, there was no statistically significant relationship between disease severity, hospital outcome, feeding interruption, feeding method, serum zinc and selenium levels in patients admitted to the ICU (p &gt; 0.05). The mean serum zinc level based on the APACHE score showed that patients in the more severe stage of the disease had lower serum zinc levels. The mean serum zinc level in patients with APACHE score 20–30 was 71.56 micrograms/dL. The mean serum zinc level in enteral feeding patients was 74.38 and in oral feeding patients was 75.36 micrograms/dL. Also, the mean serum selenium level in enteral feeding patients was 97.25 and in oral feeding patients was 97.71 nanograms/mL. Conclusion: The present study shows that zinc deficiency is significant in patients hospitalized to the intensive care unit but is not associated with disease severity, type of nutrition, interruption of nutrition, and final patient outcome. However, further studies with a larger sample size of patients are needed to draw definitive conclusions.

Objectives: To evaluate the associations between serum and follicular zinc levels and the response to intracytoplasmic sperm injection (ICSI). Patients and Methods: A prospective cohort study was conducted between May 2022 and May 2023 on 120 infertile women randomly selected based on specific criteria. The patients were classified into three groups according to stimulation response. Serum zinc level was measured in all patients on the day of ovarian stimulation, and follicular fluid zinc level was measured at the time of pickup. We monitored the patients to evaluate the correlation between serum and follicular zinc levels, as well as the reaction to ovarian stimulation. We assessed oocyte quality and quantity, fertilization rate, embryo quality, and clinical pregnancy rate. Results: The participants were homogenized at comparable ages. The 120 patients were classified into three groups according to the number of oocytes retrieved after ovum pick-up: four oocytes were categorized as poor responders (n = 40), 4-15 retrieved oocytes were categorized as normal responders (n = 40), and &gt;15 retrieved oocytes were categorized as hyper-responders (n = 40). The poor responders had significantly lower serum and follicular zinc levels than the others. There was a significant difference between the three groups (P value = 0.0001). There was a direct positive correlation between serum and follicular zinc levels. However, there was a moderately negative correlation between the serum and follicular zinc levels and the total gonadotropin dose. On the other hand, there was a slightly positive link between the amount of zinc in the serum and follicles and the response to stimulation in the ICSI cycle in terms of the number of oocytes, ovarian sensitivity index (OSI), follicular output rate (FORT), and follicle-to-oocyte index (FOI). There was a strong positive correlation between serum and follicular zinc levels and the fertilization rate and number of MII but a weak positive correlation with the number of MI. All significant correlations between serum and follicular zinc levels were found to be predictors of clinical pregnancy. Conclusions: The serum zinc level at stimulation day was reflected in the follicular fluid zinc levels after stimulation and at the time of ovum pick-up. Both of them predict the success of an ICSI cycle, including the response to stimulation and the pregnancy rate. The serum zinc level can also indicate cases that may progress to clinical pregnancy. It is crucial to measure the blood zinc levels of women preparing to undergo ICSI. The start of ICSI program should be delayed until the serum zinc level is optimal, as it is a predictor of the response to stimulation and the outcome of the ICSI cycle. Encouraging adequate zinc intake prevents the potential impact of altered zinc levels on the success rate of these women’s responses to stimulation.

Issue Highlights

To study the serum leptin and adiponectin levels among relatively healthy older people and their association with traditional cardiovascular risk factors. Personal medical history and blood sample were collected from 1515 older people of Guangzhou. Fasting serum glucose, lipids, leptin and adiponectin were measured. (1) In relatively healthy older adults aged 50 or above, from Guangzhou, the following data were seen: serum leptin levels (x(-) ± s) in men and women were (3.90 ± 2.36) ng/ml and (12.17 ± 2.01) ng/ml respectively; serum adiponectin levels in men and women were (5.33 ± 2.78) mg/L and (7.18 ± 2.58) mg/L respectively. (2) Serum leptin and adiponectin level increased with age. After adjusting for body mass index, the trend for serum leptin level in men (P < 0.001) and adiponectin level in women (P < 0.05) were significantly associated with age. (3) No association was found between cigarette smoking and levels of leptin or adiponectin in both men and women after adjusting for age (P from 0.09 to 0.76). (4) In both men and women, serum leptin and adiponectin levels were positively associated with waist circumference/body mass index, systolic blood pressure, low-density lipoprotein cholesterol and triglyceride (P from 0.04 to < 0.001). In men, leptin was also significantly associated with the increase of diastolic blood pressure and glucose but decreased with high-density lipoprotein cholesterol (P from 0.03 to 0.02). (5) Decreased adiponectin level was associated with increased waist circumference and triglyceride in both men and women (P from 0.003 to < 0.001) and with the increased body mass index, fasting plasma glucose as well as with decreased high-density lipoprotein cholesterol in men (P from 0.05 to < 0.001) but with increased systolic blood pressure and total cholesterol in women (P from 0.05 to 0.006). In Guangzhou city, among relatively healthy older adults aged 50 or above, their serum leptin and adiponectin levels were lower in men than in women. Serum leptin level in men and adiponectin level in women were significantly associated with the increase of age. Increased leptin and decreased adiponectin levels were associated with increased traditional cardiovascular risk factors.

Secretion of insulin is compromised in type 2 diabetes (T2DM) individuals and inadequate to accommodate for insulin resistance (IR) in peripheral tissue. Hyperleptinemia reflects leptin resistance, which is a key factor in the production of IR in T2DM patients, making leptin a potential biomarker for evaluating IR levels. The objective of the study was to assess the association of serum leptin and insulin levels among T2DM patients. This case-control research was carried out on T2DM patients. A total of 73 patients diagnosed with T2DM (the case group) and 40 healthy participants (control; group 3) were enrolled according to the American Diabetes Association (ADA) criteria. In the case group, T2DM patients were enrolled with metabolic syndrome (group 1, n = 38) or without metabolic syndrome (group 2, n = 35) according to the WHO criteria. Metabolic profiles of T2DM patients with or without metabolic syndrome were evaluated, and compare these two groups with healthy controls. The subjects of all groups were age- and gender-matched. Body mass index (BMI, P < .01), fasting (P = .0133) and postprandial (P < .01) blood sugar levels, % glycated hemoglobin (HbA1c, P < .01), and lipid profile (P < .01) were found significantly different and higher in group 1 as compared to groups 2 and 3. Serum leptin and insulin levels were found higher and significant in patients with metabolic syndrome (P < .01 for both). The values of serum leptin levels were 10.01 ± 2.7 ng/mL, 6.9 ± 2.4 ng/mL, and 4.11 ± 1.8 ng/mL, and those of serum insulin 120 ± 40.7 µIU/mL, 20.43 ± 5.2 µIU/mL, and 11.4 ± 2.5 µIU/mL in groups 1, 2, and 3, respectively. There was a positive linear correlation between BMI, blood sugar, HbA1c, serum cholesterol (TC), and triglycerides (TG) with serum insulin and leptin levels in the case group. An extremely significant correlation (R = 0.74, P < .001) was found in BMI and serum leptin level in the case group. Serum leptin and insulin levels have a positive association, with serum leptin being a significant predictor of IR syndrome (Evidence Level: 5; Technical Efficacy: Stage 3).

Mean serum zinc and copper levels were depressed in 94 children aged 1 month to 9 years who presented with meningococcal disease. The mean serum zinc level was 44 micrograms/dl (reference value 78 micrograms/dl, SD 18) and the mean serum copper level 157 micrograms/dl (reference value 159 micrograms/dl, SD 27). Nineteen patients had serum zinc levels less than 25 micrograms/dl and ten patients had serum copper levels less than 101 micrograms/dl. Serum zinc levels were significantly lower in patients who were septicaemic or in whom manifestations of severe disease such as shock, more than 20 petechiae, ecchymoses and evidence of disseminated intravascular coagulation occurred compared to those without these features. Serum copper concentrations were higher than reference levels in patients with meningitis and in less severely ill patients. Copper levels were significantly lower in patients with septicaemia, severe disease, shock, more than 20 petechiae, ecchymoses, disseminated intravascular coagulation, leucopenia and patients who died compared with patients without these features.

P-28: The utility of serum leptin and follicular fluid leptin, estradiol, and progesterone concentrations in infertility patients undergoing in vitro fertilization

Background: Hypothyroidism is associated with many biochemical abnormalities including increased serum creatinine, uric acid, and decreased serum zinc levels. Many studies were done abroad regarding serum creatinine and uric acid levels in hypothyroid patients. We designed this study in our population for evaluation and comparison of serum creatinine, uric acid, and zinc levels in hypothyroid and healthy patients.Aim & Objective of the study: The main aim of the current study is to estimate and comparison of changes in serum creatinine, uric acid and zinc levels in hypothyroid patients and healthy controls.Materials and Methods: It is an observational prospective comparative study. This study was conducted at Mamatha Academy of Medical Sciences & Hospital, Bachupally, Hyderabad, Telangana from January 2019 to July 2019. There were 50 cases and 50 controls in the age groups from 18 to 65 years. Fresh samples were taken and required tests were performed following standard protocol. Creatinine and the uric acid level was estimated by semi auto analyzer and zinc level was estimated by atomic absorption spectrophotometerResults: In the present study, mean serum creatinine and uric acid levels in cases were 3.20± 0.65 and 9.20 ± 0.47 mg/dL respectively compared to 1.04 ± 0.22 and 5.15 ± 0.77 mg/dL in controls. Mean serum zinc levels in cases were 62.50±7.50 mg/dL compared to 95.45±11.05 mg/Dl in controls. The level of serum creatinine and uric acid were significantly high and serum zinc was significantly low (p-value

Metabolic syndrome (MS) is defined as the clustering of cardiovascular risk factors and is associated with increased risk for cardiovascular morbidity and mortality [1, 2]. Oxidative stress has been hypothesized as one of the main mechanisms leading to MS [3]. Since copper, zinc and selenium are cofactors of antioxidant enzymes a lot of studies in different regions have been conducted in order to find possible differences in these trace element levels in subjects with or without MS [4-7]. However, their results were conflicting [4-7]. Therefore, the aim of the present study was to compare serum copper, zinc and selenium levels in subjects with or without MS. A total of 51 subjects (17 males/34 females, mean age ± standard deviation (SD): 69.0 ± 9.4 years, body mass index (BMI) ± SD: 33.8 ± 5.1 Kg/m2) with MS and 54 subjects without MS (22 males/32 females, mean age ± SD: 69.8 ± 9.7 years, BMI ± SD: 29.6 ± 3.7 Kg/m2), consecutively selected from the outpatient clinic of our hospital were enrolled into the study. Subjects having three or more of the criteria according to the NCEP ATP III report [8] were defined as having the MS. A thorough physical examination was performed and a detailed medical history was obtained for each participant. All measurements were performed in the morning, after 10 12 hours fast. Blood samples were drawn for measurement of serum copper, zinc and selenium levels. Serum levels of copper, zinc and selenium were determined by use of atomic mass spectrometry (ZEEnit 700, Analytical Jena, Germany). Trace element levels did not differ between subjects with or without MS: copper levels (120.7 ± 35.5 vs. 117.4 ± 39.2 μm/l, P = 0.65), zinc levels (91.5 ± 28.3 vs. 94.6 ± 23.4 μm/l, P = 0.54) and selenium levels (106.4 ± 33.8 vs. 102.8 ± 28.7 μm/l, P = 0.56). Univariate regression analysis showed that serum copper and selenium levels did not correlate with any of the MS components. Serum zinc levels correlated negatively only with glucose levels (beta = -0.50, P = 0.03) (Table 1). The present study showed that serum copper, zinc and selenium levels are not associated with the presence of MS. The Third National Health and Nutrition Examination Survey showed that serum selenium levels were similar in subjects with or without MS [5]. Furthermore, the Supplementation en Vitamines et Mineraux Antioxydants (SU.VI.MAX) trial [4], showed that serum selenium concentrations were not associated with MS. However, a recent study in Europe showed that only selenium was positively associated with a higher odd of MS in women but not in men. This association was not confirmed between copper or zinc and MS [9]. With regard to zinc the lack of association reported in our study is in accordance with the results of the SU.VI.MAX trial [4]. With regard to zinc and copper the lack of association is in accordance with the results of a study conducted in Iran [7]. In conclusion, the present study showed that serum copper, zinc and selenium levels are not associated with the components or the presence of MS. The only observed association was between serum zinc and glucose levels.

Objective: Superficial fungal infections are one of the common skin diseases. Zinc and copper are essential elements for humans, and concentrations of these trace elements may vary in various inflammatory conditions. Our aim in this study is to measure serum zinc and copper levels in patients with superficial fungal infection and to evaluate its relationship with clinical types of the disease. Materials and Methods: This study included 81 patients diagnosed with superficial fungal infection (tinea capitis, faciei, pedis, unguim, corporis, and versicolor) who applied to the Department of Skin and Venereal Diseases, Faculty of Medicine, Selcuk University. Serum zinc and copper levels were measured in all patients. Results: The mean age of the patients was 36.68 ± 17.12, and 54 (66.6%) of patients were male and 27 (33.3%) were female. There were tinea versicolor in 32 (39.5%) of the patients and other dermatophytosis infections (tinea capitis, faciei, pedis, unguium and corporis) in 49 (60.5%) of the patients. The mean serum zinc levels of the patients were determined close to the lower limit of the normal reference range with 11.41 ± 2.07 µmol / L, but zinc and copper levels were within the normal reference range (normal reference values of zinc and copper; 11-19.5 µmol / L, 80-155 µg / dL, respectively). There was no statistically significant difference in zinc and copper levels between patients with tinea versicolor and patients with other dermatophyte infections (p = 0.348, p = 0.173, respectively). In addition, there was a negative correlation between serum zinc levels and age, serum copper levels showed a statistically significant negative relationship with male sex and smoking (r = -0.359, p = 0.001; r = -0.343, p = 0.002, r = -0.283 , p = 0.033, respectively). Discussion: In our study, the majority of patients with superficial fungal infections were men. It was determined that the frequency of dermatophyte infections increased as the mean age of the patients increased. Although serum zinc and copper levels measured in patients were within the normal reference range, especially zinc levels were close to the lower limit of reference values. In addition, it was observed that various factors such as age, gender and smoking affect zinc and copper levels. As a result of these data, we think that irregularities in serum zinc and copper levels may predispose to the development of fungal infections.

To determine if hypocretin deficiency is associated with abnormally low serum leptin levels, a putative cause of increased body mass index in narcoleptics. Cross-sectional controlled study. Three hundred seventy subjects, including 111 healthy controls, 93 narcoleptic subjects with hypocretin deficiency (cerebrospinal fluid [CSF] hypocretin-1 levels < 110 pg/mL), 72 narcoleptic subjects with normal hypocretin levels, and 89 subjects with other sleep disorders After completing the Stanford Sleepiness Inventory, participants underwent spinal taps and blood sampling for measurement of CSF leptin and hypocretin-1 levels, HLA DQB1*0602 phenotyping, and serum leptin and C-reactive protein levels. Serum leptin levels were similar in narcoleptic subjects, whether hypocretin-deficient (13.2 +/- 1.7 ng/mL, mean +/- SEM) or not (13.0 +/- 1.8 ng/mL), controls (10.1 +/- 1.1 ng/mL) and subjects with other sleep disorders (11.5 +/- 1.6 ng/mL). Similarly, the CSF leptin levels and the CSF: serum leptin ratios (an indicator of brain leptin uptake) were not different between groups. Serum and CSF leptin levels were higher in women and in subjects with higher body mass indexes. Leptin brain uptake decreased in women, in the aged, and in more-obese subjects. In contrast with a presumed inhibitory effect of leptin on hypocretin-containing cells, CSF leptin levels tended to correlate positively with CSF hypocretin-1 levels. C-reactive protein was higher (4.2 +/- 0.9 mg/L) in narcoleptic subjects with hypocretin deficiency than in controls (1.4 +/- 0.3 mg/L, p = .0055), a difference still significant after adjustment on confounding factors. Our data do not support a role for leptin in mediating increased body mass index in narcolepsy. A moderate but selective increase in C-reactive protein in hypocretin-1 deficient subjects should prompt research on inflammation in narcolepsy.