Effects of Zinc Supplementation on Serum Zinc Concentrations and Cellular Immune Function in Older Adults with Marginal Zinc Status: A Randomized Controlled Pilot Trial

Background: Persistent diarrhea (PD) is a common disease in childhood worldwide. Clinical studies suggested that zinc supplementation is useful in most PD children. However, the relationship between the zinc and immune status of the PD children has not been reported. Objective: To examine serum zinc levels and immune status in 6 to 24 months old children with PD before and after 120 days of oral zinc supplementation and to evaluate the effects of zinc supplementation on serum zinc levels and immune status in PD children. Methods: A case control study was carried. Fifty-eight children aged 6 to 24 months with PD were enrolled. 58 patients were divided into two groups, zinc group (28 cases) and control group (30 cases). Laboratory investigation of serum zinc levels, Lymphocyte subsets (CD3+%, CD4+%, CD8+% and CD4+/CD8+ ratio) and immunoglobulins (IgG, IgA and IgM) levels was carried out in all these patients once at enrollment and again after 120 days of treatment. Results: Before treatment, the serum zinc concentration was 4.37 ± 1.23 μmol/L in zinc group and 4.42 ± 1.45 μmol/L in control group (P > 0.05). However, after treatment, the serum zinc concentrations in the zinc group were significantly higher (8.81 ± 2.56 μmol/L), as compared to the control group (4.12 ± 1.02 μmol/L) (P P > 0.05) before giving treatment. However, after 120 days of treatment, in the zinc group there was a significant rise in CD4+% (53.60 ± 5.78). The CD4 was significantly higher in the zinc group as compared to the control group (44.73 ± 4.39) (P P P > 0.05). Regarding immunoglobulins, there were no significant differences between zinc and control group in IgG, IgA and IgM levels (P > 0.05) at the time of enrollment (before treatment). However, after treatment, the mean IgG levels in zinc group and control group were 6.36 ± 0.95 g/l and 5.67 ± 0.74 g/l, respectively, P P < 0.05) but no significant differences in IgA levels were evident between the two groups after treatment. Conclusion: Administration of oral zinc supplement improved both serum zinc levels and immune status in children with PD. Zinc supplementation should be administered as adjunctive therapy for PD children.

Zinc supplementation and stunted infants in Ethiopia: a randomised controlled trial

The effects of zinc supplementation on serum zinc and cholesterol concentrations in hemodialysis patients

Effect of zinc supplementation on serum zinc concentration and T cell proliferation in nursing home elderly: a randomized, double-blind, placebo-controlled trial

Patients undergoing hemodialysis often require zinc supplementation owing to hypozincemia, which may reduce serum copper concentrations. However, hypoxia-inducible factor–prolyl hydroxylase inhibitors (HIF-PHIs), which are used to treat renal anemia, have been reported to increase serum copper. Therefore, this study investigates the effectiveness of a combination of HIF-PHIs and zinc for the stabilization of serum copper and zinc concentrations during zinc supplementation for patients undergoing hemodialysis with renal anemia and hypozincemia. The serum zinc and copper concentrations were retrospectively compared over an 8-month period in 20 patients being administered roxadustat (an HIF-PHI) and 20 controls. The changes in concentrations were tracked in participants taking roxadustat who initiated or increased zinc supplementation. The serum zinc concentrations of the participants were significantly higher (p < 0.001) during zinc supplementation, regardless of roxadustat administration. Post-roxadustat, the serum copper concentrations were significantly higher than those pre-roxadustat or in non-roxadustat-treated participants, irrespective of zinc supplementation (p < 0.005). Even post-roxadustat, the serum copper concentrations were significantly lower, with no increase during zinc supplementation (p < 0.040). When zinc supplementation was initiated or increased in participants taking roxadustat, copper and zinc concentrations were normalized. Thus, combining zinc supplementation with roxadustat prevents both an excessive increase in serum copper and a decrease in serum zinc.

Older subjects have a high risk of developing zinc and copper deficiencies. To determine the prevalence of copper and zinc deficiencies in adults aged over 60 years, living in Metropolitan Santiago. Analyses were performed using anonymous serum samples from older subjects living in Santiago, Chile, who participated in the multicenter project SABE. Of the studied subjects, 49.3% had enough left over serum to measure serum zinc and copper concentrations by atomic absorption spectrometry. A total of 444 men and 198 women were studied. A positive correlation between serum zinc and copper was found in both women (r = 0.44, p < 0.001) and men (r = 0.48, p < 0.001). There were no differences in serum zinc concentration by sex and age. The prevalence of subnormal serum zinc valúes was 66.9% in women and 66.7% in men. Women had a significantly higher serum copper valúes than men (p < 0.02) and there were no differences by age. Prevalence of subnormal serum copper valúes was higher in women than in men (32.9 and 23.7% respectively, p < 0.05). Women had significantly higher copper I zinc serum ratio than men (p < 0.001). Older people living in Metropolitan Santiago have a high prevalence of copper and zinc deficiencies.

Pseudogout, or calcium pyrophosphate deposition disease (CPPD), is a common form of inflammatory arthritis in older adults. Although metabolic/endocrine factors such as magnesium deficiency and hyperparathyroidism are established risk factors, the role of zinc remains unclear. Since zinc deficiency is prevalent among older adults and zinc influences inflammation control and cartilage metabolism, its potential contribution to CPPD warrants investigation. This study aimed to explore the potential association between zinc deficiency and CPPD in older adults undergoing rehabilitation. We report a case series of five women aged 82-92 years undergoing rehabilitation who developed CPPD. Affected joints included the knees, ankles, wrists, and metatarsophalangeal joints. All patients had serum zinc levels below the reference range (49-67 µg/dL), while other minerals were generally within normal limits. In our study, zinc deficiency was independent of the general malnutrition status. Recurrent CPPD occurred in two patients, particularly those with lower functional status during rehabilitation. This exploratory, hypothesis-generating case series could suggest a potential link between hypozincemia and CPPD in older adults. Lower functional status may also be related to CPPD attacks. While limited by sample size, these findings highlight a clinically relevant hypothesis that warrants further investigation in larger prospective studies.

BackgroundHuman Immunodeficiency Virus (HIV) infection has been frequently associated with zinc deficiency and anemia. Zinc deficiency can cause significant impairment in both adaptive and innate immune responses that may cause systemic inflammation and leading to anemia. However, research on the role of zinc in anemia among HIV‐infected persons is limited. We assessed the association between serum zinc and hemoglobin concentrations in a cohort of HIV‐infected persons.MethodsA cross‐sectional survey was conducted among 311 HIV‐positive people (177 men and 134 women) aged 20 to 60 years residing in Kathmandu, Nepal. Anthropometric and blood pressure examinations were performed and information on medical history, food habits, physical exercise, alcohol, smoking, and types/duration of anti‐retroviral therapy were collected. Fasting blood samples were taken for immunological, lipids, glucose, inflammation, and micronutrient markers evaluations. Serum zinc concentrations were measured by the atomic absorption method. The relationship between serum zinc and hemoglobin concentrations were assessed using multiple linear regression analysis with adjustment for potential cardiovascular, life‐style, and HIV‐related clinical confounding factors.ResultsThe means of serum zinc concentrations in men and women were 75.62 (16.27) μg/dL and 72.63 (10.05) μg/dL, respectively and of hemoglobin concentrations were 12.92 g/dL (2.24) and 11.71 g/dL (2.21), respectively. Serum zinc concentrations were positively associated with hemoglobin concentrations (β = 0.02; P = 0.016) in total participants. The relationship remained significant only in men (β = 0.02; P = 0.006) but not in women (β = −0.007; P = 0.719).ConclusionSerum zinc concentrations were positively associated with hemoglobin concentrations in HIV‐infected persons. Further prospective study to confirm the role of zinc in anemia among HIV‐infected persons is warranted.Support or Funding InformationThis study was partially supported by the Grant‐in‐Aid for Young Scientists (B) (22790581), Japan Society for the Promotion of Science, The Ministry of Education, Culture, Sports, Science and Technology, Japan; Waseda University Grants for Special Research Projects, General Grant/Ippan Josei, Japan, (2012A‐101); and by the Grant for Research on Global Health and Medicine (No. 21A‐2) from the National Center for Global Health and Medicine, Japan. The funding agency had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Zinc supplementation as adjunct therapy in children with measles accompanied by pneumonia: a double-blind, randomized controlled trial

Serum Zinc Concentrations in the US Population Are Related to Sex, Age, and Time of Blood Draw but Not Dietary or Supplemental Zinc

Association between urinary zinc excretion and lymphocyte dysfunction in patients with lung cancer

Effects of Zinc Supplementation on Serum Zinc and C-Reactive Protein Concentrations in Hemodialysis Patients

In zinc deficiency, the function of leukocytes is impaired. However, the results of studies on the zinc concentration of blood cells in zinc deficiency are conflicting, probably in part because of technical and analytical problems. The aim of this study was to investigate, under standard conditions, the uptake of 65Zn-labeled zinc by blood cells, taken from zinc-deficient rats and from rats in which an inflammation is induced. In both conditions, the serum zinc concentration is reduced. In clinical practice, this makes it difficult to determine whether the decrease in serum zinc is the result of a real or an apparent zinc deficiency. In stress, like an inflammatory disease, the decrease of zinc reflects an apparent zinc deficiency because of redistribution of serum zinc into the liver and because of decrease in serum albumin concentration. Over 70% of the serum zinc is bound to albumin. Blood cells from zinc-deficient and control rats were isolated using a discontinuous Percoll gradient and incubated under nearly physiological conditions in a 65Zn-containing medium. A significant increase in the in vitro uptake of 65Zn-labeled zinc by the blood cells of zinc-deficient rats was seen: erythrocytes 1.3, mononuclear cells 2.0, and polymorphonuclear cells 2.6 times the control values. During inflammation, no change in 65Zn-labeled zinc uptake by erythrocytes and mononuclear cells was demonstrated after 2 d, although the serum zinc and albumin concentrations were decreased, but a small but significant increase in zinc uptake by polymorphonuclear cells was observed. This study of 65Zn uptake in vitro under standard conditions may prove of value for distinguishing in patients real zinc deficiency from apparent zinc deficiency owing to, e.g., stress, although additional experiments should be performed.

Abnormal serum zinc and copper concentrations in pregnant women have been associated with a number of maternal and foetal complications during pregnancy and delivery. However, the results of previous studies are contradictory and few large scale studies have been reported. In this study we measured serum zinc and copper concentrations in maternal and umbilical cord blood from 500 Danish mothers at delivery, looking for an association between serum zinc and copper levels and various maternal and foetal complications. Preterm infants (n = 30) had significantly lower serum copper concentrations than reference infants (n = 346) (p = 0.01), whereas there was no difference in serum zinc concentrations. Mothers of preterm infants (n = 34) did not differ in serum zinc or copper concentrations from reference mothers (n = 220). Small for date infants (n = 37) and mothers of small for date infants (n = 47) had higher serum copper levels than reference infants and mothers (p = 0.02 and p = 0.04, respectively), whereas there was no difference in serum zinc concentrations. Serum zinc and copper concentrations in malformed infants (n = 14) and their mothers (n = 17) did not differ from concentrations in reference infants and mothers. Serum zinc and copper concentrations in mothers with various other complications during pregnancy and delivery did not differ from values in mothers with normal pregnancies and deliveries.

The study was conducted on 15 Holstein-Friesian cows aged between 3 and 5 years kept in the free grazing conditions in summer. The samples of milk were taken twice a year for monitoring subclinical mastitis. In addition to milk samples, the blood samples were taken to determine the concentration of zinc in serum. The occurrence of subclinical mastitis in high yielding cows was estimated based on the values of zinc concentration in blood serum and somatic cells of milk. By analyzing the samples of blood serum, a variation in the concentration of zinc in blood serum was noted depending on the season. Somatic cell count in the spring and autumn period in average was over 400.000/ml milk. Based on statistical analysis, the correlation test, it was concluded that the concentration of zinc in blood serum of cows in the experimental group had no significant effect on the somatic cells count in milk.