Low Plasma Zinc Levels Research Articles

Plasma and red blood cell zinc in cystic fibrosis.

The objectives of this study were to measure plasma and red blood cell (RBC) zinc concentrations in patients with cystic fibrosis (CF), and examine their relationship to nutritional status and pulmonary function. Plasma and RBC zinc levels were compared in 53 CF patients ranging in age from 0.5-46 years. Their relationships to weight (% ideal weight) and forced expired volume in 1 sec (FEV(1)) (% predicted value) were examined. After excluding improperly handled specimens, RBC zinc levels in 51 patients and plasma zinc concentrations in 40 patients were included for analysis. Sixteen of 51 (31%) patients had low RBC zinc levels compared to 4 of 40 (10%) with low plasma zinc concentrations (P < 0.01). Thirteen of 38 patients (34%) in whom both values were obtained had low RBC zinc concentrations compared to 4 of 38 (11%) with low plasma zinc levels (P < 0.022). Neither low RBC nor plasma zinc levels correlated with nutritional status or lung function. In conclusion, about one third of patients with CF had low RBC zinc levels. Plasma zinc concentrations may not adequately reflect overall zinc status. This deficiency did not appear to be related to either nutritional status or lung function. The significance of low RBC zinc in CF is unknown.

Substantial Reduction in Severe Diarrheal Morbidity by Daily Zinc Supplementation in Young North Indian Children

Substantial Reduction in Severe Diarrheal Morbidity by Daily Zinc Supplementation in Young North Indian Children

Second-trimester plasma homocysteine levels and pregnancy-induced hypertension, preeclampsia, and intrauterine growth restriction

Objective: The purpose of this study was to determine whether second-trimester plasma homocysteine levels are elevated among women whose pregnancies are subsequently complicated by pregnancy-induced hypertension, preeclampsia, or intrauterine growth restriction. Study Design: Women with normal but relatively low plasma zinc levels were randomly assigned to receive zinc supplementation or placebo from 19 weeks’ gestation until delivery. Plasma homocysteine concentration and plasma and erythrocyte folate levels were determined for all available stored samples (zinc group, 231/294; placebo group, 206/286) at 26 and 37 weeks’ gestation. Among all women with available samples, pregnancy-induced hypertension (n = 12) or preeclampsia (n = 4) developed in 16 women, and 22 pregnancies were complicated by intrauterine growth restriction. Results: Mean homocysteine levels in women with pregnancy-induced hypertension and preeclampsia were similar to those of control subjects at 26 weeks’ gestation but were significantly higher at 37 weeks’ gestation. Homocysteine levels were similar between women with pregnancies complicated by intrauterine growth restriction and control subjects at both time points. Conclusion: Second-trimester plasma homocysteine concentrations do not predict the subsequent development of pregnancy-induced hypertension, preeclampsia, and intrauterine growth restriction. (Am J Obstet Gynecol 2000;183:805-9.)

Recalcitrant vaginal trichomoniasis.

As Trichomonas vaginalis infects the urethra, Bartholin’s and Skene’s glands, as well as the vagina systemic treatment for trichomoniasis is recommended. The only group of drugs with safe, proved, systemic...

The role of zinc and vitamin A in persistent diarrhea among infants and young children.

The role of zinc and vitamin A in persistent diarrhea among infants and young children.

Increased diarrhoeal and respiratory morbidity in association with zinc deficiency—a preliminary report

Plasma zinc levels, in a cohort of 116 children aged 12-59 months recently recovered from an episode of acute diarrhoea attending a community health clinic in an urban slum, were related to diarrhoeal and respiratory morbidity in the 3 month period following recovery. Children with low plasma zinc levels (< 60 micrograms dl-1) spent a significantly greater number of days with watery diarrhoea (rate ratio 1.69 (95% confidence intervals 1.03-2.78)), diarrhoea associated with fever (rate ratio 1.88 (95% confidence intervals 1.05-3.34)), and acute lower respiratory tract infections (rate ratio 2.69 (95% confidence intervals 1.64-4.38)).

Behaviour of zinc in physical exercise: A special reference to immunity and fatigue

The variations in plasma zinc levels is dependent which follows intensivity of exercise. It is clear that there are short-term effects of exercise on zinc metabolism. It has also been shown that a high level of constant exercise can have long-term effects on zinc metabolism. It has been reported that runners have lower plasma zinc levels than controls. Long term endurance training has been shown to significantly decrease resting serum zinc levels in both male and female athletes compared to sedentary controls. Severe zinc deficiency can affect muscle function. One consequence of low serum zinc levels could be a reduction in muscle zinc concentrations. Since zinc is required for the activity of several enzymes in energy metabolism it could be predicted that low muscle zinc levels would result in a reduction in endurance capacity. Zinc may also be acting directly at membrane level; changes in extracellular zinc levels have been reported to influence twitch-tension relationship in muscle. Some investigators have associated acute and exhaustive exercise with decreased immune function. The mechanisms by which physical stress modulates immune competence are complex, involving both immune and neuroendocrine messengers. Muscular fatigue is of critical importance and as such it has been the subject matter of numerous investigators. Although many factors have been identified, a clear cause remains elusive. Factors discussed include: energy supply, the accumulation of metabolites, eccentric work, immune dysfunctions, etc. Recently we have demonstrated that daily high and maintained physical training over a prolonged period of time (7 mo) provokes marked modifications in the immune system of elite sportsmen accompanied by a psychological and biochemical stress level. These data suggest that the mechanism of muscukar fatigue may be the mechanism implicated in the cause of chronic fatigue.

Effects of Oral Administration of Zinc and Diiodohydroxyquinolein on Plasma Zinc Levels of Uremic Patients

Patients with chronic renal failure often have low plasma zinc (Zn) levels. Some factors that may account for abnormal Zn metabolism in these patients are low dietary Zn intake, a specific Zn transport defect, or absence of intestinal Zn ligand. In this study Zn supplementation and a Zn-chelating drug, diiodohydroxyquinolein (DQ), were used to assess the effects of Zn intake and Zn transporters on Zn plasma levels in patients with chronic renal failure. To meet this objective, 20 uremic patients were randomly assigned to one of the following groups of treatment: group 1 received placebo; group 2 Zn sulfate (100 mg/day p.o.), group 3 DQ (80 mg/day p.o.), and group 4 received Zn sulfate plus DQ at the same dosages as in groups 2 and 3. The Zn plasma levels were measured in venous samples, before and after 1 and 2 weeks of treatment, by atomic absorption spectrophotometry. The Zn plasma levels increased in group 2 patients from 8 +/- 0.2 to 10 +/- 0.4 and 11 +/- 0.9 mumol/l by the end of the 1st and 2nd weeks of treatment, respectively. In group 4 patients, the Zn plasma levels increased even more: from 9 +/- 0.1 to 14 +/- 1.6 and 13 +/- 2.1 mumol/l respectively. The plasma Zn concentration of group 1 and 3 patients remained at basal levels. These results show that DQ, when given along with Zn sulfate supplements, causes a greater increase in plasma Zn levels than that caused by either drug given alone.

Sex hormones and trace elements in rat CCL4-induced cirrhosis and hepatocellular carcinoma

Several biochemical events accompany and mediate the development of chronic liver disease and its evolution into cancer. Low plasma zinc and high copper levels have been observed in various liver diseases, such as liver cirrhosis and viral hepatitis, while increased oestradiol levels have been documented in chronic liver damage and hepatocellular carcinoma. We administered CCL4 intragastrically to 10 female Sprague Dawley rats for 30 weeks. All animals developed cirrhosis and four also developed hepatocellular carcinoma. Plasma levels of zinc, copper and oestradiol were significantly higher in the latter group than in animals with simple cirrhosis. Progesterone, AST and bilirubin showed a trend toward significant differences whereas testosterone and ALP levels were unchanged. These findings add to the evidence that sex hormones and trace elements are involved in the process of the development of chronic liver damage and carcinogenesis.

Normal gestation after 5 years on home parenteral nutrition

A case of normal gestation after 5 years on HPN is reported. The patient had her entire jejunum and ileum and right colon resected because of gangrene and has subsisted normally on HPN ever since. From the second trimester on, her HPN formula was supplemented to meet the requirement for growth and development of the foetus. Anaemia, hypoalbuminaemia, low plasma zinc levels and jaundice became manifest in the final trimester. These responded readily to readjustment of her HPN formula. A normal baby weighing 2020 g was delivered by Caesarean section at 36 weeks. Long-term HPN, final trimester abnormalities and HPN formula adjustments are discussed.

Blood Vitamin and Trace Metal Levels in Epidermolysis Bullosa

Plasma or erythrocyte levels of ten nutrients (vitamins A, C, B12 and B6; folate; thiamine; riboflavin; zinc; copper; iron) were assayed in 73 patients with various forms of inherited epidermolysis bullosa (EB). Whereas the mean level for each nutrient was within its normal range, deficient levels were noted in individual EB subsets for selected nutrients. Notable abnormalities included low levels of plasma iron and zinc (in junctional EB and recessive dystrophic EB), vitamin C (primarily in EB simplex), vitamin A (in junctional and recessive dystrophic EB), vitamin B12 (primarily in EB simplex), and vitamin B6 (especially in recessive dystrophic EB). With the exception of low plasma iron and zinc levels in junctional and recessive dystrophic EB, however, only a minority of patients in any of the EB subsets had low levels of most of the other nutrients, and an apparent correlation with malabsorption was possible with only selected nutrients.

Hyperzincuria in IDDM women. Relationship to measures of glycemic control, renal function, and tissue catabolism.

Eighteen women with insulin-dependent diabetes mellitus (IDDM) and 15 nondiabetic women participated in a study of the relationship of zincuria to measures of glycemic control, renal function, and tissue catabolism. In the IDDM women, mean +/- SE glycosylated hemoglobin was 9.8 +/- 0.5%, and fasting plasma glucose was 189 +/- 19 mg/dl; duration of diabetes averaged 15 yr. In comparison with control women, the IDDM women excreted four times as much zinc in the urine. However, the total plasma zinc concentration was significantly higher in the IDDM than in the control women (14.7 vs. 13.4 microM). The increased urinary zinc loss in the IDDM women was not related to urine volume, urinary glucose excretion, fasting plasma glucose concentration, percent glycosylated hemoglobin, or an increased glomerular filtration rate. Total urinary protein losses were four times higher in the IDDM women than in the control women, and these urinary protein losses correlated with the urinary zinc losses (P less than .007). There was no relationship between urinary zinc and the excretion of any of the amino acids, urea, or ammonia. The results of this study show that hyperzincuria in diabetes is not associated with lower plasma zinc levels. An increased zinc absorption, decreased intestinal zinc excretion, or increased tissue catabolism may support higher plasma zinc levels.

Micronutrients status of children with down syndrome: A comparative study of the effect of megadoses of vitamins with minerals or placebo

Fifty children with Down syndrome between the ages of 5 and 16 years were included in an experimental study where half the children received a megavitamin and mineral preparation and the other half received a placebo. The children were in matched pairs for a number of physical and psychosocial variables. The study lasted 8 months and biochemical studies were done at the start of the study and repeated at 4 and 8 months. Blood plasma samples were analyzed for Zn, Cu, folate, vitamin A, carotene, B 6, retinol binding protein, and RBC transketolase and glutathione reductase and serum proteins. Generally, no gross malnutrition was evident as judged by the mean values for most of the baseline laboratory data. No change in mental status was detected between the two groups at the end of the study. The blood values except RBC folate concentrations did not increase significantly on supplementation. There appeared to be an increased prevalence of low plasma zinc levels among the subjects in both the experimental and placebo groups at baseline which seemed to improve regardless of supplementation.

Zinc status, pregnancy complications, and labor abnormalities

Maternal plasma zinc levels, red blood cell levels, and serum alkaline phosphatase activity were used as indices of zinc status in 279 pregnant women at delivery and were compared with the incidence of complications during the antenatal period and major dysfunctional labor patterns. The median values for plasma zinc, red blood cell zinc, and alkaline phosphatase were used as cutoff points to subdivide the patient population into “low” and “high” groups. Low levels of maternal plasma zinc were associated with more complications in the antenatal or intrapartum periods than maternal levels of either alkaline phosphatase or red blood cell zinc. Plasma zinc levels less than the median value were more commonly associated with mild toxemia (p = 0.02), vaginitis (p = 0.01), and postdates (p = 0.01) in the antenatal period. During the intrapartum period, low plasma zinc levels were associated with a prolonged latent phase (p = 0.05), a protracted active phase (p = 0.04), labor >20 hours (p = 0.03), second stage >2.5 hours (p = 0.01), and cervical and vaginal lacerations (p = 0.02). Low levels of maternal alkaline phosphatase were strongly associated with a history of previous stillbirth (p = 0.0005). A low maternal red blood cell zinc level was not associated with complications during either period. Since a low plasma zinc level is a valid predictor of pregnancy complications and abnormal labor, the results suggest that plasma zinc screening, as part of the patient's antenatal workup should be evaluated.

Studies with an automated kinetic assay for plasma angiotensin-converting enzyme activity and its potentiation by zinc ion

Measurement of plasma angiotensin-converting enzyme (ACE) is of value in sarcoidosis and, when specific inhibitors are prescribed therapeutically, in hypertension and heart failure. In this study a rapid kinetic assay for estimation of plasma ACE is described and assessed. In particular the effects of zinc ion have been studied. In contrast to previous reports, a marked potentiation of ACE activity by micromolar concentrations of zinc was noted. The relationship between plasma zinc concentration and ACE activity in vivo was also investigated and related to albumin concentration. The findings may have implications for interpretation of plasma ACE activity in patients with low plasma zinc levels.

Zinc Deficiency in Rats Reduces the Vasodilation Response to Bradykinin and Prostacyclin

The objective of this study was to determine the effect of zinc deficiency on the blood pressure response of rats to intravenously administered doses of two chemically distinct vasodilators, bradykinin (BK) and prostacyclin (PGI2). Immature albino rats were fed a low zinc (<1 ppm) diet based on soybean protein, a similar control diet (100 ppm) ad libitum or the control diet, pair-fed. After 3 wk, the carotid arteries were catheterized for blood pressure measurement and graded doses of the vasodilators were injected as a bolus into a branch of the femoral vein. In one experiment graded doses (0–8 µg/kg body wt) of Bk and in another graded doses (0–400 ng/kg body wt) of PGI2 were injected. In a third experiment the PGI2 doses ranged from 0 to 1000 ng/kg and, in addition to the 3-wk depletion group, two groups were repleted by feeding the control diet for 1 or 4 d. The low zinc diet induced zinc deficiency as evidenced by low rates of gain and low plasma zinc levels and significantly (P<0.05) decreased the blood pressure response (Emax) to both BK and PGI2. Pair feeding had no significant effect on the response; the Emax values as determined by double-reciprocal plots of the data were unchanged by the quantity of control diet consumed. Short-term repletion did not restore the PGI2 response to control values. The data are interpreted as suggesting that zinc deficiency impairs the function of vasodilator receptors in the rat vasculature.

Do Women Using Oral Contraceptive Agents Require Extra Zinc?

Numerous clinical studies conducted during the 1970s revealed that users of oral contraceptives (OCs) had lower plasma zinc levels than nonusers. Although more recent studies have failed to confirm such an effect the issue of whether OC users require extra zinc in their diets has been given serious attention. It was thought that the fall in plasma zinc could reflect a reduction in tissue zinc status due to changes in zinc absorption excretion or tissue turnover. Taken together the research findings suggest that OCs may alter the postabsorptive utilization of zinc. Circulating zinc levels may be reduced while some tissue levels may be increased. In addition the release of zinc from tissues may be depressed in OC users. However there is no evidence that these changes alter the dietary zinc requirement. Estimates of endogenous zinc losses are not increased by OC use an increased incidence of clinical signs of zinc depletion (e.g. diarrhea skin lesions and infection) is not evident in OC users and zinc-dependent functions are not compromised by OC use. Finally there is no evidence that OC use before conception has a negative effect on zinc utilization during subsequent pregnancy and lactation.

Natural killer cell activity in post-necrotic cirrhotic patients as related to hepatitis-B virus infection and plasma zinc levels

In view of the suggested physiological role of natural killer (NK) cells in immunosurveillance and defence against viral infections, we have investigated the relationship between hepatitis B virus (HBV) infection and NK activity against K-562 cells in patients with post-necrotic cirrhosis. Overall, the NK activity in cirrhotic patients did not differ from age- and sex-matched controls. However, cirrhotic males with evidence of HBV infection with or without HBs antigenemia tend to have lower NK activity than controls. Cirrhotic males without evidence of HBV infection do not differ from controls. Such a trend was not observed in the female cirrhotic patients examined. In addition significantly reduced NK activity was observed in cirrhotic patients with low plasma zinc levels. This relationship is of interest because of the known association between zinc deficiency and various immunodeficiencies.

Zinc status of infants with fetal alcohol syndrome.

Plasma and urinary zinc levels were examined in 6 infants with fetal alcohol syndrome to determine whether zinc deficiency, if present in fetal alcohol syndrome patients, is secondary to an increased urinary zinc excretion. Six infants born to nonalcoholic mothers served as controls. There was no significant difference in creatinine clearance, urine flow rate, or plasma albumin concentrations between the two groups. Plasma concentrations of zinc were significantly lower in fetal alcohol syndrome patients (62.5 +/- 2.8 micrograms/dl) in comparison to controls (71 +/- 1.8 microgram/dl), (p = 0.0001). Urinary excretion of zinc in fetal alcohol syndrome patients averaged 646 +/- 125 micrograms/24 h, significantly higher than in control subjects (76.6 +/- 22 micrograms/24 h), (p = 0.0001). Thus (1) lower plasma zinc levels are present in infants with fetal alcohol syndrome and (2) increased urinary zinc excretion appears to be responsible for decreased plasma zinc concentrations.

A Formula for Correcting Plasma Zinc Levels against Protein Concentration

Plasma zinc and total protein concentrations were measured in 13 normal volunteers, before and after a five-minute occlusion of the antecubital vein with a sphygmomanometer cuff. The percentage increment before and after five minutes of venous occlusion was 10.2 ± 4.7% for total protein and 8.8 ± 6.0% for zinc concentration. Both these differences were statistically significant (p &lt; 0.001). We propose an equation for correction of plasma zinc levels according to concentration of total proteins. Using this equation the corrected values of plasma zinc before and after 5 minutes of venous occlusion were similar, that is, 12.33 ± 1.94 and 12.20 ± 2.05 μmol/l. In addition we found that of seven hypoproteinemic patients on continuous ambulatory peritoneal dialysis (CAPD) who had low plasma zinc levels compared to normal (uncorrected for protein concentration) controls, only two had “true” hypozincemia when their plasma zinc was corrected against protein using this formula and compared to normals (corrected for protein) controls. The paper discusses the clinical usefulness of this adjustment of measurements of plasma zinc concentration.