Mean Serum Zinc Concentration Research Articles

Patients with dermatitis herpetiformis, acne, psoriasis and Darier's disease have low epidermal zinc concentrations.

Zinc concentration was determined in epidermis, papillary dermis and serum in patients with dermatitis herpetiformis, acne or psoriasis and in two small groups of patients with ichthyosis vulgaris and Darier's disease. Except in ichthyosis vulgaris the zinc level in epidermis was decreased in all these disorders. The mean serum zinc concentration was, however, significantly decreased only in men with dermatitis herpetiformis. There was no correlation between the concentration of zinc in epidermis or dermis and that in serum. The decreased epidermal zinc concentration indicates that many of the patients have a zinc deficiency in spite of a "normal" serum zinc value. Supplementation of zinc might therefore be of value in patients with these disorders.

Serum alkaline phosphatase and serum zinc concentrations in preterm infants with rickets and fractures.

This study aimed to determine the longitudinal changes in serum zinc concentrations and the relationship between serum alkaline phosphatase (AP) activity and serum zinc concentrations in small preterm infants. The total serum AP and serum zinc concentrations were determined serially at 3, 6, 9, and 12 months in 72 infants with mean (+/- SEM) birth weights of 1000 +/- 29 g and gestational ages of 28.6 +/- 0.3 weeks. Twenty-four of 72 infants had radiographic evidence of rickets and/or fractures (R/F). In infants with R/F, group mean (+/- SEM) serum AP (371 +/- 42 U/L) and serum zinc (12.5 +/- 1.0 mumol/L) concentrations were significantly higher at 3 months compared with infants in the non-R/F group (193 +/- 12 U/L and 9.6 +/- 0.3 mumol/L, respectively). During the study, the serum AP concentrations decreased, and the serum zinc concentrations increased; both stabilized after 6 months. The serum AP concentrations were not related to the serum zinc concentrations. We speculate that in preterm infants, an increased bone turnover and a release of tissue (bone) zinc may contribute to the higher group mean serum AP and serum zinc concentrations at the time of diagnoses in infants with R/F compared with those infants without R/F.

Infection and immunity in Down syndrome: A trial of long-term low oral doses of zinc

To determine whether orally administered zinc supplements could correct the abnormal humoral and cell-mediated immunity of Down syndrome, we randomly assigned 64 children with Down syndrome, aged 1 to 19 years and living at home, to receive either zinc gluconate or placebo daily for 6-month periods with crossover from one regimen to another. Control subjects were siblings and age-matched, unrelated children. Serum zinc, copper, and measures of immune system competence were tested at 3- or 6-month intervals. Parents kept daily logs of clinical symptoms such as cough and diarrhea and of physician visits. Mean serum zinc concentrations increased to about 150% of baseline during zinc supplementation, but we found no effect on serum levels of copper, immunoglobulins, or complement; on lymphocyte number or subset distribution; or on in vitro response to mitogens. Children with Down syndrome who were receiving zinc had a trend toward fewer days or episodes of cough and fever but no change in other clinical variables. Long-term, low-dose oral zinc supplementation to improve depressed immune response or to decrease infections in children with Down syndrome cannot be recommended.

Zinc status of children with sickle cell disease: relationship to poor growth.

We examined the zinc status of 80 children with sickle cell disease (SCD) and 44 disease-free sibling controls aged 3 to 18 years. For both patients and controls, variations in serum zinc by age, type of hemoglobinopathy, and growth status were measured. The mean serum zinc concentration of patients was significantly lower than for controls (77.8 +/- 9.9 vs. 82.2 +/- 9.8 micrograms/dl, mean +/- 1SD, P less than .05). Serum levels of alkaline phosphatase (AP) and retinol-binding protein (RBP), two zinc-dependent proteins, were also lower among patients (AP: 171 +/- 66 vs. 243 +/- 97 IU/L, P less than .001; RBP: 1.92 +/- .9 vs. 2.77 +/- .9 mg/dl, P less than .001). Patients greater than or equal to 12 years of age (n = 34) had significantly lower zinc levels than those less than 12 years (74.5 +/- 8.4 vs. 80.3 +/- 10.3 micrograms/dl, P less than .01), and children with homozygous SCD (Hb SS, n = 55) had a more pronounced deficiency than those with a variant hemoglobinopathy (76.3 +/- 8.9 vs. 81.5 +/- 11.5, micrograms/dl, P less than .05). Patients classified as having "poor" growth (height-for-age less than 5th percentile, n = 24) had a lower serum zinc level than those with "normal" growth (72.8 +/- 8.0 vs. 79.8 +/- 10.0 micrograms/dl, P less than .01). Dietary intake data, body mass index, and serum total protein and albumin levels were similar for patients and controls, suggesting that zinc deficiency in SCD does not relate to inadequate dietary intake. The origin of low serum zinc levels in children with SCD is more likely to relate to factors such as increased urinary zinc excretion, chronic intravascular hemolysis, and/or zinc malabsorption.

Serum zinc response in thermal injury.

Zinc is an essential trace element required for RNA and DNA synthesis and the function of over 200 zinc metalloenzymes. After surgery or trauma, the serum zinc concentration usually decreases. The magnitude and duration of this hypozincemia after thermal injury are unclear, as are mechanisms for this hypozincemia. In this study we evaluated, over the duration of their hospital course, serum zinc concentrations in 23 thermal injury patients. The initial mean serum zinc concentration was significantly depressed (42 +/- micrograms/dl; normal 66-110 micrograms/dl). By the second week of hospitalization, serum zinc concentrations gradually increased into the normal range in the majority of patients. Mechanisms for this hypozincemia were evaluated. Decreases in the serum zinc concentration did not correlate with increased urinary zinc excretion; thus increased urinary zinc excretion was an unlikely mechanism for the observed hypozincemia. Values for albumin, the major zinc binding protein in serum, generally were inversely correlated with the serum zinc concentration. Thus, hypoalbuminemia could not explain the decreased serum zinc concentration. Certain cytokines such as interleukin-1 are known to cause a decrease in the serum zinc concentration as part of the acute phase response. Therefore, we measured serum C reactive protein concentrations as an indicator of the acute phase response. Thermally injured patients initially had markedly elevated C-reactive protein levels which gradually decreased during hospitalization. We suggest that the initial hypozincemia observed in thermally injured patients may be a reflection of interleukin-1 mediated acute phase response. Whether one should vigorously attempt to correct this initial marked hypozincemia requires further investigation.

A study of zinc status of elderly institutionalized patients.

In a study of zinc status in the elderly, the mean serum and leucocyte zinc concentrations were found to be significantly lower in continuing-care patients compared with elderly people living in the community. The mean daily dietary intakes of zinc, protein and fibre did not differ between the two groups. Serum zinc levels were found to correlate with serum albumin levels. No significant relationship was found between the mean serum or leucocyte zinc concentrations of patients and either their mental status or the presence of skin pressure damage, leg ulcers or unhealed wounds.

Zinc concentrations in maternal blood during pregnancy and post partum, in cord blood and amniotic fluid.

Zinc deficiency was reported to lead to congenital malformations and abnormal fetal development, and zinc concentration in amniotic fluid has been found to be correlated with fetal birth weight. In the present study, zinc concentrations were estimated in 8 pregnant women at 15 gestational weeks and 68 pregnant women at term. Maternal serum zinc concentration in early and term pregnancy was significantly lower than that of the non-pregnant controls (mean values +/- SEM being 9.8 +/- 0.6, 9.3 +/- 0.2, and 11.5 +/- 0.3 mumol/l, respectively). Maternal serum zinc concentrations reached the non-pregnant level by one week post partum. The mean serum zinc concentration in cord blood was 14.4 (+/- 0.4) mumol/l. The zinc concentration in the amniotic fluid was very low both in early pregnancy and at term 1.1 and 0.8 mumol/l, respectively, and no correlation was found to the birth weight. Low serum zinc content in pregnant women occurs as a normal feature and congenital malformation as a consequence of disturbed zinc metabolism is probably only to be seen in instances of extreme zinc deficiency in conjunction with malnutrition.

Copper, zinc and superoxide dismutase levels in cord blood

Serum copper and zinc concentrations and SOD activities in the cord blood of preterm and term infants were determined. Neither the mean cord serum copper and zinc concentrations nor the cord blood SOD activities were significantly different between preterm and term infants. Cord blood SOD activities were not correlated with either serum copper or serum zinc concentrations. Cord serum copper concentrations were negatively correlated with gestational age, birth weight and head circumference.

Anorexia, serum zinc, and immunologic response in small cell lung cancer patients receiving chemotherapy and prophylactic cranial radiotherapy.

Anorexia is a major clinical problem for patients with certain types of cancer. The specific mechanisms that result in this spontaneous decline in food intake remain unknown. In noncancer populations, zinc has been shown to play a role in maintaining normal appetite, taste acuity, and immunocompetence. One purpose of this prospective, longitudinal study of cachexia in ten males with small cell lung carcinoma was to determine if anorexia (caloric intake), perceived taste changes, zinc intake, and impaired cellular immunity were associated with serum zinc concentrations. The average daily caloric intake declined 490 kcal from time of diagnosis to seven months after diagnosis (mean caloric intake = 72% of RDA). Daily zinc intake ranged from 6.5 to 25.4 mg over the seven months. During this period, the mean serum zinc concentrations, although low (71 micrograms/dl), remained within the normal range. The average weight declined from 81.7 to 74.1 kg. There was no identifiable pattern of perceived taste changes; most of the perceived changes were recorded during the period coinciding with prophylactic cranial radiation. At the initial testing, four of nine subjects were anergic to a battery of skin test antigens (mumps, candida, tuberculin purified protein derivative). The only subject who remained responsive to two antigens throughout the study remained alive at 12 months. Caloric intake was inadequate to maintain weight. While zinc intake was low, low normal serum zinc concentrations were maintained; thus in this sample, serum zinc does not appear to be the anorexigenic factor.

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

Patients with bronchogenic carcinoma often have low serum zinc concentrations and sometimes have markedly elevated renal zinc losses. Since normal zinc metabolism is critical for the proper function of T lymphocytes and natural killer cells, the effect of zinc status on T cell phytohemagglutinin response and peripheral blood lymphocyte natural killer cell activity was studied in patients with lung cancer. Mean (± SEM) serum zinc concentration in 75 patients with cancer was 67.4 ± 2.2 μg/dl versus 96.0 ± 8.0 μg/dl for normal subjects. Patients with low serum zinc levels (less than 70 μg/dl) had significantly higher urine zinc excretion than patients with normal serum zinc levels (1,385 ± 240 μg per 24 hours versus 392 ± 107 μg per 24 hours) (p <0.001). This pattern of zinc concentrations (i.e., low serum zinc in combination with high urine zinc) is typical of patients with mild zinc deficiency, and suggests that a mild chronic zinc deficiency state was present in some of these patients. When lymphocyte data were analyzed according to serum zinc concentrations and urinary zinc excretion, low serum zinc concentration and high urine zinc excretion both correlated with depressed T cell phytohemagglutinin response (p <0.005 and p <0.001, respectively). For instance, mean maximal phytohemagglutinin response in patients with urinary zinc excretion of more than 700 μg per 24 hours was 22,132 ± 3,201 cpm (n = 14) compared with 68,130 ± 6,850 cpm for patients with normal zinc excretion (n = 7). Peripheral blood lymphocyte natural killer cell activity did not correlate with either serum or urine zinc values. Oral zinc sulfate (220 mg, three times daily for six weeks) was then administered to patients with hyperzincuria (mean = 992 μg per 24 hours). Zinc-supplemented patients had normalization of T cell phytohemagglutinin response after zinc therapy, whereas control patients demonstrated continued T cell dysfunction. Natural killer cell activity did not change in either group during the study period. These data suggest that a mild subclinical zinc deficiency state may exist in some patients with lung cancer and may be an important cause of abnormal T cell function. Furthermore, zinc supplementation may be useful to improve lymphocyte function in selected patients. Whether zinc supplementation would alter the course of the disease or the patient's prognosis is presently unknown.

Serial changes in selected serum constituents in low birth weight infants on peripheral parenteral nutrition with different zinc and copper supplements

One hundred and five infants of birth weight 2000 g or less who received peripherally administered parenteral nutrition for periods of three or more weeks, were randomly assigned to groups receiving different amounts of zinc and copper supplement. The blood concentrations of zinc, copper, retinol-binding protein, prealbumin, alkaline phosphatase and aspartate transaminase were followed weekly. Mean serum zinc, retinol-binding protein and prealbumin declined significantly over time while alkaline phosphatase rose. Only the group receiving the highest zinc supplement maintained a mean serum zinc concentration within the normal range at seven weeks. No difference in the protein or enzyme concentrations was found between the different zinc supplement groups. No difference was seen in serum copper or ceruloplasmin between copper dose groups although one intravenous supplement was double that of the other.

Serum zinc and urinary zinc excretion of trauma patients

Eight male patients who had suffered severe trauma were longitudinally monitored for serum zinc, total protein, alkaline phosphatase and urea nitrogen. Daily urinary zinc and creatinine excretion were also measured. The trauma patients were followed from less than 24 hours to 240 hours after admission. The initial mean serum zinc concentration at less than 24 hours after admission was significantly lower (P<.05) than the concentrations at 97–168 and 169–240 hours post admission. The initial mean serum zinc of 41 ug/dl was also lower than the mean of 87 ug/dl observed in twelve healthy males. By 240 hours after admission 6 of the 8 patients had serum zinc values comparable to the healthy males. Serum zinc concentration was significantly correlated (P <.05) with serum alkaline phosphatase but not with serum total protein, albumin or urea nitrogen. An increase in urinary zinc excretion compared to that observed in the twelve healthy men did not occur until 97–168 hours post admission. An increase in urinary creatinine excretion also occurred at this time period, which suggests that the increased loss of zinc was due to muscle catabolism. The initial decrease in serum zinc below values observed for the healthy males was not accompanied by a decrease in serum albumin or an increase in urinary zinc excretion.

Copper and zinc levels in the blood of Thoroughbreds in training in the United Kingdom

The concentration of copper and zinc in the blood and sera of over 300 Thoroughbreds in training was determined by atomic absorption between February 1979 and July 1981. The mean (+/- sd) concentration of copper in the serum of stabled Thoroughbreds (79 +/- 16 micrograms/dl) was significantly (P less than 0.0001) lower than that of those at grass (101 +/- 26 micrograms/dl), whereas the mean serum zinc concentration of stabled Thoroughbreds (170 +/- 54 micrograms/dl) was higher than that of those at grass (111 +/- 45 micrograms/dl). No such differences were observed in whole blood. There were marked differences in the mean serum copper and zinc concentrations in the blood of Thoroughbreds housed in different stables. Significant changes occurred throughout the year in the mean values from individual stables. However, there were no such changes in the mean values of the total population. The observed differences were probably caused by dietary variations. The results emphasise the need to establish reference values related to diet if copper and zinc levels in blood are to be used for interpretative purposes.

Zinc and T-lymphocyte function in hemodialysis patients

Thirteen patients maintained on long-term hemodialysis were studied with respect to their serum zinc concentration and T-lymphocyte response to phytohemagglutinin. Six patients demonstrated depression of T-cell mitogen response, while seven patients demonstrated a normal response. The mean serum zinc concentration of the patients with abnormal response was lower than those patients with a normal response (63 ± 11 versus 75 ± 14 g/dl, respectively). There was no significant correlation between an individual's serum zinc concentration and T-cell response (r = 0.16). Five patients whose T-cell responses were depressed were given intravenous zinc chloride during each dialysis run for 6 wk (10 mg intravenous zinc, three times weekly) and were evaluated before and after therapy. All five patients remained anergic to four skin test antigens. Only one patient (who had the lowest pretreatment serum zinc concentration at 48 g/d1) demonstrated a significant improvement in mitogen response after zinc therapy. Although dialysis patients commonly have low serum zinc concentrations and depressed mitogen response, in our patients these two findings were generally unrelated. Additionally, supplemental zinc did not change base-line measurements of T-lymphocyte mitogen response in four of five patients studied.

Zinc Utilization in Pregnant and Nonpregnant Women Fed Controlled Diets Providing the Zinc RDA

Eight pregnant (P) women in their third trimester and 10 nonpregnant (NP) women participated in a 21-day confined metabolic study. The participants were fed semipurified liquid diets providing 20 mg zinc/day. Apparent zinc balance was calculated and parameters of zinc status assessed. Even though an adequate amount of a readily available form of zinc was fed, the P women consistently maintained lower mean serum zinc concentrations than the NP controls (69 µg/dl vs. 97 µg/dl). Although the dietry zinc intake was constant throughout the study, most subjects' salivary zinc levels varied greatly. In this study, salivary zinc concentration was not a sensitive indicator of zinc intake. There were no differences in the concentration of zinc in hair between the P and NP groups; mean values ranged from 180–220 ppm. In both groups, approximately 95% of the measured zince output was lost in the feces and only 5% excreted in the urine. The P women tended to excrete more zinc in their urine than the NP women (900 µg/day vs. 650 µg/day), but they excreted less zinc in their feces. The P women demonstrated a greater apparent zinc retention than the NP women (1.9 ± 0.6 vs. 0.9 ± 0.5 mg/day). This difference, however, was not statistically significant (P > 0.05).zinc zinc status zinc excretion zinc absorption human balance study pregnancy

Zinc concentration in hair and serum of pregnant women in Belfast

Serum and hair levels of zinc were estimated in 28 nonpregnant women and 60 pregnant women at 20 to 22 wk of gestation (2nd trimester), 36 to 37 wk of gestation (3rd trimester), and 3 days postpartum. The mean serum zinc concentration was significantly lower in pregnant subjects compared to the nonpregnant and showed a continuous significant decline with increasing duration of pregnancy. Mean hair concentration in the various stages of study of pregnant women and nonpregnant subjects were comparable. However, a progressive decrease in hair zinc concentration was noted with advancing pregnancy; the decline between 2nd and 3rd trimester was statistically significant. Mean serum zinc concentration in umbilical cord blood was approximately twice that in maternal blood. Smoking had no effect on zinc concentration, while the effect of alcohol and parity was inconsistent. Oral contraceptive usage before conception appeared to lower hair zinc concentration and increase serum zinc concentration during pregnancy. Two subjects had spontaneous abortion and these had serum zinc in the lower range and hair zinc values in the higher range. The remaining 58 subjects gave birth to normal neonates weighing 2500 to 4500 g. The study revealed that zinc nutrition of the majority of the expectant mothers was adequate for normal growth and development of fetus. The possible cause and implication of observed changes in zinc metabolism are discussed.

Zinc and copper nutriture of women taking oral contraceptive agents

A cross-sectional and follow-up study of young women taking oral contraceptive agents revealed a marked increase in serum copper levels. This increase was significant after the taking of oral contraceptive agents for 3 months. No significant effect of oral contraceptive agents on serum zinc and hair levels or copper were observed. There was no correlation between duration of oral contraceptive agent therapy and zinc or copper concentrations in serum or hair. Serum and hair concentration of zinc or copper were also not significantly correlated.

Serum zinc levels in lung cancer patients.

Serum zinc concentrations were determined in 26 extensive squamous cell lung cancer patients and were tested for correlations with survival, response to therapy, nutritional status indices, and various host defense characteristics. Subnormal serum zinc levels were found in 24 of the 26 patients. The mean serum zinc concentration was 43.2/micrograms 100 ml +/- 3.6 S.E.M. (normal = 80-100 micrograms/100 ml). A significant (P = 0.007) survival advantage was demonstrated for those patients with pretreatment zinc concentrations greater than 45 micrograms%, but serum zinc levels did not correlate with response to chemotherapy (also significantly affecting survival). Decreased serum zinc concentrations were significantly associated with decreased neutrophil migration measured by the skin window technique and with decreased triceps skin fold thickness but not with any of the other host defense and nutritional induces measured. These data suggest that further studies are indicated to examine the role of serum zinc concentration as a possible sensitive prognostic characteristic and to determine if zinc administration may be of therapeutic benefit in cancer patients.

Zinc status of elderly black Americans from urban low-income households

The zinc status of 135 elderly blacks, aged 60 to 87 years, from urban low-income households was evaluated based on the zinc content of hair and/or serum. The mean (+/- SD) hair zinc concentration was 142 +/- 77 microgram/g and the mean (+/- SD) serum zinc concentration was 93 +/- 15 microgram/dl. Of the study population 39% had a hair zinc concentration less than or equal to 100 microgram/g and/or a serum zinc concentration less than or equal to 80 microgram/dl. Eleven percent had a hair zinc concentration less than or equal to 70 microgram/g and/or a serum zinc concentration less than or equal to 70 microgram/dl. These findings suggest that the zinc status of this elderly population may be less than ideal.

Determination of zinc in serum and urine by atomic absorption spectrophotometry; Relationship between serum levels of zinc and proteins in 104 normal subjects

Serum and urine zinc were measured by atomic absorption spectrophotometry. The drift in base-line was continuously registered and corrections for the drift were made in the calculations of zinc measurements to avoid any adjustment in the instrument settings. Food intake was shown to lower the serum zinc concentration by 19% on average ( p < 0.001). A diurnal variation of serum zinc was observed with a minimum at 7 p.m. Venous stasis elevated the mean serum zinc concentration by 13% ( p < 0.001) and the mean serum protein level by 14% ( p < 0.001). Weak correlations between serum zinc and both the serum concentration of proteins and of albumin were found in 104 normal subjects. There was no correlation between serum concentrations of zinc and α 2-macroglobulin. The concentration of serum zinc was 9% higher in males than in females ( p < 0.005) which was not explained by sex differences in serum protein concentrations. Furthermore, males had a higher excretion rate of zinc in urine than females, when expressed as μmol Zn/24 hour ( p < 0.01). This difference disappeared when urine zinc was corrected to urinary excretion rate of creatinine. Our results show that blood samples for serum zinc measurement should be taken in the morning in fasting state. The urinary zinc excretion rate should be related to the creatinine excretion rate to avoid sex differences.