Normal Serum Zinc Levels Research Articles

Effect of Oral Administration of Zinc Sulphate with Simultaneous Use of Nonspecific Immunostimulation on the Course of Trichophytosis in Beef Cattle

Abstract The paper assesses the treatment of cutaneous fungal infection in young beef cattle caused by Trichophyton verrucosum using orally administered zinc sulphate for 28 d at 2 g per animal per day and subcutaneous application of 2.5 mg/kg levamisole administered three times every 7 d. The study was conducted on animals at the age of 110 to 122 d, which were divided into two experimental groups: group I (animals suffering from ringworm with low levels of zinc in serum) and group II (animals suffering from ringworm with normal levels of zinc in serum). The remaining animals (control group) were divided into three subgroups: K (clinically healthy animals, which had normal serum levels of zinc), KI (animals infected with ringworm and showing a reduced level of zinc), and KII (animals suffering from ringworm with normal serum zinc levels). During the study the following parameters were investigated: clinical signs of fungal infection, zinc content in serum, percentage of phagocytic cells, and phagocytic index. The symptoms of the disease were observed only in group II on day 56. In group I, an increase in the percentage of phagocytic cells was observed, as compared to the original values, on days 7, 21, and 56 and a fall in this parameter was noted on days 14 and 28. In group II, there was a decrease on day 14 and an increase in comparison to the original values, followed by a gradual fall till day 56 of the experiment. In group I, phagocytic index remained on a stable level till day 56 and in group II until day 28, and subsequently began to increase gradually. It was found that oral supplementation of zinc sulphate combined with nonspecific immunostimulation may be applied in fighting skin fungal infection in cattle, and that zinc and levamisole may exhibit synergism affecting the evolution of nonspecific immunity.

A Case of Acrodermatitis Enteropathica Localized on the Hands and Feet with a Normal Serum Zinc Level

Acrodermatitis enteropathica is classified as a congenital autosomal recessive type and an acquired transient type. This disease manifests as acral and periorificial dermatitis, alopecia, intractable diarrhea, and failure to thrive. Whereas the autosomal hereditary type is caused by malabsorption of zinc in the intestine, the acquired type is caused by low nutritional support or decreased peripheral release of zinc from blood. We experienced a case of a 5-month old, breast feeding, full-term female presenting with only acral bullous dermatitis without diarrhea, periorificial dermatitis and an abnormal serum zinc level.

Maternal and Neonatal Serum Zinc Level and Its Relationship with Neural Tube Defects

Neural tube defect (NTD) is a multi-factorial disorder in which nutritional, genetic and environmental factors are involved. Among the nutritional factors, low level of serum zinc has been reported from different parts of the world. This hospital-based case-control study was conducted with the objective of finding the relationship between serum zinc level in newborns and their mothers and NTDs in a Bangladeshi population. The study was conducted during August 2006-July 2007 at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. In total, 32 mothers and their newborns with NTDs were included as cases and another 32 mothers with their normal babies were included as controls. Concentration of serum zinc was determined by pyro-coated graphite furnace atomic absorption spectrophotometer (GF-AAS). The mean age of the case and control mothers was 25.28 years and 24.34 years respectively. The mean gestational age of the case newborns was 36.59 weeks and that of the control newborns was 37.75 weeks. The mean serum zinc level of the case and control mothers was 610.2 microg/L and 883.0 microg/L respectively (p < 0.01). The mean serum zinc level of the case and control newborns was 723 microg/L and 1,046 microg/L respectively (p < 0.01). In both case and control groups, the serum zinc level of the newborns positively correlated with that of the mothers. The serum zinc levels of the mothers and newborns negatively correlated with NTDs. Mothers with serum zinc level lower than normal were 7.66 [95% confidence interval (CI) 2.5-23.28] times more likely to have NTDs compared to the normal zinc level of mothers. After adjusting for the zinc level of the newborns, parity, and age of the mothers, this risk reduced 1.61 times [confidence interval (CI) 95% 0.24-8.77]. On the other hand, the low serum zinc level of the newborns was 7.22 times more associated with NTDs compared to the newborns with the normal serum zinc level, which was statistically significant (p = 0.001). After adjusting for other factors, such as maternal age and parity, newborns with the low serum zinc level was found to be 9.186 times more likely to be associated with NTDs compared to newborns with normal serum zinc level. Based on the findings, it may be concluded that the low serum zinc levels of newborns may be associated with NTDs. To confirm these findings, a further study with a larger sample-size is recommended. Moreover, a follow-up study with zinc supplementation to pregnant women and its impact on NTDs is also recommended.

A case of acquired acrodermatitis enteropathica with a normal serum zinc level but a low level in the hair

Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder of early infancy, and is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Serum zinc levels are usually low in untreated patients and the oral administration of zinc sulfate can clear skin lesions and other symptoms. Although premature and cow's milk-fed infants are at particular risk of developing AE, there have been a few reports about AE in term and breast-fed infants. We report a case of transient AE in a 4-month-old breast-fed infant. This patient suffered from diarrhea and dermatitis for more than a month. Her skin lesions were erythematous, scaly, crusted, psoriasiform, eczematous, with an eruption at the chin, and a periorificial disposition with involvement of the flexural areas of lower extremities. Her serum zinc level was almost normal at 129μg/dL (reference range: 60-121μg/dL), but the zinc level in her hair was low: 8 mg percent (reference range: 10-21 mg percent). Skin biopsy findings were consistent with AE. Seven days after zinc supplementation, the skin lesions and diarrhea improved. The authors recommend that a clinical trial of zinc supplementation be considered in cases where there are suspicious of AE, even when the serum zinc level is normal.

Effect of Zinc Supplementation on Growth Hormone Secretion, IGF-I, IGFBP-3, Somatomedin Generation, Alkaline Phosphatase, Osteocalcin and Growth in Prepubertal Children with Idiopathic Short Stature

Controversy exists about the effect of zinc on growth and the GH-IGF system. Zinc supplementation has been shown to stimulate linear growth in zinc-deficient children. However the mechanism of this effect has not been well characterized. Furthermore, the effect of zinc supplementation on non-zinc-deficient short children is unknown. We investigated the effect of zinc supplementation on endogenous GH secretion, serum IGF-I and IGFBP-3 concentrations, IGF-I and IGFBP-3 generation in response to exogenous GH, bone formation markers, and linear growth of non-zinc-deficient children with idiopathic short stature. We analyzed prospectively serum zinc, IGF-I, IGFBP-3, alkaline phosphatase, osteocalcin, and GH response to clonidine test, and performed a somatomedin generation test before and 6 weeks after zinc supplementation in 22 (16 M, 6 F) prepubertal children with idiopathic short stature. Serum IGF-I increased from 67.4+/-70.6 to 98.2+/-77.3 ng/ml (p <0.001), IGFBP-3 from 2326+/-770 to 2758+/-826 ng/ml (p <0.001), alkaline phosphatase from 525+/-136 to 666+/-197 U/l (p <0.0001), and osteocalcin from 16.8+/-10.6 to 25.8+/-12.8 ng/ml (p <0.05) after zinc supplementation despite there being no difference in GH response to clonidine after zinc supplementation (peak GH 11.6+/-6.9 vs 13.4+/-7.8 ng/ml, GH area under the curve during clonidine test 689+/-395 vs 761+/-468, NS). Percent change in IGF-I and IGFBP-3 during the somatomedin generation test was not significantly affected by zinc supplementation (118% vs 136% and 57% vs 44%, respectively). There was no significant correlation between percentage increase in zinc levels and percentage increase in parameters tested. Height SDS or weight SDS did not improve significantly in 17 patients who continued on zinc supplementation for at least 6 months (6-12 months) (-2.59 vs -2.53 SDS and -1.80 vs -1.67 SDS, respectively). Zinc supplementation increased basal IGF-I, IGFBP-3, alkaline phosphatase and osteocalcin without changing GH response to clonidine. Zinc supplementation did not affect sensitivity to exogenous GH as tested by IGF-I and IGFBP-3 generation test. These results suggest a direct stimulatory effect of zinc on serum IGF-IGFBP-3, alkaline phosphatase and osteocalcin. Despite improvements in the above parameters, zinc supplementation to children with idiopathic short stature with normal serum zinc levels did not significantly change height or weight SDS during 6-12 months follow-up.

The role of zinc in management of tinnitus

Objective: Several therapeutic modalities have been tried in patients with tinnitus. These trials have given rise to unsatisfactory results in most of the patients since the etiology and pathophysiology of tinnitus is unclear. Significant correlation between tinnitus and decreased zinc level and also reduction in severity of tinnitus after zinc therapy has been reported in some clinical studies. The aim of this study is to find out the prevalence of hypozincemia in patients suffering from tinnitus of various origins (presbyacusis, acoustic trauma and ototoxicity) at young and elderly population and to investigate the effect of zinc therapy upon the severity of tinnitus. Methods: Forty consecutive patients with severe tinnitus were included in this study between April 1998 and May 2000. There were 32 men (80%) and eight women (20%) with an age ranging between 19 and 67 (mean 40.6 years). Eleven patients were over the age of 50. The zinc level was measured in non-diluted serum by flame atomic absorption spectrophotometry (normal values; 50–120 μg/dl) from fasting blood samples. All the patients were given zinc pills 220 mg each, once a day and 2 h before lunch for 2 months. The patients were required to fulfill a tinnitus scoring scale and a handicap questionnaire before and after treatment. The Wilcoxon rank sum test and McNemar test were used for the statistical analysis. Results: Six patients were hypozincemic and seven patients had decreased serum zinc levels. No significant change has been observed in frequency and severity of tinnitus measured by audiologic tests after zinc therapy. Twenty-three (57.5%) of these patients reported some relief of tinnitus in the tinnitus scoring scale but the rate of improvement was ignorable ( P>0.05). Decrease in severity of tinnitus after zinc therapy in elder group was better than the younger ones. Conclusion: Our study could not confirm the high incidence of hypozincemia in patients with tinnitus as reported previously. Zinc therapy for 8 weeks presented no promising effect on tinnitus in three groups of patients and the difference between the rate of improvement in severity of tinnitus after zinc intake in patients with normal and low serum zinc level was not significant. Zinc supplement provided relief of tinnitus in some of the elder people who apparently had dietary zinc deficiency.

Zinc levels and infections in hospitalized patients with AIDS

Impaired cellular and humoral immunity and phagocytic function have been attributed to zinc deficiency. This study examined the association between low serum zinc concentration and opportunistic infections in hospitalized patients with the acquired immune deficiency syndrome (AIDS). We examined the records from all 505 inpatient consultations performed by our Nutrition Service from May 1992 through June 1994. The medical records from all 228 patients with AIDS with known serum zinc levels (determined by atomic absorption spectrophotometry) were reviewed. The length of HIV seropositivity, most recent CD4 count, presence of diarrhea, and degree of malnutrition were noted. The principal diagnosis accounting for the admission was grouped according to the type of infection: Pneumocystis carinii pneumonia (PCP), viral, fungal, bacterial, and other. Sixty-seven patients (29%) had abnormally low serum zinc levels (LSZ < 55 μg/dL), 49 patients (21%) had borderline low serum zinc (BSZ ≥ 55 and ≤ 65 μg/dL), and 112 (49%) patients had normal serum zinc levels (NSZ > 65 μg/dL). There was no significant difference among the groups in CD4 count, length of HIV seropositivity, presence of diarrhea, or severity of malnutrition. Patients with zinc deficiency (LSZ) had a significantly higher incidence of bacterial infection than did patients with normal zinc. Patients with borderline zinc levels had an intermediate incidence of bacterial infection. There were no significant differences among the three groups in the incidence of PCP, viral, or fungal infections. Severe zinc deficiency was noted in 29% and borderline levels in an additional 21% of hospitalized AIDS patients. A low zinc level was not associated with the length of HIV seropositivity, CD4 count, or degree of malnutrition. Hypozincemia was associated with an increased incidence of concomitant systemic bacterial infections.

Serum zinc and plasma lipoproteins in elderly women: Findings from the nun study

Supplementation with zinc has been associated with changes in lipoprotein levels in prior studies. The purpose of this study was to define further the relationship between serum zinc and plasma total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides. This study was conducted in a homogeneous population of elderly women who were not taking zinc supplements. Fasting blood samples were drawn from 87 women, 77–99 years old. Serum zinc concentrations were significantly positively correlated with total cholesterol (r = 0.37, P = <0.01) and with LDL-cholesterol (r = 0.41, P = <0.001). In 77–84-year-old women (N = 47), a normal serum zinc level (70–150 μg/dl) was associated with a 27 mg/dl higher mean LDL-cholesterol (P = 0.06) compared to low serum zinc (<70 μg/dl). In 85–99-year-old women (N = 40), a normal serum zinc was associated with a 49 mg-dl higher mean LDL-cholesterol (P = 0.002) compared to low serum zinc. These associations were not materially affected by the potential confounding effects of weight, weight change over 8 years, triceps skinfold, or serum C-reactive protein. Overall, serum zinc concentration had a strong positive association with plasma LDL-cholesterol and to a lesser extent, with total plasma cholesterol in this population. The association between serum zinc and plasma cholesterol may be due to a third factor, such as red meat consumption, which is a significant source of zinc and saturated fat. Alternatively, zinc may play a role in cholesterol metabolism. © 1995 Wiley-Liss, Inc.

Serum zinc and plasma lipoproteins in elderly women: Findings from the nun study

Supplementation with zinc has been associated with changes in lipoprotein levels in prior studies. The purpose of this study was to define further the relationship between serum zinc and plasma total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides. This study was conducted in a homogeneous population of elderly women who were not taking zinc supplements. Fasting blood samples were drawn from 87 women, 77–99 years old. Serum zinc concentrations were significantly positively correlated with total cholesterol (r = 0.37, P = <0.01) and with LDL-cholesterol (r = 0.41, P = <0.001). In 77–84-year-old women (N = 47), a normal serum zinc level (70–150 μg/dl) was associated with a 27 mg/dl higher mean LDL-cholesterol (P = 0.06) compared to low serum zinc (<70 μg/dl). In 85–99-year-old women (N = 40), a normal serum zinc was associated with a 49 mg-dl higher mean LDL-cholesterol (P = 0.002) compared to low serum zinc. These associations were not materially affected by the potential confounding effects of weight, weight change over 8 years, triceps skinfold, or serum C-reactive protein. Overall, serum zinc concentration had a strong positive association with plasma LDL-cholesterol and to a lesser extent, with total plasma cholesterol in this population. The association between serum zinc and plasma cholesterol may be due to a third factor, such as red meat consumption, which is a significant source of zinc and saturated fat. Alternatively, zinc may play a role in cholesterol metabolism. © 1995 Wiley-Liss, Inc.

A cross‐sectional study of growth, puberty and endocrine function in patients with thalassaemia major in Hong Kong

A cross-sectional study of growth, puberty and endocrine function was performed on 35 girls and 33 boys with thalassaemia major. Despite regular transfusion and chelation therapy, 75% of the girls and 62% of the boys over the age of 12 years were below the third percentile for height. Hypogonadotropic hypogonadism was found in a similar percentage of patients. Moderate to marked zinc deficiency secondary to chelation therapy was considered unlikely because normal serum zinc levels were found in all but three of our patients, but we could not exclude the possibility of a marginal status of zinc nutrition causing growth failure. Growth hormone deficiency and diabetes mellitus were sometimes encountered but hypothyroidism, hypoparathyroidism and adrenal insufficiency were rare among our patients. Most of the patients with growth failure had normal growth hormone (GH) response to insulin induced hypoglycaemia. The serum insulin-like growth factor-1 (IGF-1) levels were low in our patients and no significant difference in the serum IGF-1 levels was found between prepubertal children with or without growth failure (0.4 +/- 0.1 mU/mL vs 0.37 +/- 0.11 mU/mL, P = 0.39). Similarly, no difference in the serum IGF-1 levels was found between pubertal children with or without growth failure (0.48 +/- 0.2 U/mL vs 0.56 +/- 0.14 U/mL, P = 0.26). Delayed sexual maturation and a possible defect in growth unrelated to the GH-IGF-1 axis may be responsible for the growth failure in adolescent children with thalassaemia major.

Nutrition and cellular immunity in hospital patients.

1. The interrelations between nutritional and cellular immune function measurements were studied in seventy patients suffering from various degrees of malnutrition. They included patients with liver disease, inflammatory bowel disease, neoplastic disease, neurological patients, post-operative surgical patients and patients with respiratory problems. 2. Nutritional measurements included: anthropometry, serum proteins, various vitamins and trace elements, and a prognostic nutritional index (PNI) was calculated. 3. Immunological measurements included: (1) natural killer (NK) cell activity, (2) antibody-dependent cellular cytotoxicity (ADCC), (3) lymphocyte proliferation in response to the mitogens concanavalin A (Con A), phytohaemagglutinin (PHA) and pokeweed mitogen (PWM) in both AB and autologous serum. 4. There was no association between anthropometric measurements and tests of immune function. 5. The lymphocyte proliferation in response to mitogenic stimulation in the malnourished patients was depressed in autologous serum compared with the response of the same lymphocytes in pooled AB serum. The lymphocyte proliferation in response to Con A correlated with transferrin in autologous serum (r 0.46, n 49, P less than 0.01) and to a lesser extent in AB serum (r 0.33, n 51, P less than 0.05). There was a difference in the Con A-stimulated tritiated-thymidine uptake between patients with low and normal serum zinc levels (P less than 0.05) for cultures performed in autologous serum, but not AB serum. 6. There was a significant correlation between NK cell activity and vitamin C (r 0.43, n 60, P less than 0.01). There was no relation between nutritional measurements and ADCC or the lymphocyte response to stimulation with PHA or PWM. 7. The results suggest that the severity of overall malnutrition does not influence several different aspects of the cellular immune response. However, the results do suggest that certain individual nutrients, particularly vitamin C and Zn, do influence the immunoreactivity of different lymphocyte subpopulations.

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.

ESTUDO SOBRE O ESTADO NUTRICIONAL EM RELAÇÃO AO ZINCO NA AMAZÔNIA. I. Níveis de Zinco no Sôro e Ingestão de Zinco em Operários de Manaus, 1978 ()

SUMÁRIO O objetivo deste estudo foi verificar se a baixa ingestão de zinco relatada para a população da área urbana da cidade de Manaus, no Estado do Amazonas, está associada com niveis balxos de zinco sérico. O estudo foi realizado com trabaIhadores percebendo salários baixos, em quatro fábricas de Manaus. Duas destas fábricas forneciam alimentação e assistência médica. A média e a mediana da ingestão de zinco dietético, foi 54.7% e 49.3% respectivamente das recomendações diárias. americanas. A ingestão de zinco foi mais alta nos trabalhadores nascidos em Manaus, que possuiam um meIhor nível de escolaridade e que tinham renda familiar mais alta, mas essas diferenças foram evidentes unicamente nas fábricas que não forneciam refeição. A ingestão de zinco diminui com a idade em ambos os sexos, sendo mais alto nos homens do que nas mulheres em todos os grupos por idade. Essa tendência foi observada em todas as fábricas. Não houve diferença significativa do nível de zinco sérico entre homens e mulheres. Porém o valor de zinco no soro tende a declinar também com a idade em ambos os sexos. A média do nível de zinco sérico de trabalhadores com renda familiar baixa e média foi significativamente mais baixa do que trabalhadores com renda familiar alta (P&lt;.001. P&lt;.05). 34% de todos os trabalhadores com renda familiar baixa, 26% com renda familiar média e 17% com renda familiar alta, tinham níveis de zinco sérico deficientes (&lt; 11.5 μmol/l). A concentração de zinco no soro foi relacionada com ingestão de zinco do sexo masculino (r=0.26 p&lt;.02) mas não em operários do sexo feminino (r=0.11 p&lt;.1). A ingestão de zinco em trabalhadores de ambos os sexos com nível de zinco sérico déficiente foi significativamente mais baixa do que aqueles com nível de zinco sérico normal. A ingesta de zinco nos homens foi mais alta do que nas mulheres para todos os níveis de zinco sérico.

Serum zinc levels in corticosteroid-treated asthmatic patients.

Summary Serum zinc levels have been measured in twenty-four asthmatic patients, of whom sixteen were on long term corticosteroid therapy. They were carefully screened to exclude any concomitant disease. The non-steroid-treated asthmatics had normal serum zinc levels which ranged from 89 to 138 μg/ml. The corticosteroid-treated patients had a mean serum zinc level of 64 ± 9 μg/100 ml; this was significantly lower than normal (P = &amp;lt; 0·001).