Serum Micronutrient Levels Research Articles

Assessment of the Nutritional Status, Bone Mineralization, and Anthropometrics of Children with Thalassemia Major.

Objective:Children with thalassemia major (TM) are prone to growth failure and micronutrient deficiency. Thus, this study aimed to evaluate nutritional status, anthropometrics, and bone mineralization defects in patients with regular blood transfusion.Methods:Data obtained were analyzed by evaluating laboratory tests, anthropometric measures, and bone mineral density.Results:This study included 29 patients (62% male and 38% female) with a mean age of 12.26±4.74 years, mean pre-transfusion hemoglobin of 8.64±1.01 g/dL, and mean serum ferritin of 1158.6±556.8 ng/mL. Vitamin D (72.4%), selenium (72.4%), and folate (37.9%) deficiencies were most frequent. Hypocalcemia was observed in 17.2%, hypomagnesemia in 3.5%, and decreased ceruloplasmin in 10.3% of patients. Folate was higher between 2 and 6 years old (p=0.028). Ceruloplasmin was higher between 6 and 10 years old (p=0.018). Selenium was significantly higher in patients with a ferritin of ≥1,500 (p=0.008). No significant ferritin-related differences were found in other micronutrients (p>0.05). Body mass index (BMI) were <5 percentile (p) in 31% of patient, whereas none was >95 p. Height in 24.5% and weight in 20.7% of patients were <3 p, whereas none with >97 p. BMI of patients aged 10-18 years was significantly higher (p=0.001). Anthropometric percentiles did not significantly differ in the mean serum ferritin and micronutrient levels. Hypoparathyroidism was observed in 13.8% and hypothyroidism in 3.5% of patients. Low bone density was detected in 14.8% (2 osteopenic and 2 osteoporotic) of patients. Bone mineral density did not significantly differ in the ferritin and micronutrient levels.Conclusions:Nutritional support and deficiency prevention are important to minimize the burden of complications and increase the life expectancy and quality in patients with TM.

ASSESSMENT OF THE NUTRITIONAL STATUS, BONE MINERALIZATION AND ANTHROPOMETRICS OF CHILDREN WITH THALASSEMIA MAJOR

Children with thalassemia major are prone to growth failure and micronutrient deficiency. In this study, we aimed to evaluate nutritional status, anthropometrics, bone mineralization defects in regularly transfused patients. We analyzed the data obtained by evaluating laboratory tests, anthropometric measures, and bone mineral density. Twenty-nine patients (62% male, 38% female) with mean age 12.26±4.74 years, mean pre-transfusion hemoglobin 8.64±1.01 g/dl, mean serum ferritin 1158.6±556.8 ng/ml were included. Vitamin D (72.4%), selenium (72.4%), folate (37.9%) deficiencies were the most frequent ones. In 17.2% hypocalcemia, 3.5% hypomagnesemia, in 10.3 % decreased ceruloplasmin were observed. Folate was higher between 2≤ and&lt;6 years (p:0.028). Ceruloplasmin was higher between 6≤ and&lt;10 years (p:0.018). Selenium was significantly higher in patients with ferritin ≥1500 (p=0.008). No significant ferritin-related differences were found in other micronutrients (p&gt;0.05)For body mass index (BMI) 31% were under the 5th percentile, none was over the 95th percentile. For height, 24.5%, for weight 20.7% were under the 3rd, none was over 97th percentile. BMI of patients 10≤age≤18 years old was significantly higher (p=0.001). Anthropometric percentiles did not differ significantly in terms of mean serum ferritin and micronutrient levels. Hypoparathyroidism was observed in 13.8%, hypothyroidism in 3.5% of the patients. Low bone density was detected in 14.8% (2 osteopenic, 2 osteoporotic) patients. Bone mineral density did not differ significantly in terms of ferritin and micronutrient levels. Nutritional support and prevention of deficiencies are important to minimize the burden of complications, to increase the life expectancy and quality in TM patients.

Serum Inflammation Biomarkers and Micronutrient Levels in Nigerian Breast Cancer Patients with Different Hormonal Immunohistochemistry Status

Background: The importance and relevance of serum inflammation biomarkers and DNA methylation-dependent micronutrients in breast tumorigenesis is gaining wider acceptance. However, the association of serum inflammation biomarkers and micronutrient status with expression of estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor receptor-2 (HER-2) by the tumor has not been investigated in Nigerian breast cancer patients. The objective of this study was to determine the levels of serum biomarkers of inflammation (Homocysteine, Nitric Oxide (NO), Hydrogen peroxide (H2O2), Myeloperoxidase (MPO), Tumor necrosis factor alpha (TNF-α), Interleukins 6 and 8 (IL-6 and IL-8) and DNA methylation-dependent micronutrients [Zinc (Zn), Folic acid, Vitamin B6 and B12] in breast cancer patients with different hormone receptor levels (ER, PR and HER-2). Methods: One hundred and fifteen women (80 with breast cancer and 35 controls) were randomly recruited for this study. Serum levels of homocysteine, folic acid, vitamins B6, vitamin B12, TNF-α, IL-6 and IL-8) were analyzed using ELISA. The levels of NO, MPO, H2O2 and Zn were analyzed using spectrophotometer. The levels of serum inflammation biomarkers and DNA methylation-dependent micronutrients in patients with breast cancer and control subjects without breast cancer as well as breast cancer patients with ER, PR and HER-2 expression were determined. Results: The results showed that mean serum levels of IL-6 (p=0.002), IL-8 (p=0.018) and H2O2 (p=0.000) were significantly increased while TNF-α (p=0.014) and NO levels (p=0.044) were significantly decreased in breast cancer compared to healthy controls (p&lt;0.05). However, there were no statistically significant differences in the levels of Zn, homocysteine, Vitamin B6, Vitamin B12 and MPO in breast cancer patients and controls (p&gt;0.05). Furthermore, the levels of serum inflammatory biomarkers and methylation-dependent micronutrients were similar in HER-2, ER and PR breast cancer hormone subtypes. Conclusion: Systemic inflammation exists in breast cancer patients but the inflammation biomarkers and methylation-dependent micronutrients did not differ among patients with PR, ER and HER-2 antigen expression.

Fecal Markers of Environmental Enteric Dysfunction and their Relation to Faltering Growth in a Sample of Egyptian Children

BACKGROUND: Chronic malnutrition is a long-term health condition that has threatening effects on children’s health. Environmental enteric dysfunction (EED) is a subclinical disorder affecting the small intestine that may occur due to exposure to environmental pathogens and toxins. AIM: The present research was intended to detect the value of fecal biomarkers of intestinal epithelial damage alpha-1anti-trypsin (AAT) and intestinal inflammation Myeloperoxidase (MPO) and Neopetrin (NEO), also to quantify their association with faltering growth in stunted and underweight children. PATIENTS AND METHODS: This case–control study included 105 children with moderate malnutrition as a case group and 100 children of normal body weight and height as a control group. Quantification of fecal markers levels of intestinal permeability AAT and intestinal inflammation (NEO and MPO) along with serum micronutrients levels (iron and zinc) in children with malnutrition in comparison to controls. RESULTS: Fecal markers of intestinal permeability AAT and intestinal inflammation NEO had statistically significant higher levels in children with malnutrition, while serum micronutrients (iron and zinc) had statistically significant lower levels in children with malnutrition. CONCLUSION: Faltering growth is associated with elevated fecal markers of intestinal permeability AAT and intestinal inflammation NEO. EED may be a cause for faltering growth.

Serum gonadotropins, cortisol, PSA, and micronutrient levels among men with prostate carcinoma

BackgroundProstate cancer (PrCa) is a malignant tumour of the prostate that has many associated risk factors. There is continuous rise in the incidence among adult blacks which is a reflection of racial differences in testosterone concentrations.MethodsThe study involves 50 PrCa patients attending or referred to two tertiary health Institutions and 25 healthy men as controls. Weight and height of participants were measured, and body mass index (BMI) was calculated. Ten millilitres of venous blood sample was collected from each participant, allowed to clot, and then centrifuged at 5000 rpm for 5 min at room temperature (22–28 °C) to obtain the serum. Serum cortisol, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total prostate-specific antigen (TPSA), free prostate-specific antigen (FPSA), selenium, copper, magnesium, and zinc were determined. Prostate ultrasonography and biopsy were also done for histopathological studies.ResultFrom this study, a significant increase (p < 0.05) in weight, BMI, serum FPSA, TPSA, and copper; a non-significant increase (p > 0.05) in serum cortisol, testosterone; a significant decrease (p < 0.05) in serum LH, selenium, zinc, and magnesium; and a non-significant decrease (p > 0.05) in serum FSH were observed among people living with PrCa when compared to the controls. However, no significant difference (p > 0.05) was observed in the height between the two groups. Ultrasonography and histology revealed evidence of prostatitis, hypertrophy, and carcinoma among the test group.ConclusionIt can be concluded that PrCa is associated with increase serum cortisol, testosterone, and copper; and decreased serum LH, FSH, selenium, zinc, and magnesium concentrations and combination of biochemical, ultrasonographic, and histologic features are of diagnostic importance.

Micronutrient status in bariatric surgery patients receiving postoperative supplementation per guidelines: Insights from a systematic review and meta-analysis of longitudinal studies.

The micronutrient status and optimal monitoring schedule after bariatric surgery have not been sufficiently assessed. This systematic review and meta-analysis investigated the longitudinal changes in micronutrient status after bariatric surgery. PubMed, EMBASE, and Cochrane Library were searched for articles that measured preoperative and postoperative serum micronutrient levels in patients undergoing Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Among guideline-adherent studies, the longitudinal changes in micronutrient status were investigated using weighted mean difference (WMD) using a random-effects model. Among the 82 included studies, the guideline adherence rates for micronutrient supplementation after bariatric surgery did not exceed 20%. In patients supplemented per guidelines, vitamin A significantly decreased after RYGB by -7.54 (95% confidence interval [CI], -10.16 to -4.92) μg/dl at 12-23 months, vitamin E decreased after RYGB by -2.35 (95% CI, -3.65 to -1.05) μg/dl at ≥24 months, and ferritin by -54.93 (95% CI, -77.19 to -32.67] μg/L at ≥24 months after SG, compared with baseline, with moderate level of evidence. Significant decreases in micronutrient levels at certain follow-up intervals in studies with supplementation per guidelines need to be considered to establish a post-bariatric micronutrient monitoring schedule for timely detection and management of micronutrient deficiencies.

Biocultural pathways linking periodontal disease expression to food insecurity, immune dysregulation, and nutrition.

In this article, we test theoretical pathways leading to and resulting from periodontal disease to better understand how periodontal disease, which is measurable in both past and present populations, integrates biocultural context and affects whole-body physiology. We use data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and logistic and linear regressions to test pathways linking psychosocial stress to periodontal disease, and periodontal disease to serum vitamin C levels. We then use causal mediation analysis to test the role of mediating variables in these pathways (n = 1853 individuals). Food insecurity was positively associated with periodontal disease and negatively associated with serum counts of C-reactive protein (CRP) and neutrophils. Neither CRP nor neutrophils significantly mediated the relationship between food insecurity and periodontal disease. Periodontal disease was negatively associated with serum vitamin C levels and positively associated with neutrophil counts. Neutrophils may mediate the relationship between periodontal disease and vitamin C. We identify two main findings: (a) periodontal disease contributes to and may result from immune dysregulation, particularly of neutrophils, and (b) an immune response to chronic infection such as periodontal disease is metabolically expensive for the body to maintain and likely depletes serum micronutrient levels. Both micronutrient status and serum neutrophil counts affect multiple skeletal and physiological phenotypes and thus position periodontal disease in whole-body context.

Micronutrient levels and their effects on the prognosis of visceral leishmaniasis treatment, a prospective cohort study

BackgroundMicronutrients are minerals and vitamins and they are essential for normal physiological activities. The objectives of the study were to describe the progress and determinants of micronutrient levels and to assess the effects of micronutrients in the treatment outcome of kalazar.MethodsA prospective cohort study design was used. The data were collected using patient interviews, measuring anthropometric indicators, and collecting laboratory samples. The blood samples were collected at five different periods during the leishmaniasis treatments: before starting anti-leishmaniasis treatments, in the first week, in the second week, in the third week, and in the 4th week of anti-leishmaniasis treatments. Descriptive statistics were used to describe the profile of patients and to compare the treatment success rate. The generalized estimating equation was used to identify the determinants of serum micronutrients.ResultsThe mean age of the patients were 32.88 years [SD (standard deviation) ±15.95]. Male constitute 62.3% of the patients and problematic alcohol use was present in 11.5% of the patients. The serum zinc level of visceral leishmaniasis patients was affected by alcohol (B − 2.7 [95% CI: − 4.01 - -1.5]), DDS (B 9.75 [95% CI: 7.71–11.79]), family size (B -1.63 [95% CI: − 2.68 - -0.58]), HIV (B -2.95 [95% CI: − 4.97 - -0.92]), and sex (B − 1.28 [95% CI: − 2.5 - -0.07]). The serum iron level of visceral leishmaniasis patients was affected by alcohol (B 7.6 [95% CI: 5.86–9.35]), family size (B -5.14 [95% CI: − 7.01 - -3.28]), malaria (B -12.69 [95% CI: − 14.53 - -10.87]), Hookworm (− 4.48 [− 6.82 - -2.14]), chronic diseases (B -7.44 [95% CI: − 9.75 - -5.13]), and HIV (B -5.51 [95% CI: − 8.23 - -2.78]). The serum selenium level of visceral leishmaniasis patient was affected by HIV (B -18.1 [95% CI: − 20.63 - -15.58]) and family size (B -11.36 [95% CI: − 13.02 - -9.7]). The iodine level of visceral leishmaniasis patient was affected by HIV (B -38.02 [95% CI: − 41.98 - -34.06]), DDS (B 25 .84 [95% CI: 22.57–29.1]), smoking (B -12.34 [95% CI: − 15.98 - -8.7]), chronic illness (B -5.14 [95% CI: − 7.82 - -2.46]), and regular physical exercise (B 5.82 [95% CI: 0.39–11.26]). The serum vitamin D level of visceral leishmaniasis patient was affected by HIV (B -9.43 [95% CI: − 10.92 - -7.94]), DDS (B 16.24 [95% CI: 14.89–17.58]), malaria (B -0.61 [95% CI: − 3.37 - -3.37]), and family size (B -1.15 [95% CI: − 2.03 - -0.28]). The serum vitamin A level of visceral leishmaniasis patient was affected by residence (B 0.81 [95% CI: 0.08–1.54]), BMI (B 1.52 [95% CI: 0.42–2.6]), DDS (B 1.62 [95% CI: 0.36–2.88]), family size (B -5.03 [95% CI: − 5.83 - -4.22]), HIV (B -2.89 [95% CI: − 4.44 - -1.34]),MUAC (B 0.86 [95% CI: 0.52–1.21]), and age (B 0.09 [95% CI: 0.07–0.12]).ConclusionThe micronutrient levels of visceral leishmaniasis patients were significantly lower. The anti-leishmaniasis treatment did not increase the serum micronutrient level of the patients.

Iron, Vitamin B12, Folate and Copper Deficiency After Bariatric Surgery and the Impact on Anaemia: a Systematic Review.

Bariatric surgery may increase the risk of iron, vitamin B12, folate and copper deficiencies, which can cause anaemia. This review aims to critique the evidence on the prevalence of these nutritional deficiencies and the impact on anaemia in the first 12months after surgery. PRISMA and MOOSE frameworks, the NHMRC evidence hierarchy and The Academy of Nutrition and Dietetics bias tool were used to systematically critique current literature. Seventeen studies reported on deficiency prevalence with the majority being of low quality. Important confounders to serum micronutrient levels were not adequately considered. Results on the prevalence of nutritional anaemias were also lacking. Further investigation into the prevalence of iron, vitamin B12, folate and copper deficiency and its impact on anaemia in bariatric surgery is needed.

Association between serum micronutrient levels and febrile seizures among febrile children in Southern India: A case control study

BackgroundFebrile seizures are prevalent in children. Interactions between the neurotransmitters and micronutrients levels in the biological fluids have been implicated in its occurrence. ObjectiveTo assess the serum copper (Cu), magnesium (Mg) and zinc (Zn) levels in febrile children and to evaluate their association with febrile seizures. MethodsThe study included 35 children with febrile seizures as cases and 35 children with febrile illnesses without seizures as controls. Children between six months to five years were included in the study group. The serum Cu, Mg and Zn levels were analyzed by the semi-auto analyzer. Data analysis was done using SPSS Version 25.0. ResultThe median age for the febrile seizure was 24 (IQR: 12–36) months with male preponderance of 65.7%. The median serum copper and magnesium levels were increased and decreased significantly (p < 0.001), among febrile seizure children in comparison to the control group. Median serum zinc levels in the febrile seizure group were less but were not statistically significant (p = 0.626). Higher serum levels of copper had higher odds of seizures (OR: 22.67; 95% CI: 2.73–495.98; p < 0.0001) and lower levels of magnesium had higher odds of seizures (OR: 29.41; 95% CI: 6.90–142.86; p < 0.0001). Serum copper levels had sensitivity and specificity of 80% and 71% respectively in predicting febrile seizure at a cutoff value of ≥19.55 μmol/L. ConclusionIncreased serum copper levels and decreased serum magnesium levels were significantly associated with febrile seizures. A threshold value of serum copper levels ≥19.55 μmol/L is associated with a febrile seizure.

The effect of hemodialysis, peritoneal dialysis and renal transplantation on nutritional status and serum micronutrient levels in patients with end-stage renal disease; Multicenter, 6-month period, longitudinal study

PurposeNutritional status and micronutrient levels of end stage renal disease (ESRD) patients may vary depending on the mode of renal replacement therapy (RRT). We aimed to compare the effects of hemodialysis, peritoneal dialysis (PD) and renal transplantation (RT) on micronutrient levels and nutritional status in ESRD patients. Patients and MethodsA total of 77 ESRD patients who had not received RRT were included in this prospective longitudinal study. All ESRD patients underwent a blood serum analysis that assessed the micronutrients such as selenium, copper, zinc, chromium, retinol, thiamine and vitamin B6 as well as a nutritional status assessment. After the baseline assessments and the initiation of RRT was accomplished, all patients were followed for 6 months. ResultsThe study showed significant improvements in subjective global assessment scores (percentage increases in score A were 26.6 and 36.6; p = 0.039 and p = 0.001; respectively), mid-arm circumference and the skin-fold thicknesses (p < 0.001, p < 0.001; respectively) in the RT and hemodialysis groups. The examinations at sixth month revealed a significant increase in body weight (4.8 kg; p = 0.002) and albumin levels (0.6 g/dL; p < 0.001) in only RT group. Zinc, thiamin and vitamin B6 were the most deficient micronutrients (44.1 %, 24.7 % and 35.1 %; respectively) in ESRD patients. There was a significant increase in selenium and retinol levels (p = 0.020 and p < 0.001; respectively) but a significant decrease in thiamin levels (p = 0.041) in RT patients. A significant increase in retinol levels (p = 0.028) and a significant decrease in thiamin levels (p = 0.022) was observed in the hemodialysis patients. However, no significant change in micronutrient levels was observed in the PD patients. ConclusionThe results support the recommendation that ESRD patients should be supplemented with water-soluble vitamins, especially thiamine and vitamin B6, and trace elements, especially zinc. RT appears to be superior to other modes of RRT when examining SGA score, anthropometric measurements, albumin and micronutrient levels.

Polyneuropathy in Critically Ill Mechanically Ventilated Children: Experience From a Tertiary Care Hospital in North India*

To determine the prevalence of critical illness polyneuropathy and its risk factors in critically ill children mechanically ventilated for 7 days or more. Observational cohort study. PICU of a tertiary care hospital from North India. Children 1-15 years old admitted in PICU from June 2016 to September 2017, mechanically ventilated for 7 days or more, excluding those with diagnosed neuromuscular disease, stroke, or spinal pathology. Demographic details, diagnosis, treatment details, and anthropometry at admission and enrolment were recorded. Nerve conduction studies were performed after enrolment and repeated a week later, if the child was still in PICU. Medical Research Council scoring for muscle strength was performed in survivors. Risk factors including Pediatric Index of Mortality-2 score, sepsis, multiple organ dysfunction, hypoalbuminemia, use of steroids, neuromuscular-blocking agents, and vasopressors were recorded. Samples for the level of micronutrients (copper, zinc, folate, and vitamin B12) were collected at the time of enrolling the child and at the time of discharge. Thirty-two children were enrolled, of whom 29 had features of critical illness polyneuropathy on evaluation at day 8 of mechanical ventilation (prevalence, 90.6% [95% CI, 80.5-100%]). The polyneuropathy was axonal in 26 (81.2%), mixed in one patient (3.1%), and uncharacterized in two (6.2%). Sepsis and multiple organ dysfunction were present in 31 subjects (96.9%). No risk factors for critical illness polyneuropathy could be identified although the study was not sufficiently powered to do so. The difference between serum micronutrient levels (copper, zinc, folate, and vitamin B12) between patients who developed polyneuropathy, and those who did not, was statistically insignificant. We observed a high prevalence of critical illness polyneuropathy in children in PICU, mechanically ventilated for 7 days or more; almost all of whom had underlying sepsis.

Relative contributions of the correlates of stunting in explaining the mean length-for-age z-score difference between 24-month-old stunted and non-stunted children living in a slum of Dhaka, Bangladesh: results from a decomposition analysis

ObjectiveUsing MAL-ED (Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health) Bangladesh birth cohort data, we sought to measure the relative contributions of...

Juice powder concentrates: nutritional supplements in periodontology

Periodontitis is a ubiquitous, chronic inflammatory condition of the tooth-supporting apparatus. Various risk factors/indicators are associated with periodontal diseases, including nutritional status. With oxidative stress driving periodontal inflammation there is credibility in considering additional benefits from phytonutritional supplements when used in conjunction with conventional therapy for periodontal disease. Contemporary research utilizing robust methodology, such as double-blind, randomized, placebo-controlled trials, in conjunction with serum micronutrient levels to assess bioavailability of phytonutrients following nutritional supplementation, may begin to provide an evidence base for delivering nutritional advice as part of periodontal prevention/therapy. CPD/Clinical Relevance: Some mechanisms underpinning nutritional modulation of inflammatory periodontal disease, as well as the evidence behind the use of Juice Powder Concentrates (JPCs), are of relevance in periodontal therapy.

Influence of petroleum product exposure on serum micronutrient concentrations in automobile mechanics

Background Aim of the Study: Occupation-related pathological presentations have been recognized in automobile mechanics, several of which are oxidative stress-induced. Altered micronutrient levels can help in predicting the possibility of oxidative stress-related diseases. It is for this reason that micronutrient levels are being assessed in auto mechanics. Materials and Methods: Questionnaire was administered to obtain information on workers' safety assessment, lifestyle choices, and work experience. Estimation of micronutrient levels was carried out on sera of 80 adult males, 40 of whom were auto mechanics and the other 40 constituted the control group. Essential trace elements (Zn, Cu, Se, Mn, Co, Fe, Mo, and Cr) and vitamins (Vitamins A, B6, C, D, and E, thiamine, riboflavin, niacin, and folic acid) were determined using atomic absorption spectrometry and high-performance liquid chromatography, respectively. Student's t-test was utilized to establish a significant difference between test and control groups. P ≤ 0.05 was considered statistically significant. Results: Micronutrients with antioxidant attributes such as Zn, Cu, Mn, Se, Vitamin E, and ascorbic acid were significantly reduced compared with controls. Data obtained from an administered questionnaire showed that there were no conscious efforts or program to ensure the safety of the mechanics. Conclusions: Auto mechanics are prone to altered serum micronutrient levels.

Essential Mineral Intake During Pregnancy and Its Association With Maternal Health and Birth Outcomes in South East Queensland, Australia.

Micronutrient supplements are often recommended during pregnancy, yet their role and necessity remain poorly understood in the Australian population. This study aimed to determine the essential mineral intake of a population of pregnant women in South East Queensland and investigate the effects of supplements on their micronutrient status and birth outcomes. Women completing the Oral Glucose Tolerance Test at two South East Queensland hospitals between 180 and 210 days gestation provided fasting blood samples and dietary data using the Maternal Outcomes and Nutrition Tool (n = 127). Birth outcomes were sourced from medical records. Serum elemental profiles were determined by inductively coupled plasma mass spectrometry (ICP-MS) analysis. Intake of 8 essential minerals was compared with Australian dietary recommendations; matched serum mineral levels were compared with the current Queensland pregnancy reference ranges. Data were examined using cross-sectional cohort design and independent sample t-tests. Supplement use had no significant influence on serum values of trace elements or the incidence of hypertensive disorders, gestational diabetes, preterm birth or infant birthweight. Dietary selenium, zinc and iodine were significantly higher in women birthing beyond 41 completed weeks; selenium (P = .026) and zinc (P = .034) both made unique contributions to the regression models when controlling for confounders. Women exhibited adequate to excessive serum micronutrient levels compared with pregnancy reference ranges, a finding consistent with dietary intake calculations. Data suggest that excessive essential mineral intake contributed to prolonged pregnancy in this cohort, supporting previous studies in this population. Further research is required to determine individual needs and eliminate the potential for harm before recommending pregnancy supplements.

Effects of Plantago major extract on serum levels of antioxidant vitamins and minerals in broiler

The aim of this study was to evaluate the effects of Plantago major liquid extract on serum antioxidant vitamin and mineral concentrations of broiler. The experiment consisted of the control and 2 treatment groups, composed of 28 Ross 308 broiler chicks (Total, 84). A basal (control) diet was formulated. P. Major was added to the control diet as following: PM1 (5 g/kg feed), PM2 (10 g/kg feed). The chicks were feed for 42 days ad libitum. The serum micronutrients (Retinol, á-tocopherol, vitamin D, calcium, magnesium, iron, manganese, and zinc) levels were determined. The retinol, á-tocopherol, Fe, Mg, Mn levels were not affected, and the Zn levels decreased in the PM1 and PM2. The supplementation of P. major has affected the serum vitamin D and Zn levels for this study, and should be analyzed for the alterations on the metabolism in subsequent studies.

Abstract P-367: CRITICAL ILLNESS POLYNEUROPATHY IN MECHANICALLY VENTILATED CHILDREN

Aims & Objectives: Background: Critical illness polyneuropathy (CIP), a symmetrical multifactorial axonal polyneuropathy is reported to be common in critically ill adults; the reported prevalence being 25–100%. Information about the prevalence of the condition in critically ill children is scarce. Objectives: To determine the prevalence of polyneuropathy and its risk factors in critically ill, mechanically ventilated children. Methods In an observational study, we enrolled children aged 1–15 years admitted in PICU from June 2016 to September 2017, mechanically ventilated for ≥7 days, excluding those with diagnosed neuromuscular disease, stroke or spinal pathology. Information was collected regarding demography, diagnosis, treatment details and anthropometry at admission and enrolment. Nerve conduction studies were performed after enrolment and repeated a week later, if the child was still in PICU. Risk factors including PIM2 score, sepsis, multiorgan dysfunction, hypoalbuminemia, use of steroids, neuromuscular blocking agents and vasopressors were recorded. Serum micronutrient levels (Copper, Zinc, Folate, Vitamin B12) were measured at enrolment and at discharge. Results Thirty-two children were enrolled, of whom 29 had features of CIP [Prevalence 90.6% (95% CI; 80.5–100%)]. The polyneuropathy was axonal in 26 (81.2%), uncharacterized in 2 (6.2%) and mixed in 1 patient (3.1%). Sepsis and multiorgan dysfunction were present in 31 subjects (96.9%). No risk factors for CIP could be identified. The difference between serum micronutrient levels (Copper, Zinc, Folate, Vitamin B12) between patients who developed polyneuropathy and those who did not, was statistically insignificant. Conclusions The prevalence of CIP in children in PICU, mechanically ventilated for ≥7 days, is as high as in adult population.

Maternal and neonatal micronutrient levels in newborns with CHD.

It is suggested that folic acid and/or multivitamins, taken periconceptionally, have a role in the prevention of many congenital anomalies. The aim of this study was to determine the serum micronutrient levels in mother-infant pairs with CHD compared with those with healthy newborns and their mothers. Serum levels of folic acid, homocysteine, zinc, vitamin A, vitamin D, and vitamin B12 were measured from 108 newborns with CHD (study group) and 103 healthy newborns (control group). The mothers' micronutrient levels were also measured simultaneously. When compared with healthy newborns, for both maternal and neonatal data, homocysteine and zinc levels were higher and vitamin D levels were lower in the study group. In multivariate analysis, only maternal high zinc levels were associated with CHD in the newborns (p=0.02, OR: 0.9, 95% CI 0.8-0.9). The results did not change when analysed for truncal anomalies including truncus arteriosus, tetralogy of Fallot, and d-transposition of great arteries. There were positive correlations between maternal and neonatal levels of micronutrients, except vitamin B12. We thought that high homocysteine and zinc levels and low vitamin D levels in mother-infant pairs might have a role in the aetiopathogenesis of CHD. Large-scale, prospective studies are needed to clarify the role of micronutrients in CHDs.

Hair Mineral and Trace Element Contents as Reliable Markers of Nutritional Status Compared to Serum Levels of These Elements in Children Newly Diagnosed with Inflammatory Bowel Disease.

Patients with inflammatory bowel disease (IBD) are at high risk for nutritional deficiencies because of long-term inflammation in the gut mucosa and decreased oral intake. Because inflammation responses affect serum micronutrient concentrations, serum levels are limited in reflecting body nutrient status in acute and chronic illness. We investigated the usefulness of measuring trace elements in hair as reliable markers of nutritional status compared to serum levels in children with IBD. We retrospectively analyzed pediatric patients newly diagnosed with Crohn's disease (n = 49) and ulcerative colitis (n = 16) and controls (n = 29) from 2012 to 2016. Serum micronutrient levels, inflammatory markers, and hair trace element content were evaluated and compared at the time of diagnosis and before initiating treatment. Serum calcium (p < 0.001), iron (p < 0.001), zinc (p = 0.013), selenium (p = 0.008), albumin (p < 0.001), prealbumin (p < 0.001), hemoglobin and hematocrit (p < 0.001), and WBC (p = 0.001) and lymphocytes (p < 0.001) differed significantly between the groups. After adjustment for the erythrocyte sedimentation rate, serum zinc and selenium levels were no longer significantly different between the groups (p < 0.062 and p < 0.057, respectively). Following hair analysis for mineral and trace elements, iron (p = 0.033), selenium (p = 0.017), and manganese (p = 0.009) differed significantly between the groups. Serum micronutrient levels need cautious interpretation in conjunction with inflammatory markers. Hair mineral and trace element measurement may support understanding micronutrient status in children with IBD.