Serum Zn Levels Research Articles

Serum Selenium, Iron, Zinc, and Copper Concentrations in Renal Transplant Recipients Treated with Mycophenolate Mofetil

There are data available in the literature on bioelement concentrations in the serum of various groups of patients; however, very little is known about the serum concentration of selenium (Se), iron (Fe), zinc (Zn), and copper (Cu) in renal transplant patients treated with immunosuppressive drugs, including mycophenolate mofetil (MMF). Monitoring of serum bioelement concentrations in renal transplant recipients is of profound importance, as the proper bioelement levels seem to prolong the normal function of the transplanted organ. Thus, the aim of this current study was to examine and carry out comparative analysis involving serum concentrations of Se, Fe, Cu, and Zn of renal transplant recipients treated with MMF and without MMF. The material consisted of blood samples from 115 patients of the Department of Nephrology, Transplantology, and Internal Medicine of Independent Public Clinical Hospital No. 2, Pomeranian Medical University, in the city of Szczecin in the northwestern Poland. Serum Se, Fe, Cu, and Zn levels were quantified by inductively coupled mass spectroscopy (ICP-MS). Taking into account all patients, MMF increases Cu level. Cu and Fe concentrations were significantly higher in women treated with MMF; in group of younger patients treated with MMF, Se level was significantly lower comparing with those whose regimen did not include MMF. Additionally, MMF in combination with prednisone increased Se concentration in blood of transplant recipients. Our study highlights that trace elements should be monitored to allow for an early detection of trace elements deficits, which can easily be corrected for by an adjusted diet or supplemental intake.

Association of Serum Zinc Levels in Overweight and Obesity.

Low levels of zinc (Zn) have adverse effects on physiological and metabolic functions in humans, especially in processes linked with obesity. In this work, serum Zn levels and their associations with biochemical parameters (glucose, triglycerides, and total cholesterol), sex, and body mass index (BMI) were determined. The distribution of the study sample by sex was homogeneous: 52.6% were women and 47.4% were men. Women had higher BMI and Zn levels (normal weight and obesity) than men, but the differences in BMI and serum Zn levels by sex were not significant (p > 0.05). Nevertheless, the results obtained showed a decrease in serum Zn levels in overweight and obese individuals (p < 0.05) and a negative correlation between BMI and serum Zn levels (r = - 0.663 and p < 0.001); additionally, a significant correlation was identified between cholesterol and triglyceride values (r = 0.493 and p < 0.001). In conclusion, this study demonstrated decreased serum Zn levels in overweight and obese individuals.

The Association between The Degree of Liver Cirrhosis Severity and Zinc Serum Level

Background: Impaired liver function in LC (Liver Cirrhosis) can cause Zinc deficiency (Zn). One of the causes of Zn deficiency in LC is decreased albumin synthesis, whereas albumin is required as the main Zn binding protein in plasma. However, some studies of the severity of LC with Zn serum levels still provide controversial results.Objective: To determine the association between the degree of LC severity and Zn serum level.Methods: The subjects of this study were LC patients in Gastroentero-Hepatology Unit and Internal medicine wards in of Dr. Soetomo General Hospital Surabaya for three months. Diagnosis of LC was based on clinical examination according to Soehardjno-Soebandiri criteria and other findings (ultrasound or endoscopy). The degree of LC severity was determined based on the CTP score (Child-Turcotte-Pugh). Serum Zn concentration was measured by atomic absorption spectrophotometry method. The research design used the cross-sectional method. The statistical test used was Spearman correlation.Results: Forty-three patients fulfilled the study criteria. The subjects consisted of 27 males (62.8%) and 16 females (37.2%) with the mean age of 53.81 ± 8.67 years. Based on the CTP scores, we obtained CTP A of 4 patients (9.3%), CTP B of 19 patients (44.2%) and CTP C of 20 patients (46.5%). The mean of Zn serum level in CTP A, CTP B, and CTP C score was 58.3 ± 19.6 μg/dl, 43.4 ± 14.5 μg/dl and 31.6 ± 10 μg/dl respectively. The result of the statistical test showed a significant correlation between LC severity and Zn serum level (p &lt;0.05 and r = -0.583).Conclusion: The heavier the severity of LC, the lower Zn serum levels.

The Relationship Between Metabolic Syndrome Development and Tissue Trace Elements Status and Inflammatory Markers.

Insulin resistance, impaired glucose regulation, dyslipidemia, low-grade inflammation, and elevated blood pressure are main components of the metabolic syndrome (MetS). Trace elements, especially zinc (Zn) and copper (Cu) and cytokines, have physiological importance due to their presence in inflammatory processes and glucose metabolism. Therefore, this study aimed to investigate the potential relationship between cytokine responses and trace elements in different tissues of sucrose-induced MetS rats compared with healthy controls (n:7/groups). Tissue Zn concentrations are found to be decreased in the liver (p = 0.00) and pancreas (p < 0.01) and increased in the kidney (p = 0.00) and heart tissues (p < 0.001) of MetS group. Serum Zn levels were also found to be decreased in MetS compared with control group (p < 0.01), while there was any significant difference in serum Cu concentrations between groups. The Cu concentration (p < 0.01) was found decreased, and Zn/Cu ratio (p < 0.01) was found increased in kidney tissues. TNF-α, IL-6 levels were found increased in MetS tissues. With this study, the Zn and Cu concentrations and their relationships with inflammatory response in different tissues in MetS are reported for the first time in the literature. Serum and tissue Zn levels with diversities in distribution were found to have a higher impact on MetS pathogenesis than Cu levels. It has been concluded that there is a relationship between Zn and Cu concentrations and inflammatory marker levels in MetS pathophysiological mechanisms.

Serum Zinc Level and non-Protein Respiratory Quotient in Patients with Chronic Liver Diseases.

We sought to clarify the correlation between non-protein respiratory quotient (npRQ) in indirect calorimetry and serum zinc (Zn) level in chronic liver diseases (CLDs, n = 586, 309 liver cirrhosis (LC) patients, median age = 63 years). Clinical parameters potentially linked to npRQ <0.85 (best cutoff point for the prognosis in LC patients) were also examined in receiver operating characteristic curve (ROC) analyses. The median npRQ was 0.86. The median serum Zn level was 64 μg/dL. The median npRQ in patients with non-LC, Child–Pugh A, Child–Pugh B and Child–Pugh C were 0.89, 0.85, 0.83 and 0.82 (overall p < 0.0001)). The median serum Zn level in patients with npRQ <0.85 (58 μg/dL) was significantly lower than that in patients with npRQ ≥ 0.85 (68 μg/dL) (p < 0.0001). The correlation coefficient (r) between npRQ level and serum Zn level for all cases was 0.40 (p < 0.0001). Similar tendencies were observed in all subgroup analyses. The highest correlation coefficient between serum Zn level and npRQ was found in patients with Child–Pugh C (n = 22, r = 0.69). In ROC analyses for npRQ <0.85, serum Zn level had the highest area under the ROC (AUC) among baseline laboratory parameters (AUC = 0.69). In conclusion, serum Zn level can be helpful for npRQ in patients with CLDs.

Serum zinc concentration and quality of life in chronic liver diseases.

Health related quality of life (HRQOL) in chronic liver disease (CLD) patients has been attracting much attention these days because it is closely associated with clinical outcomes in CLD patients. HRQOL has become established as an important concept and target for research and practice in the fields of medicine. A critique of HRQOL research is the lack of conceptual clarity and a common definition of HRQOL. Using a clear definition of HRQOL may increase the conceptual understanding. In this study, we aimed to elucidate the association between serum zinc (Zn) level and HRQOL as assessed by the Beck Depression Inventory-2nd edition (BDI-II), Pittsburgh Sleep Quality Index Japanese version (PSQI-J) and the 36-Item Short Form Health Survey (SF-36) in CLD patients (n = 322, median age = 65 years, 121 liver cirrhosis (LC) patients (37.6%)). The median serum Zn level for all cases was 73.2 μg/dl. The median BDI-II score and PSQI-J score were 6 and 5, respectively. Patients with higher BDI-II score tended to have lower serum Zn level compared with those with lower BDI-II score. Similar tendencies were observed in patients with higher PSQI-J score. In the SF-36, physical functioning, role physical and physical component summary score significantly correlated with serum Zn level regardless of age, liver disease etiology and the LC status. While mental health and mental component summary score did not significantly correlate with serum Zn level regardless of age, liver disease etiology and the LC status. In conclusion, serum Zn level can be a useful marker for decreased HRQOL in patients with CLDs, especially for physical components.

Detection of serum zinc levels in neonates with bronchopulmonary dysplasia

Background: Bronchopulmonary dysplasia (BPD) is common chronic lung disease that occurs mainly in premature neonates who suffered from respiratory distress and managed with oxygen and mechanical ventilation. Aim: The aim of this study is the detection of the serum zinc (Zn) levels in neonates with BPD. Patient and Methods: A prospective case–control study was done on 25 cases of BPD neonates incubated in the neonatal intensive care unit of Tanta University Hospital suffering (patient group) and 25 healthy neonates (who did not develop BPD) with matched gestational age and sex (control group). The study was conducted from August 2016 to February 2018. The sample of venous blood was taken from infants within the first 3 h. Serum Zn levels were determined. Results: Serum Zn levels were significantly lower in neonates who had BPD (patient group) if compared with neonates who did not developed BPD (control group). Cutoff value of the serum Zn levels in cases of BPD was 6.9 μmol/L, the area under the curve was 0.991, the sensitivity was 100%, the specificity was 96%, the positive predictive value was 96%, the negative predictive value was 100%, and the accuracy was 98%. Conclusion: Neonates with BPD are accompanied by decrease in serum Zn levels and it could be used as the early predictor for BPD development in neonates. Recommendation: Zn supplementation to the neonates who are susceptible to develop BPD.

Evaluation of serum levels of trace elements in children with biliary atresia and their correlation with liver histopathology

Background:Children with biliary atresia (BA) have impaired metabolism of trace elements (TEs) (i.e., zinc, copper, selenium, and manganese), leading to an alteration in the serum levels. However, this alteration in serum level has any correlation with liver histopathological changes is not yet clear.Materials and Methods:This prospective study attempts to evaluate the preoperative serum levels of TE in comparison to controls and its correlation with liver histology in children with BA. Kasai portoenterostomy (KPE) and liver biopsy were performed in all cases. On liver histology, various parameters assessed and were graded according to predefined criteria. Serum levels of TE were determined again 12 weeks post-KPE and compared with the preoperative levels.Results:Mean(±standard deviation [SD]) preoperative serum Zn, Cu, Se, and Mn levels (in μg/dl) in BA patients were 41.6 ± 12.8, 130.6 ± 12.8, 50.0 ± 10.0, and 32.0 ± 20.0, respectively; in controls, these levels were 77.9 ± 13.7, 133.7 ± 13.7, 87.0 ± 13.0, and 8.0 ± 5.5, respectively. Mean postoperative levels in all patients were 68.5 ± 19.0, 91.7 ± 19.0, 79.0 ± 19.0, and 28.0 ± 12.0, respectively. Mean(±SD) postoperative serum Zn, Cu, Se, and Mn levels in BA patients with bile excretion were 73.8 ± 14.9, 83.6 ± 13.8, 85.0 ± 15.0, and 26.0 ± 10.0, respectively, whereas in those with no bile excretion, they were 40.6 ± 12.8, 134.0 ± 23.0, 49.0 ± 11.0, and 44.0 ± 16.0, respectively. In liver histology, specific parameters showed correlation with high Mn and low Zn levels.Conclusion:Serum TE levels are altered in children with BA and the establishment of successful biliary drainage may change the subsequent postoperative serum concentration. Serum Zn and Mn levels can signify specific histopathological liver changes and the extent of liver damage.

Zinc has a role in pathogenesis of pityriasis alba

Background: Pityriasis alba (PA) is a common disease of children and seen in most of the developing countries. The exact pathogenesis of PA is still not well established. Some cases of PA have been associated with atopic dermatitis, while most cases have no association with it. Objectives: The objective was to evaluate the role played by zinc (Zn) in the pathogenesis of PA. Patients and Methods: Sixty patients suffering from PA were included in the study, and 30 apparently healthy individuals of matching age and sex were recruited as a control group. Serum Zn, hemoglobin, and albumin were measured in both groups. In addition, skin phototype and body mass index were recorded. The American Academy Criteria of atopic dermatitis diagnosis were applied to the participants in this study. PA patients were examined dermatologically with a recording of the site, size, and number of lesions. Results: There was no difference in the presence of atopic dermatitis between the patient and control groups (P = 0.672). PA lesions were detected in the faces of all patients. There were no statistically significant differences between patients and controls regarding serum hemoglobin concentration (P = 0.763) or serum albumin (P = 0.487). The serum level of Zn was lower in patients with PA than controls (P

The status of zinc in type 2 diabetic patients and its association with glycemic control.

BACKGROUND:Zinc (Zn) is a trace element that carries antioxidant properties. Deficiency of Zn increases oxidative stress, especially in diabetes. The objective of this study was to assess the relationship between the level of Zn and glycemic control in type 2 diabetes.MATERIALS AND METHODS:A cross-sectional study was carried out in the Department of Medicine at King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia, from March 2018 to September 2018. A total of 440 participants were included in the study; 252 of these had type 2 diabetes and 188 were controls. All participants had laboratory investigations including fasting blood sugar (FBS), glycosylated hemoglobin, and lipid profile and Zn levels. These two groups (diabetics and controls) were further divided into Zn deficient group and normal Zn group according to their Zn levels. Data were analyzed by using SPSS software.RESULTS:The mean Zn level was 11.7 + 1.5 in the control group, whereas it was significantly low (9.3 + 1.6) in the diabetic group (P < 0.001). Zn deficiency in the control group was only 6.4%, while in the diabetic group, it was 67.9%, (P ≤ 0.001). The mean ages for the low Zn group and normal Zn group were 40.9 + 12.5 and 37.5 + 10.1, respectively, and the Zn deficient group was higher in age (P = 0.003). There was no significant statistical difference between genders regarding Zn deficiency. Obesity was associated with significantly low Zn levels (P = 0.016). The serum Zn level was significantly negatively associated with FBS and glycated hemoglobin in diabetic participants (P < 0.001).CONCLUSION:Diabetic patients have Zn deficiency compared to normal individuals and poor glycemic control is associated with low Zn levels.

Zinc status of under-five children in selected urban and rural settings in Enugu State, Nigeria

Background: High incidence of zinc (Zn) deficiency, especially among under-five children, is widely reported in developing countries including Nigeria. Objective: The aim of this study was to provide data on the Zn status of under-five children in Enugu State. Materials and Methods: This was a descriptive cross-sectional study of under-five children in Enugu South (urban) and Nkanu West (rural) local government areas (LGAs). A total of 409 children (244 urban and 165 rural) were enrolled in the study. Non-fasting venous blood (2 mL) was obtained from a total of 409 under-five children and the serum Zn was determined by using an atomic absorption spectrophotometer. Serum Zn level of < 70 µg/L was defined as Zn deficiency. Results: Although 222 (54%) of the children were adequate, 187 (46%) were deficient in Zn. Of the 165 children from the rural area, 73 (44%) were deficient in Zn, whereas in urban area, of 244 children, 112 (46%) were deficient in Zn (<70 µg/dL). The mean serum Zn level (73.86 ± 15.99 µg/dL) of the urban under-five children was significantly (P = 0.009) higher than that of the rural children (68.25 ± 9.04). In the rural setting, higher incidence of Zn deficiency occurred among the male subjects (32 [52.8%]) compared to the female subjects (35 [37.6%]) although the difference was not statistically significant (P = 0.08). Conclusion: The results indicate a high incidence of Zn deficiency in the studied population, which seems higher in the rural than in the urban LGA. Nutrition educational programs, intake of food rich in Zn and supplements should be promoted to improve Zn intake especially in infant and young child feeding practices.

The Copper/Zinc Ratio Correlates With Markers of Disease Activity in Patients With Inflammatory Bowel Disease.

BackgroundZinc (Zn) and copper (Cu) are trace elements that serve as cofactors in catalytic processes with impact on immune responses. In patients with inflammatory bowel disease (IBD), decreased levels of serum Zn and Cu have been observed. Here, we investigated the effect of inflammation on serum concentrations of these trace elements in patients with IBD.MethodsIn this cross-sectional study, 98 patients with Crohn disease (CD) and 56 with ulcerative colitis (UC) were prospectively enrolled. Disease activity parameters, such as C-reactive protein (CRP) and fecal calprotectin (FC) were compared to serum Zn, Cu, and Cu/Zn ratio.ResultsZinc insufficiency was observed in 11.2% of patients with CD and 14.3% with UC, Cu insufficiency in 20.4% with CD and 7.1% with UC. Anemia, hypoalbuminemia, increased FC, and elevated CRP were more frequently present in Zn-insufficient patients with IBD. In contrast, lower serum CRP values and a trend to lower FC were observed in Cu-insufficient patients. In multiple linear regression models adjusted for age, gender, and serum albumin, CRP positively correlated with serum Cu (P < 0.001) and the Cu/Zn ratio in both CD and UC (P < 0.001) but not with serum Zn concentrations. FC levels correlated only with the Cu/Zn ratio in patients with UC (P < 0.038).ConclusionSystemic inflammation inversely affected the serum Zn and Cu concentrations and, consequently, resulted in an increased Cu/Zn ratio.

Serum levels of zinc, copper, selenium and glutathione peroxidase in the different groups of colorectal cancer patients.

Background:Colorectal cancer (CRC) is considered the fourth type of cancer that causes death worldwide. Changes in the levels of zinc (Zn), copper (Cu), and selenium (Se) as well as low glutathione peroxidase (GPx) activity can lead to CRC and this study was aimed to evaluate their possible use as diagnostic markers.Methods:CRC patients (n=90) were divided into three groups; newly diagnosed, before surgery, and after surgery. These groups were compared to healthy subjects (n=30); the mean age ±SD was 50.63±9.26 and 49.97±10.85 for CRC patients and healthy subjects, respectively. Biochemical study for serum levels of Zn and Cu was measured by FAAS, Se was measured by HGAAS, and ELISA for GPx.Results:Zn, Cu, Se and GPx were significantly lower in all CRC patient groups, except for the after surgery group which showed no differences for Zn and GPx as compared to the healthy subjects. Positive correlations were found between Se and Zn and between Se and GPx (r=0.71, r=0.42; P<0.01, respectively) in all CRC patient groups. A receiver operating characteristic (ROC) curve analysis was applied for the newly diagnostic group showing all the parameters that can be used as diagnostic markers for CRC.Conclusion:The present results conclude that Zn, Cu Se, and GPx can be used as diagnostic markers for CRC, where the decrease of these parameters may be associated with an increased risk of CRC and as indicators of the response to therapy.

Does the frequency domain parameters among pregnant women with gestational hypertension associated with levels of serum zinc, magnesium, and copper? A cross-sectional study

Back ground: In addition to the imbalance in the cardiac autonomic function, deficiency of micronutrients such as zinc (Zn), magnesium, and copper (Cu) was also found to be one of the cause of hypertensive disorders of pregnancy. Although there are number of studies done to know the autonomic balance and serum trace elements among preeclamptic women, none of the studies were done among the gestational hypertensives, hence, we have chosen this study on association between the level of micronutrients and frequency domain parameters of heart rate variability (HRV) among newly diagnosed gestational hypertensives. Aim and Objective: This study aims to estimate the serum levels of Zn, magnesium, and Cu and its association with frequency domain parameters of HRV among non-pregnant, normotensive pregnant, and gestational hypertensives. Materials and Methods: The study was done in Sri Venkateswara Medical College and Hospital. Blood pressure and heart rate were recorded after 15 min rest. HRV was analyzed using Kubios HRV analyzer by recording 5 min resting electrocardiogram in supine position with PHYSIOPAC-PP4, MEDICAID system, Chandigarh, among 35 normal pregnant, 35 gestational hypertensive, and 35 non-pregnant women of 20–35 years of age group. Serum Zn, magnesium, and Cu analysis were done in the same day using standardized autoanalyzer method. Results: With GraphPad Prism software, statistical analysis was done. Kolmogorov–Smirnov test was done to test the normality. Data following Gaussian distribution are tabulated as mean ± SD or it is expressed as median (interquartile range). Either one-way ANOVA, Turkey’s multiple comparison, or Kruskal–Wallis and Dunn’s multiple comparison test were done to compare the parameters among all the three groups. Spearman correlation was done to know the association of Zn, magnesium, and Cu with frequency domain parameters of HRV in all three groups. Conclusion: Frequency domain parameters of HRV show a significant higher sympathetic and lower parasympathetic activity among the study group (P < 0.0001). There is no significant variation in the level of micronutrients among the groups and all were within normal limit. There is no significant association between the frequency domain parameters and the level of micronutrients.

Effect of long-term proton pump inhibitor therapy on complete blood count parameters and selected trace elements: a pilot study.

Proton pump inhibitors (PPIs) are widely prescribed for several gastrointestinal conditions, often as long‑term therapy. The effects of term PPI use have not been fully elucidated. We aimed to determine the association between long‑term PPI use and complete blood count parameters, particularly red blood cell (RBC) count, white blood cell (WBC) count, and hemoglobin concentrations, as well as serum levels of selected micronutrients such as selenium (Se), iron (Fe), copper (Cu), and zinc (Zn). We enrolled 37 patients on long‑ term PPI therapy (mean [SD] age, 57.1 [15.4] years) and 30 healthy controls (mean [SD] age, 39.3 [11.8] years). In each group, complete blood count, and serum Fe levels were performed, and serum Cu, Zn, and Se levels were measured using atomic absorption spectrometry. Red blood cell and WBC counts were lower in the PPI group compared with controls (mean [SD], 4.24 [0.55] ×106/μl vs 4.7 [0.4] ×106/μl; P <0.001 and 6.13 [1.44] ×103/μl vs 7.3 [1.28] ×103/μl; P <0.001, respectively). Hemoglobin and serum Fe concentrations were also lower in the PPI group (mean [SD], 12.5 [1.8] g /dl vs 14.3 [0.8] g /dl; P <0.001 and 16.3 [5.4] μmol/l vs 23.4 [2.7] μmol/l; P <0.001, respectively). Serum Zn and Cu concentrations were higher in PPI users than in controls. Long‑term PPI therapy may reduce RBC and WBC counts as well as hemoglobin levels, leading to iron deficiency. It may also aff ect concentrations of some micronutrients, although the underlying mechanism of this association is not fully clear.

Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD)

BackgroundEssential trace elements and minerals play a significant role in neurodevelopment. Although certain studies demonstrated impaired essential trace element and mineral status in children with ADHD, the existing data are insufficient. The objective of the present study was to assess serum trace element and mineral levels in children with ADHD. MethodsSerum trace element and mineral levels in 68 children with ADHD and 68 neurotypical controls were assessed using ICP-MS at NexION 300D (PerkinElmer Inc., USA) equipped with ESI SC-2 DX4 autosampler (Elemental Scientific Inc., USA). ResultsSerum Cr, Mg, and Zn levels in children with ADHD were 21 % (p = 0.010), 4 % (p = 0.005), and 7 % (p = 0. 001) lower as compared to the healthy controls, respectively. In turn, serum Cu/Zn values were 11 % higher than those in the control group. Age and gender had a significant impact on serum element levels in ADHD. Particularly, preschool children were characterized by significantly increased Cu (+8 %; p = 0.034), and Cu/Zn (+19 %; p < 0.001) values, whereas serum Zn (-9 %; p = 0.004) level was decreased. In primary school-aged children only 6 % (p = 0.007) lower Mg levels were observed. Both boys and girls with ADHD were characterized by 8 % (p = 0.016) lower serum Zn levels and 10 % (p = 0.049) higher Cu/Zn values when compared to neurotypical girls. Boys with ADHD also had significantly higher Cu/Zn, exceeding the respective control values by 12 % (p = 0.021), predominantly due to a 7 % (p = 0.035) decrease in serum Zn. Serum Mg levels were also found to be significantly lower than those in neurotypical children by 5 % (p = 0.007). In adjusted regression models serum Cr (β=-0.234; p = 0.009) and Cu/Zn (β = 0.245; p = 0.029) values were significantly associated with ADHD, respectively. Two-way ANOVA revealed a significant impact of ADHD on Cr, Mg, Zn, and Cu/Zn, whereas age was associated with Cu, I, Mg, Mo, and Cu/Zn, whereas gender accounted only for variability in serum Mn levels. Principal component analysis (PCA) also revealed significant contributions of Mg, Zn, and Cu/Zn values to ADHD variability. ConclusionsHypothetically, the observed decrease of essential trace elements, namely Mg and Zn, and elevation of Cu/Zn may significantly contribute to the risk of ADHD or its severity and/or comorbidity.

ROLE OF ZINC DEFICIENCY IN THE SUSCEPTIBILITY TO DELAYED POLYNEUROPATHY IN ORGANOPHOSPHORUS INTOXICATED PATIENTS IN ZAGAZIG UNIVERSITY HOSPITALS, ZAGAZIG, EGYPT

Organophosphorus pesticides are widely used as insecticides in agriculture both in developed and developing countries in spite of reported poten­tial toxicity. They induce neurotoxic effects either upon acute or chronic exposure. It was found previously that zinc (Zn) supplementation exerted a neuroprotective effect against organophosphorus pesticide-induced neurodegenerative disorders in experimental animals. This study therefore, aimed to investigate the possible association between serum zinc level and organophosphorus-induced delayed polyneuropathy. Fifty acute organophosphorus poisoned cases admitted to Zagazig University Hospitals from February to August 2016 were enrolled in this study. Another Forty six healthy individuals (age- and sex-matched) served as a control group. Both groups were investigated for serum lipid peroxidation product (malondialdehyde: MDA) and total antioxidant capacity (TAC) levels as well as lymphocytic neuropathy target esterase (NTE) and plasma acetylcholinesterase (AChE). Then, they were followed up for 4 weeks to assess the development of delayed polyneuropathy (diagnosed clinically and confirmed by motor and sensory conduction studies). Serum levels of Zn, MDA and TAC as well as lymphocytic NTE and plasma AChE were measured for those developed organophosphorus delayed polyneuropathy. Organophosphorus intoxication has resulted in a significant elevation in the levels of MDA, suggesting oxidative stress. On the other hand, TAC levels as well as measured lymphocytic NTE and plasma AChE activities were found to be significantly reduced in the intoxicated group. However, at the end of the follow up period, 7 cases developed delayed polyneuropathy; 5 of them were Zn deficient while the rest were with normal Zn level. Cases with delayed polyneuropthy showed also a significant increase in lipid peroxidation along with impairment of estrases activities compared to cases on admission. Furthermore, serum Zn level showed a significant positive correlation with TAC, AChE, NTE and a negative correlation with MDA, where serum zinc level seems to be the strongest determinants for the prediction of delayed polyneuropathy. Thus, we conclude that Zn deficiency has a potential role in organophosphorus -induced delayed polyneuropathy. This may be due to its involvement in the activity of antioxidant enzymes. However, further future large scale studies are needed to clarify the exact mechanism by which Zn deficiency mediated neurotoxicity upon organophosphorus induced polyneuropathy.

Potential Role of Nutrient Intake and Malnutrition as Predictors of Uremic Oxidative Toxicity in Patients with End-Stage Renal Disease.

Oxidative stress is an important risk factor for cardiovascular disease and death in hemodialysis (HD) patients. However, whether biochemical and nutritional markers might be useful to stratify HD patients according to the risk of oxidative damage remains unclear. We investigated whether low-cost and easily available parameters such as the profile of nutrients intake, nutritional status, and antioxidant defenses can predict lipid and protein oxidation in HD patients. Forty-nine HD patients (women = 20, men = 29), ranging from 18 to 65 years of age (73.5%) were submitted to biochemical and nutritional analysis. At least 93.9% of HD patients had malnutrition. A patient's stratification according to nutritional risk was highly coherent with anthropometric parameters and nutrients intake, which were complementarily used as markers of malnutrition. Nutritional stratification was unable to reveal differences in the oxidative status. On the other hand, carbohydrate and zinc intake, serum zinc (Zn), glutathione peroxidase (GPx) activity, total antioxidant capacity (TAC), and nonprotein antioxidants (npAC) in serum were predictive markers of lipid (R2 = 0.588, P < 0.001) and protein (R2 = 0.581, P < 0.001) oxidation. Interestingly, GPx activity, TAC, and npAC exhibited good (>80% < 90%) or excellent (>90%) accuracy to estimate lipid oxidation (P ≤ 0.01). Regarding the prediction of protein oxidation, GPx activity and TAC presented regular accuracy (>70% < 80%), and Zn serum levels exhibited good sensitivity (P ≤ 0.01). Herein, we provided evidence that clinical characteristics relevant to predict different levels of lipid and protein oxidation in HD patients can be easily obtained, during routine hospital visits by means of the combined analyses of biochemical and nutritional parameters.

Assessment of Zinc and Iron Status among Malnourished Children under 5 Years Old in Gaza City

Background: Malnutrition in children often begins at birth and is associated with retarded physical and cognitive development. Micronutrients are essential for healthy growth and development. Objective: To investigate zinc and iron status among malnourished children under 5 years in Gaza city. Methodology: This cross sectional study consisted of 149 malnourished children under 5 years old from both sexes. Questionnaire interview with parents was used. Anthropometric measurements (weight, length and height) were taken. Blood samples were drawn for determination of serum Zinc and iron|. Statistical analysis was performed using SPSS version 18.0. Results: The study population was (149) cases; (53.7%) males and (46.3%) females. It was found that (61.7%) of the children were moderately underweight, (40%) of them were moderately stunted and about forty one percent (40.9%) of the study population were mildly wasted. The majority of surveyed children (91.3%) received immediate breastfeeding and more than two third (71.1%) of them were breast fed exclusively. The mean levels of serum zinc and iron were (79.8±15.6, 76.4±29.9, respectively). There were no statistically significant in zinc and iron levels according to gender, number of household, source of income, monthly income (NIS) and type of home. While there was significant association between length of breastfeeding period and serum iron levels. In contrast, there was no significant association between immediate breastfeeding, exclusive breastfeeding length of breastfeeding period, age of introducing infant formula, age of introducing complementary food with serum Zn levels. Recommendations: Childhood malnutrition among children under 5 years appears to be a public health problem in GS and interventions to improve children nutritional status must be in concern.

Serum Zinc Level Classification System: Usefulness in Patients with Liver Cirrhosis.

Currently, the Japanese society of clinical nutrition (JSCN) defines serum zinc (Zn) level < 60 μg/dL as Zn deficiency and 60 μg/dL ≤ serum Zn level < 80 μg/dL as subclinical Zn deficiency, and 80 μg/dL ≤ serum Zn level < 130 μg/dL as normal Zn range. We aimed to elucidate the prognostic impact of this Zn classification system in patients with liver cirrhosis (LC) compared to the Child–Pugh classification and the albumin–bilirubin (ALBI) grading system (n = 441, median age = 66 years). The Akaike information criterion (AIC) with each evaluation method was tested in order to compare the overall survival (OS). The median serum Zn level was 65 μg/dL. There were 56 patients with normal Zn level, 227 with subclinical Zn deficiency and 158 with Zn deficiency. OS was well stratified among three groups of serum Zn level (p < 0.0001). The AIC value for survival by the Zn classification system was the lowest among three prognostic models (AIC: 518.99 in the Child–Pugh classification, 502.411 in ALBI grade and 482.762 in the Zn classification system). Multivariate analyses of factors associated with OS revealed that serum Zn classification by JSCN was an independent factor. In conclusion, the serum Zn classification proposed by JSCN appears to be helpful for estimating prognosis in LC patients.