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Ceballos-Rasgado M, Brazier AKM, Gupta S, Moran VH, Pierella E, Fekete K, Lowe NM. Methods of Assessment of Zinc Status in Humans: An Updated Review and Meta-analysis. Nutr Rev 2024:nuae072. [PMID: 38917458 DOI: 10.1093/nutrit/nuae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
CONTEXT The assessment of zinc status is difficult but essential for the identification of zinc deficiency and evaluation of interventions to improve zinc status. OBJECTIVE The purpose of this systematic review (SR) and meta-analysis was to update the previously published SR of biomarkers of zinc status, conducted by the European Micronutrient Recommendations Aligned (EURRECA) network in 2009, to answer the question: Which putative measures (biomarkers) of zinc status appropriately reflect a change in zinc intake of at least 2 weeks? DATA SOURCES A structured search strategy was used to identify articles published between January 2007 and September 2022 from MEDLINE (Ovid), Embase (Ovid), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles were identified using previously defined eligibility criteria. DATA EXTRACTION Data were extracted and combined with data from the previous SR. DATA ANALYSIS A random-effects model was used to calculate pooled mean differences using STATA (StataCorp). The risk of bias and the certainty of evidence for all outcomes were assessed. Additional data on 7 of the 32 previously reported biomarkers were identified, along with data on an additional 40 putative biomarkers from studies published since 2007. Pooled data analysis confirmed that, in healthy participants, both plasma/serum zinc concentration and urinary zinc excretion responded to changes in zinc intake (plasma/serum: mean effect [95% CI], controlled studies: 2.17 µmol/L [1.73, 2.61]; P < .005, I2 = 97.8; before-and-after studies: 2.87 µmol/L [2.45, 3.30]; P < .005, I2 = 98.1%; urine zinc: 0.39 mmol/mol creatinine [0.17, 0.62]; P < .005, I2 = 81.2; 3.09 µmol/day [0.16, 6.02]; P = .039, I2 = 94.3). CONCLUSION The updated analyses support the conclusion that plasma/serum and urinary zinc respond to changes in zinc intake in studies of healthy participants. Several additional putative biomarkers were identified, but more studies are needed to assess the sensitivity and reliability. SYSTEMATIC REVIEW REGISTRATION PROSPERO no. CRD42020219843.
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Affiliation(s)
- Marena Ceballos-Rasgado
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Anna K M Brazier
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Swarnim Gupta
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Victoria H Moran
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Elisa Pierella
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
| | - Katalin Fekete
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Pécs 7624, Hungary
| | - Nicola M Lowe
- Centre for Global Development, University of Central Lancashire, Preston PR1 2HE, United Kingdom
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Shahida S, Rehman S, Ilyas N, Khan MI, Hameed U, Hafeez M, Iqbal S, Elboughdiri N, Ghernaout D, Salih AA, Matouq M. Determination of Blood Calcium and Lead Concentrations in Osteoporotic and Osteopenic Patients in Pakistan. ACS OMEGA 2021; 6:28373-28378. [PMID: 34723034 PMCID: PMC8552473 DOI: 10.1021/acsomega.1c04565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/28/2021] [Indexed: 05/31/2023]
Abstract
Osteoporosis is the leading cause of deformity and bones fracture all over the world and has some relationship with the blood concentrations of calcium and lead. Therefore, in the current study, the blood samples of 58 control and 56 clinically diagnosed osteoporotic and osteopenic patients were taken from different hospitals in Pakistan and analyzed for calcium and lead concentrations using atomic absorption spectrometry. In female control samples, the mean calcium value was found to be 98.53 ± 4.81 μg/mL, and in male control samples, the mean blood calcium level was found to be 121.33 ± 7.27 μg/mL. In female control samples, the mean lead value was found to be 0.133 ± 0.005 μg/mL, and in male control samples, the mean lead level was found to be 0.183 ± 0.008 μg/mL. All the male and female control samples showed a mean value of calcium of 115.63 ± 5.2 μg/mL and a mean value of lead of 0.153 ± 0.007 μg/mL. In osteoporotic female patients, the decline in the mean calcium value was found to be 34.93 ± 1.9 μg/mL, and in male patients, the decrease in the mean calcium level was found to be 47.73 ± 2.5 μg/mL. The increase in the mean value of lead in osteoporotic females was 4.13 ± 0.22 μg/mL, whereas in male patients, the increase in the mean lead value was 0.95 ± 0.07 μg/mL. All the male and female patients showed a decrease in the mean value of calcium of 41.43 ± 2.2 μg/mL and an increase in the mean value of Pb of 3.63 ± 0.16 μg/mL.
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Affiliation(s)
- Shabnam Shahida
- Department
of Chemistry, University of Poonch, Rawalakot, Azad Kashmir 7475, Pakistan
| | - Sohaila Rehman
- Chemistry
Division, Pakistan Institute of Nuclear
Science and Technology, P.O. Nilore, Islamabad 44000, Pakistan
| | - Nabila Ilyas
- Department
of Chemistry, University of Poonch, Rawalakot, Azad Kashmir 7475, Pakistan
| | - Muhammad Imran Khan
- Research
Institute of Sciences and Engineering, University
of Sharjah, Sharjah 27272, United Arab Emirates
| | - Usman Hameed
- Department
of Chemistry, Women University of Azad Jammu
& Kashmir, Bagh 12500, Pakistan
| | - Muhammad Hafeez
- Department
of Chemistry, University of Azad Jammu and
Kashmir, Muzaffarabad 12500, Pakistan
| | - Sajid Iqbal
- Chemistry
Division, Pakistan Institute of Nuclear
Science and Technology, P.O. Nilore, Islamabad 44000, Pakistan
| | - Noureddine Elboughdiri
- Chemical
Engineering Department, College of Engineering, University of Ha’il, P.O. Box 2440, Ha’il 81441, Saudi Arabia
- Chemical
Engineering Process Department, National School of Engineers Gabes, University of Gabes, Gabes 6029, Tunisia
| | - Djamel Ghernaout
- Chemical
Engineering Department, College of Engineering, University of Ha’il, P.O. Box 2440, Ha’il 81441, Saudi Arabia
- Chemical
Engineering Department, Faculty of Engineering, University of Blida, P.O. Box 270, Blida 09000, Algeria
| | - Alsamani Ahmed Salih
- Chemical
Engineering Department, College of Engineering, University of Ha’il, P.O. Box 2440, Ha’il 81441, Saudi Arabia
| | - Mohammed Matouq
- Chemical
Engineering Department, Al-Balqa Applied
University, Amman, P.O. Box 4486, 11131, Jordan
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Lowe NM, Fekete K, Decsi T. Methods of assessment of zinc status in humans: a systematic review. Am J Clin Nutr 2009; 89:2040S-2051S. [PMID: 19420098 DOI: 10.3945/ajcn.2009.27230g] [Citation(s) in RCA: 288] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Zinc is an essential micronutrient for human health and has numerous structural and biochemical roles. The search for a reliable, sensitive, and specific index of zinc status has been the subject of considerable research, which has resulted in the identification of a number of potentially useful biomarkers. OBJECTIVE The objective was to assess the usefulness of biomarkers of zinc status in humans. DESIGN The methods included a structured search strategy using Ovid MEDLINE, EMBASE (Ovid), and the Cochrane Library CENTRAL databases; formal inclusion and exclusion criteria; data extraction into an Access database; quality and validity assessment; and meta-analysis. RESULTS Data on 32 potential biomarkers from 46 publications were analyzed. Plasma zinc concentration responded in a dose-dependent manner to dietary manipulation in adults, women, men, pregnant and lactating women, the elderly, and those at low and moderate baseline zinc status. Urinary zinc excretion responded to zinc status overall and in all subgroups for which there were sufficient data. Hair zinc concentration also responded, but there were insufficient studies for subgroup analysis. Platelet, polymorphonuclear cell, mononuclear cell, and erythrocyte zinc concentration and alkaline phosphatase activity did not appear to be effective biomarkers of zinc status. CONCLUSIONS This systematic review confirms that in healthy individuals, plasma, urinary, and hair zinc are reliable biomarkers of zinc status. Further high-quality studies using these biomarkers are required, particularly in infants, adolescents, and immigrant population groups for whom there are limited data. Studies are also required to fully assess a range of additional potential zinc biomarkers.
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Affiliation(s)
- Nicola M Lowe
- Centre for Applied Sport and Exercise Sciences, School of Psychology, the University of Central Lancashire, Preston, United Kingdom.
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Dar NA, Mir MM, Salam I, Malik MA, Gulzar GM, Yatoo GN, Ahmad A, Shah A. Association between copper excess, zinc deficiency, and TP53 mutations in esophageal squamous cell carcinoma from Kashmir Valley, India--a high risk area. Nutr Cancer 2009; 60:585-91. [PMID: 18791921 DOI: 10.1080/01635580802290231] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Trace element deficiency or excess is implicated in the development or progression in some cancers. Here we report the elevated level of copper and low level of zinc in the plasma of esophageal cancer patients in Kashmir India--a high incidence area. The average level of copper was significantly higher (P < 0.0001) for patients than for controls, with a mean concentration of 169 microg/dl and 149 microg/dl for patients and controls, respectively. The control group consisted of 55 healthy individuals matched for age, sex, and place of residence of the patients. In contrast, the average level of zinc in patients was significantly lower than in controls (P < 0.0001), with a mean concentration of 86.8 microg/dl and 96.1 microg/dl for patients and controls, respectively. The levels of both copper and zinc showed significant differences based on gender and age in patients as compared to controls. Similarly, smokers depicted a significant increase in serum copper (N = 39, P = 0.002) and a decrease in serum zinc approaching level of significance in the patient group as compared to controls. The copper and zinc levels were significantly altered in patients (N = 40) when compared to controls as a function of snuff consumption. The differences in the levels of copper and zinc showed significant association with the consumption of local salted tea up to 1,500 ml per day, but the changes were insignificant beyond that. Patients with poorly differentiated tumors (N = 7) had a higher copper concentration than those with moderately or well-differentiated tumors (P < 0.0001). To validate the general notion that imbalance in copper and zinc levels may lead to higher prevalence of TP53 mutations, we compared the 3 variables, and no association was found between copper concentration and TP53 mutation status; but patients with TP53 mutant tumor had lower zinc levels than those with no mutation. In conclusion, our results point toward a role of the trace element imbalance in the esophageal tumorigenesis in high-risk Kashmiri population exposed to a range of nitroso compounds or their precursors. Further prospective cohort studies are warranted to determine whether change in the plasma zinc and copper homeostasis may represent an independent risk factor for this malignancy as well as a possible target for preventive intervention.
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Affiliation(s)
- Nazir Ahmad Dar
- Department of Clinical Biochemistry, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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Gonzalez A, Peters U, Lampe JW, Satia JA, White E. Correlates of toenail zinc in a free-living U.S. population. Ann Epidemiol 2008; 18:74-7. [PMID: 17923419 PMCID: PMC2701730 DOI: 10.1016/j.annepidem.2007.07.100] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2007] [Revised: 07/16/2007] [Accepted: 07/21/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE No prior studies have reported on dietary correlates of toenail zinc, an easily collected biomarker of zinc status. The study aim was to identify dietary and other factors that influence toenail zinc in a healthy population, in order to understand the usefulness of this biomarker in public health studies. DESIGN Cross-sectional comparison of toenail zinc with questionnaire measures of demographic and behavioral factors, dietary intake and supplement use. SETTING Western Washington State, US. SUBJECTS 106 men and 106 women, who are participants in a large cohort study, of whom 66% used multivitamins or individual supplements containing zinc. RESULTS Increased toenail zinc concentrations were associated with increased dietary zinc intake (adjusted difference in toenail zinc between those in the highest quartile of intake vs. lowest = 11.0 ppm, p for trend = 0.03), with the association primarily among men. Borderline associations of increased toenail zinc were found with decreased vegetable intake (p=0.08) and increased body mass index (p=0.11). Supplemental zinc and intake of phytic acid, alcohol, iron (from food or supplements) did not influence toenail zinc. CONCLUSION Toenail zinc concentrations vary with dietary zinc intake, even in a healthy population with presumably little zinc deficiency.
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Affiliation(s)
- Alejandro Gonzalez
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA and Department of Epidemiology, University of Washington, Seattle, WA
| | - Ulrike Peters
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA and Department of Epidemiology, University of Washington, Seattle, WA
| | - Johanna W. Lampe
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA and Department of Epidemiology, University of Washington, Seattle, WA
| | - Jessie A. Satia
- Department of Nutrition, University of North Carolina, Chapel Hill, NC
| | - Emily White
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA and Department of Epidemiology, University of Washington, Seattle, WA
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Abstract
Zinc is an essential micronutrient for human growth, development, and immune function. Zinc deficiency impairs overall immune function and resistance to infection. Mild to moderate zinc deficiency can be best detected through a positive response to supplementation trials. Zinc supplementation has been shown to have a positive effect on the incidence of diarrhea (18% reduction, 95% CI: 7-28%) and pneumonia (41% reduction, 95% CI: 17-59%), and might lead to a decrease in the incidence of malaria. Zinc has also proven to decrease the duration of diarrhea by 15% (95% CI: 5-24%). Maternal zinc supplementation may lead to a decrease in infant infections. Studies assessing the role of zinc supplementation among persons with HIV, tuberculosis, and the common cold have not been conclusive. Two studies have shown zinc supplementation to decrease child mortality by more than 50%. Zinc clearly has an important role in infant and childhood infectious diseases; programs to increase the intake of zinc among deficient populations are needed.
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Affiliation(s)
- Christa Fischer Walker
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Abstract
Routine supplementation of total parenteral nutrition mixtures with the readily available single or combination trace elements products is becoming more widespread. As more is learned about deficiency syndromes and monitoring techniques, so too must we understand more about the physicochemical interactions between individual trace elements and other nutrients, that could ultimately affect bioavailability. Expert pharmaceutical assessment of these complex reactions, that have been demonstrated to occur in solution, becomes increasingly important in order to optimize the efficacy of micronutrient therapy.
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Affiliation(s)
- G Hardy
- Nutrition and Food Science Research Group, School of Biological and Molecular Sciences, Oxford Brookes University, UK.
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