Recent insights into trace element deficiencies: causes, recognition and correction

A Novel Manganese Ion Delivery Carrier Promotes Immune Cell Proliferation and Enhances Innate Immune Responses

Manganese is a transition metal that is an essential trace element for human health. Manganese ions (Mn2+), which serve as one of the most common transition metal ions, play vital roles in enhancing innate immune responses. However, immune agonists based on Mn2+ are poorly utilized in clinical trials due to poor chemodynamics and adverse events. In this work, we designed a novel delivery carrier for loading manganese ions by constructing hFn-MT3(Mn2+) protein nanoparticles (termed as NPs(Mn2+)), which contained human ferritin heavy chain (hFn) and metallothionein-3 (MT3), induced by isopropyl β-d-thiogalactoside (IPTG) and manganese ions in the prokaryotic expression system. The NPs(Mn2+) protein nanoparticles could not only stimulate immune cell proliferation but also activate innate immune responses via the cGAS-STING-IRF3 signaling pathway. Collectively, our results unveil a candidate strategy for delivering metal ions beyond Mn2+ and may broaden metal ion clinical use in the field of immunotherapies.

Organic Trace Minerals Enhance the Gut Health of British Shorthair Cats by Regulating the Structure of Intestinal Microbiota

Trace minerals are essential for biological processes, including enzyme function, immune response, and hormone synthesis. The study assessed the effects of different dietary trace minerals on the gut health, microbiota composition, and immune function of cats. Eighteen adult British Shorthair cats were divided into three groups receiving inorganic trace minerals (ITM), a 50/50 mix of inorganic and organic trace minerals (ITM + OTM), or organic trace minerals (OTM) for 28 days. The OTM showed enhanced immune capacities, reduced intestinal barrier function, and lower inflammation condition. The OTM altered gut microbiota diversity, with a lower Simpson index and higher Shannon index (p < 0.05). Specifically, the abundance of Bacteroidota, Lachnospiraceae, and Prevotella in the OTM group were higher than the ITM group (p < 0.05). Metabolomic analysis identified 504 differential metabolites between the OTM and ITM groups (p < 0.05, VIP-pred-OPLS-DA > 1), affecting pathways related to steroid hormone biosynthesis and glycerophospholipid metabolism (p < 0.05, VIP-pred-OPLS-DA > 2). Additionally, there was a significant correlation between intestinal microbiota and differential metabolites. To conclude, dietary OTM can modulate the gut metabolite and microbiota composition, enhance immune and intestinal barrier function, and mitigate inflammation in cats, highlighting the benefit of using OTM in feline diet to promote the intestinal and overall health.

Nutrition and melanoma: the contribution of trace elements in onset, progression, and treatment of melanoma

Melanoma is a highly malignant and drug-resistant disease that imposes a substantial economic burden on the world. There are many studies linking trace elements to diverse types of cancers, including melanoma. This review elucidates the relationship between trace elements exposure and melanoma. It was identified that copper, manganese, selenium, zinc, iron, and many other trace elements were associated with melanoma in humans. In terms of epidemiology, different elements have different correlations with melanoma. These trace elements affect the occurrence and development of melanoma through various mechanisms, such as oxidative stress and the MAPK pathway. The literature on the role of trace elements in the pathogenesis and treatment of melanoma depicts promising prospects for this field.

Trace Toxins: The Key Component of a Healthful Diet

Although it is well established that a vegetable-rich (Mediterranean) diet is associated with health benefits in later life, the mechanisms and biological origins of this benefit are not well established. This review seeks to identify the components a healthful diet that reduce the individual's suffering from non-communicable disease and extend longevity. We note the difference between the claims made for an essential diet (that prevents deficiency syndromes) and those argued for a diet that also prevents or delays non-communicable diseases and ask: what chemicals in our food induce this added resilience, which is effective against cardiovascular and neurodegenerative diseases, diabetes and even cancer? Working in the framework of acquired resilience (tissue resilience induced by a range of stresses), we arguethat the toxins evolved by plants as part of allelopathy (the competition between plant species) are key in making the 'healthful difference'. We further suggest the recognition of a category of micronutrients additional to the established 'micro' categories of vitamins and trace elements and suggest also that the new category be called 'trace toxins'. Implications of these suggestions are discussed.

Assessment of macro, trace and toxic element intake from rice: differences between cultivars, pigmented and non-pigmented rice

Pigmented and non-pigmented rice varieties (grown in different areas) were collected in China, Yunnan, to investigate the content of macro-, trace elements and potentially toxic elements (PTEs), and to assess the health risk associated with dietary intake. The order of elemental concentrations in rice was Mn > Zn > Fe > Cu > Se for trace elements, P > K > Mg > Ca > Na for macro elements, and Cr > As > Cd for PTEs. Rice with a high concentration of essential elements also associated with a high content of PTEs. In addition, higher content of Cr, Mn and Na were found in pigmented rice. The health risk assessment showed that the daily intake of all elements was below the tolerable limit (UL). Moreover the intake of Fe, Zn and Se was far from sufficient for the nutrient requirement. The PTEs in rice dominated the health risk. Of concern is that this rice consumption is likely to contribute to carcinogenic risks in the long term and that adults are at higher health risk from pigmented rice compared to non-pigmented rice. This study confirms that the lack of essential micronutrients in rice and the health risk associated with rice diets should remain a concern.

Epigallocatechin gallate alleviated the in vivo toxicity of ZnO nanoparticles to mouse intestine

To evaluate the oral toxicity of nanoparticles (NPs), it is necessary to consider the interactions between NPs and nutrient molecules. Recently, we reported that epigallocatechin gallate (EGCG), a healthy component in green tea, alleviated the toxicity of ZnO NPs to 3D Caco-2 spheroids in vitro. The present study investigated the combined effects of EGCG and ZnO NPs to mice in vivo. Mice were administrated with 35 or 105 mg/kg bodyweight ZnO NPs with or without the presence of 80 mg/kg bodyweight EGCG via gastric route, once a day, for 21 days, and the influences of EGCG on the toxicity of ZnO NPs to intestine were investigated. We found that EGCG altered the colloidal properties of ZnO NPs both in water and artificial intestine juice. As expected, ZnO NPs induced toxicological effects, such as decreased bodyweight, higher Chiu's scores, and ultrastructural changes in intestine, whereas EGCG alleviated these effects. Combined exposure to EGCG and ZnO NPs also changed trace element levels in mouse intestine. For example, the levels of Ti, Co, and Ni were only significantly elevated after co-exposure to EGCG and ZnO NPs, and Fe levels were only significantly decreased by ZnO NPs. Western blot analysis suggested that tight junction (TJ) and endoplasmic reticulum (ER) proteins were elevated by ZnO NPs, but EGCG inhibited this trend. Combined, these data suggested that gastric exposure to ZnO NPs induced intestinal damage, trace element imbalance, and TJ/ER protein expression in mouse intestine, whereas EGCG alleviated these effects of ZnO NPs.

Sustainable production of extracellular polymeric substances and iron or copper complex from glutinous rice processing wastewater

Essential trace minerals play vital roles in maintaining human and animal health. However, an overdose of the existing inorganic trace minerals is prone to induce detrimental effects that outweigh positive benefits. In this study, an extracellular polymeric substances (EPS)-producing bacterium, identified as Bacillus licheniformis CCTCC M2020298, was isolated from marine using glutinous rice processing wastewater as enrichment medium. The EPS yield of Bacillus licheniformis CCTCC M2020298 could reach 8.62 g/L by using glutinous rice-processing wastewater containing medium. Furthermore, the potential of the EPS as a carrier for synthesizing EPS-iron (Fe) and EPS-copper (Cu) complex was explored. The results showed that the optimum condition for the synthesis EPS-Fe were the reaction temperature 70°C, pH 8.5–9.0 and mass ratio of EPS to trisodium citrate 2:1. The iron content of EPS-Fe reached 77.4 mg/g. Under the same condition, the copper content of EPS-Cu reached 90.7 mg/g. The elemental composition, functional groups and valence state of the mineral elements of EPS-Fe and EPS-Cu were well characterized. The EPS-Fe and EPS-Cu exhibited antioxidant activity in scavenging ·OH, DPPH and ·O2− free radicals, thereby leading to reduced oxidative stress and apoptosis levels in human colonic epithelial cells in vitro. They also inhibited the proliferation of mouse hepatocellular carcinoma H22 and the growth of intestinal pathogens in vitro. This study provided an effective avenue for EPS production from glutinous rice processing wastewater and proved the potential of EPS-Fe and EPS-Cu complexes as a new-type comprehensive essential trace mineral supplement.

Zinc, Copper, and Iron in Selected Skin Diseases

Trace elements are essential for maintaining the body's homeostasis, and their special role has been demonstrated in skin physiology. Among the most important trace elements are zinc, copper, and iron. A deficiency or excess of trace elements can be associated with an increased risk of skin diseases, so increasing their supplementation or limiting intake can be helpful in dermatological treatment. In addition, determinations of their levels in various types of biological material can be useful as additional tests in dermatological treatment. This paper describes the role of these elements in skin physiology and summarizes data on zinc, copper, and iron in the course of selected, following skin diseases: psoriasis, pemphigus vulgaris, atopic dermatitis, acne vulgaris and seborrheic dermatitis. In addition, this work identifies the potential of trace elements as auxiliary tests in dermatology. According to preliminary studies, abnormal levels of zinc, copper, and iron are observed in many skin diseases and their determinations in serum or hair can be used as auxiliary and prognostic tests in the course of various dermatoses. However, since data for some conditions are conflicting, clearly defining the potential of trace elements as auxiliary tests or elements requiring restriction/supplement requires further research.

Micronutrient status and protein-energy malnutrition in free-living older adults: a current perspective

PURPOSE OF REVIEW

This review addresses the newest findings on micronutrient status and protein-energy malnutrition in the increasingly aging global population; understanding the nutritional challenges they face is vital for healthcare, well being, and public health.

RECENT FINDINGS

The review examines deficiencies in macro- and micronutrients among nonhospitalized, free-living older adults, revealing significant associated health consequences, including frailty, cognitive decline, and reduced quality of life. Deficiencies in fat-soluble vitamins such as A, D, and E, are common in older populations, emphasizing the need for close monitoring for status of these. Furthermore, water-soluble vitamin deficiencies, especially vitamins B12 and C are also common, and pose health risks, including neurological disorders and cognitive decline. Iron and iodine deficiencies contribute to anemia, and neurocognitive disorders. Finally, protein-energy malnutrition is common in older adults living in high-resource countries and may occur concomitant with depletion of one or more micronutrients.

SUMMARY

Addressing specific nutritional deficiencies is fundamental to enhancing the wellbeing and quality of life for free-living older adults. Protein-energy malnutrition, impacting over 25% of those aged 65 and above, results in a range of health issues, including poor wound healing, susceptibility to infections, anemia, and delayed convalescence. These concerns are aggravated by inadequate energy, macronutrient, and micronutrient intake, affecting muscle strength and overall health. Future research should focus on tailored appropriate monitoring of at-risk individuals, specific nutritional interventions, and dietary strategies to mitigate these issues and improve health outcomes among older adults.

Biofortification revisited: Addressing the role of beneficial soil microbes for enhancing trace elements concentration in staple crops

Trace element deficiency is a pervasive issue contributing to malnutrition on a global scale. The primary cause of this hidden hunger is related to low dietary intake of essential trace elements, which is highly prevalent in numerous regions across the world. To address deficiency diseases in humans, fortification of staple crops with vital trace elements has emerged as a viable solution. Current methods for fortifying crops encompass chemical amendments, genetic breeding, and transgenic approaches, yet these approaches possess certain limitations, constraining their agricultural application. In contrast, fortifying staple crops through the utilization of soil-beneficial microbes has emerged as a promising and economically feasible approach to enhance trace element content in crops. A specific subset of these beneficial soil microbes, referred to as plant growth-promoting microbes, have demonstrated their ability to influence the interactions between plants, soil, and minerals. These microbes facilitate the transport of essential soil minerals, such as zinc, iron, and selenium, into plants, offering the potential for the development of tailored bioinoculants that can enhance the nutritional quality of cereals, pulses, and vegetable crops. Nevertheless, further research efforts are necessary to comprehensively understand the molecular mechanisms underlying the uptake, transport, and augmentation of trace element concentrations in staple crops. By delving deeper into these mechanisms, customized bioinoculants of soil-beneficial microbes can be developed to serve as highly effective strategies in combating trace element deficiency and promoting global nutritional well-being.

Assessing the Correlation between Blood Trace Element Concentrations, Picky Eating Habits, and Intelligence Quotient in School-Aged Children

INTRODUCTION

Inadequate levels of iron, zinc, and copper have been linked to growth impairment and cognitive and motor development deficits. The objective of this study is to examine the deficiencies of trace elements and their correlation with selective eating patterns and the intelligence quotient (IQ) of children.

METHODS AND PATIENTS

The cross-sectional analysis involved 430 children aged between 7 and 10 years. Blood samples were analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to measure the trace elements levels. Children's IQs were assessed using Raven's Standard Progressive Matrices.

RESULTS

Among the sample group, 20.3% exhibited iron deficiency, 42.5% had zinc deficiency, and 14% had insufficient copper levels. Single trace element deficiency was observed in 56.9% of the children, while 66.7% showed coexisting deficiencies of iron and zinc. Children with lower development levels exhibited significantly lower serum zinc levels compared to those with higher development levels (76.78 ± 10.67 vs. 81.14 ± 10.19 μg/dL). The analysis reveals that picky eaters had lower serum iron levels (76.59 ± 10.42 μg/dL) and higher serum copper levels (123.74 ± 13.45 μg/dL).

CONCLUSION

A strong association was observed between zinc deficiency, picky eating habits, and lower developmental stages. The findings underscore the importance of monitoring nutritional status in children, given the significant implications for their cognitive development.

Proposal to Screen for Zinc and Selenium in Patients with IgA Deficiency

The increase in life expectancy can be a consequence of the world's socioeconomic, sanitary and nutritional conditions. Some studies have demonstrated that individuals with a satisfactory diet variety score present a lower risk of malnutrition and better health status. Zinc and selenium are important micronutrients that play a role in many biochemical and physiological processes of the immune system. Deficient individuals can present both innate and adaptive immunity abnormalities and increased susceptibility to infections. Primary immunodeficiency diseases, also known as inborn errors of immunity, are genetic disorders classically characterized by an increased susceptibility to infection and/or dysregulation of a specific immunologic pathway. IgA deficiency (IgAD) is the most common primary antibody deficiency. This disease is defined as serum IgA levels lower than 7 mg/dL and normal IgG and IgM levels in individuals older than four years. Although many patients are asymptomatic, selected patients suffer from different clinical complications, such as pulmonary infections, allergies, autoimmune diseases, gastrointestinal disorders and malignancy. Knowing the nutritional status as well as the risk of zinc and selenium deficiency could be helpful for the management of IgAD patients.

OBJECTIVES

to investigate the anthropometric, biochemical, and nutritional profiles and the status of zinc and selenium in patients with IgAD.

METHODS

in this descriptive study, we screened 16 IgAD patients for anthropometric and dietary data, biochemical evaluation and determination of plasma and erythrocyte levels of zinc and selenium.

RESULTS

dietary intake of zinc and selenium was adequate in 75% and 86% of the patients, respectively. These results were consistent with the plasma levels (adequate levels of zinc in all patients and selenium in 50% of children, 25% of adolescents and 100% of adults). However, erythrocyte levels were low for both micronutrients (deficiency for both in 100% of children, 75% of adolescents and 25% of adults).

CONCLUSION

our results highlight the elevated prevalence of erythrocyte zinc and selenium deficiency in patients with IgAD, and the need for investigation of these micronutrients in their follow-up.

Iron deficiency in sepsis patients managed with divided doses of iron dextran: a prospective cohort study

Iron deficiency (ID) impairs hemoglobin (Hb) synthesis and immune function, both crucial for sepsis patients. We assessed the impact of iron dextran on reticulocyte (Ret) Hb equivalent (Ret-He) and Ret subpopulations in iron-deficient sepsis patients. In this prospective clinical study we enrolled patients with sepsis or septic shock with procalcitonin concentration > 0.5 ng/mL, diagnosed with ID based on Ret-He. Study subjects received divided doses of iron dextran until normalization of Ret-He. The study population included 35 subjects. The median Ret-He increase after 2 doses of iron dextran was 3.0 (IQR 1.9-6.1) pg (p < 0.01) with median time to normalization 4 (IQR 3-5) days. Although no change in Ret percentage [Me 1.5 (IQR 1.1-2.1) vs. Me 1.4 (IQR 1.1-2.4) %, p = 0.39] and number [Me 0.05 (IQR 0.04-0.07) vs. Me 0.05 (IQR 0.03-0.06) 10⁶/µL, p = 0.88] was noted, Ret subpopulations changed significantly (p for all < 0.01). Divided doses of iron dextran relatively quickly normalize Ret-He in iron-deficient sepsis patients. Changes in Ret subpopulations suggest increased erythropoietic activity. Further research is needed to explore the role of intravenous iron in this clinical setting.

Analysis of the active ingredients and health applications of cistanche

Cistanche is a tonic Chinese medicine commonly used in traditional Chinese medicine, with 2016, CFSA through the alxa desert cistanche safety evaluation, cistanche began to officially enter the food field. At present, the research on cistanche mainly focuses on the extraction, isolation and purification and pharmacological effects, and its pharmacological effects such as neuroprotective effects, immunomodulation, antioxidant anticancer and hepatoprotective liver protection have attracted the attention of researchers. This review mainly reviews the research status, chemical composition and health benefits, analyzes its application prospects in food, and aims to provide certain theoretical support for the safe application of cistanche in functional food.

Birth Size Outcomes in Relation to Maternal Blood Levels of Some Essential and Toxic Elements

Exposures to toxic trace elements and deficiencies of essential trace elements during pregnancy may impact fetal growth. This study was conducted to determine the association between maternal blood levels of essential elements including manganese (Mn), copper (Cu), and zinc (Zn) and toxic elements including arsenic (As), cadmium (Cd), and lead (Pb) at the first trimester with neonatal anthropometric parameters. This cross-sectional study was conducted in 2019-2020 in Isfahan, Iran. Overall, 263 mother-infant pairs were recruited in the first trimester of pregnancy. Maternal whole blood was collected, and essential and toxic elements were determined by mass spectrometry (ICP-MS)-based method. Birth size measurements were performed according to standardized protocols. Geometric means and standard deviations of maternal blood concentrations of Mn, Cu, Zn, As, Cd, and Pb were 3.94 ± 0.82, 5.22 ± 0.57, 7.67 ± 0.58, 2.21 ± 0.77, - 0.59 ± 0.98, and 3.23 ± 0.72 µg/l, respectively. Mean age of mothers was 29.94 ± 5.22 years. Thirty-one (12.1%) neonates were preterm. Maternal blood Pb levels were negatively correlated with birth weight (β = - 0.22 (CI 95%: - 0.38, - 0.05) p = 0.010) and marginally with birth head circumference (β = - 0.14(CI 95%: - 0.29, 0.02), P = 0.094) after adjustment for potential confounder variables. There was no significant association between Mn, Cu, Zn, As, Cd, and birth size measurements. Reverse association was found between maternal blood Pb levels and birth weight and birth head circumference. There is limited evidence related to the association between essential and toxic elements during pregnancy with birth size measurements and pregnancy disorders. More studies are suggested to assess of the effect of the trace elements and birth outcomes.

The Extent of Burn Injury Significantly Affects Serum Micro- and Macroelement Concentrations in Patients on the First Day of Hospitalisation

Burns exceeding 30% of total body surface area (TBSA) result in considerable hypovolemia coupled with the formation and release of inflammatory mediators, leading to subsequent systemic effects known as burn shock. Because of plasma exudation and the associated losses of large quantities of minerals, severe burns can lead to nutritional deficiencies and consequently disrupt homeostasis and metabolism of the entire body. The study group comprised 62 patients, who were divided into 3 groups according to the severity of burns. Serum samples were tested for concentrations of Ca, Mg, Mn, P, K, Zn, Cu, Fe, Se, Na, Cr, Ni, and Al. The mineral concentrations in serum of patients with burn injuries differ significantly from reference values, but this is not affected by the extent of the body burn. There are statistically significant decreases in serum concentrations of elements important for antioxidant protection (Zn, Cu, Se), and significant increases in the concentrations of toxic elements (Al and Ni), which may aggravate the effects associated with the state of burn shock. The Spearman rank correlation analysis did not reveal any statistically significant relationships between the serum concentrations of Mn, Ni, Al, K, Na, P, Mg, Zn, Se, Cr and the affected body surface area and severity of the burn—the values were at the lower end of the reference range. The obtained results indicate that proper nutrition, including elements replenishment, is extremely important in the recovery process of burn patients and time to nutrition is an important factor affecting patient survival after severe burn.

Single and Combined Associations of Plasma and Urine Essential Trace Elements (Zn, Cu, Se, and Mn) with Cardiovascular Risk Factors in a Mediterranean Population

Trace elements are micronutrients that are required in very small quantities through diet but are crucial for the prevention of acute and chronic diseases. Despite the fact that initial studies demonstrated inverse associations between some of the most important essential trace elements (Zn, Cu, Se, and Mn) and cardiovascular disease, several recent studies have reported a direct association with cardiovascular risk factors due to the fact that these elements can act as both antioxidants and pro-oxidants, depending on several factors. This study aims to investigate the association between plasma and urine concentrations of trace elements and cardiovascular risk factors in a general population from the Mediterranean region, including 484 men and women aged 18−80 years and considering trace elements individually and as joint exposure. Zn, Cu, Se, and Mn were determined in plasma and urine using an inductively coupled plasma mass spectrometer (ICP-MS). Single and combined analysis of trace elements with plasma lipid, blood pressure, diabetes, and anthropometric variables was undertaken. Principal component analysis, quantile-based g-computation, and calculation of trace element risk scores (TERS) were used for the combined analyses. Models were adjusted for covariates. In single trace element models, we found statistically significant associations between plasma Se and increased total cholesterol and systolic blood pressure; plasma Cu and increased triglycerides and body mass index; and urine Zn and increased glucose. Moreover, in the joint exposure analysis using quantile g-computation and TERS, the combined plasma levels of Zn, Cu, Se (directly), and Mn (inversely) were strongly associated with hypercholesterolemia (OR: 2.03; 95%CI: 1.37−2.99; p < 0.001 per quartile increase in the g-computation approach). The analysis of urine mixtures revealed a significant relationship with both fasting glucose and diabetes (OR: 1.91; 95%CI: 1.01−3.04; p = 0.046). In conclusion, in this Mediterranean population, the combined effect of higher plasma trace element levels (primarily Se, Cu, and Zn) was directly associated with elevated plasma lipids, whereas the mixture effect in urine was primarily associated with plasma glucose. Both parameters are relevant cardiovascular risk factors, and increased trace element exposures should be considered with caution.

Accumulation and Enrichment of Trace Elements by Yeast Cells and Their Applications: A Critical Review

Maintaining the homeostasis balance of trace elements is crucial for the health of organisms. Human health is threatened by diseases caused by a lack of trace elements. Saccharomyces cerevisiae has a wide and close relationship with human daily life and industrial applications. It can not only be used as fermentation products and single-cell proteins, but also as a trace elements supplement that is widely used in food, feed, and medicine. Trace-element-enriched yeast, viz., chromium-, iron-, zinc-, and selenium-enriched yeast, as an impactful microelements supplement, is more efficient, more environmentally friendly, and safer than its inorganic and organic counterparts. Over the last few decades, genetic engineering has been developing large-scaled genetic re-design and reconstruction in yeast. It is hoped that engineered yeast will include a higher concentration of trace elements. In this review, we compare the common supplement forms of several key trace elements. The mechanisms of detoxification and transport of trace elements in yeast are also reviewed thoroughly. Moreover, genes involved in the transport and detoxification of trace elements are summarized. A feasible way of metabolic engineering transformation of S. cerevisiae to produce trace-element-enriched yeast is examined. In addition, the economy, safety, and environmental protection of the engineered yeast are explored, and the future research direction of yeast enriched in trace elements is discussed.

Anemia in the pediatric patient

The World Health Organization estimates that approximately a quarter of the world's population suffers from anemia, including almost half of preschool-age children. Globally, iron deficiency anemia is the most common cause of anemia. Other important causes of anemia in children are hemoglobinopathies, infection, and other chronic diseases. Anemia is associated with increased morbidity, including neurologic complications, increased risk of low birth weight, infection, and heart failure, as well as increased mortality. When approaching a child with anemia, detailed historical information, particularly diet, environmental exposures, and family history, often yield important clues to the diagnosis. Dysmorphic features on physical examination may indicate syndromic causes of anemia. Diagnostic testing involves a stepwise approach utilizing various laboratory techniques. The increasing availability of genetic testing is providing new mechanistic insights into inherited anemias and allowing diagnosis in many previously undiagnosed cases. Population-based approaches are being taken to address nutritional anemias. Novel pharmacologic agents and advances in gene therapy-based therapeutics have the potential to ameliorate anemia-associated disease and provide treatment strategies even in the most difficult and complex cases.

Associations between whole blood trace elements concentrations and HbA1c levels in patients with type 2 diabetes

Previous researches have been conducted to study the associations of trace elements on Type 2 diabetes (T2D) risk. The present study focuses on the evaluation of potential associations between trace elements and Hemoglobin A1c (HbA1c) in patients with T2D, via the determination of their levels in human whole blood. 100 diabetes without complications, 75 prediabetes and 40 apparently healthy subjects were studied. The levels of eleven trace elements including lithium (Li), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), copper (Cu), zinc (Zn), selenium (Se), strontium (Sr) and molybdenum (Mo) were measured using inductively coupled plasma mass spectrometry (ICP-MS). The levels of fasting glucose, HbA1c, Hemoglobin, lipid, liver function, kidney function, thyroid function and demographic data were obtained from the Laboratory Information System. Nonparametric correlation (Spearman) was used to analyze the relationship between trace elements and HbA1c. The contents of V, Cr, Mn, Fe, Co, Cu, Zn and Mo in diabetes increased comparing with the healthy subject while Li decreased. But the levels of Li, V, Cr, Mn, Co, Se and Mo negatively correlated with HbA1c in the diabetes subjects (r value: - 0.2189, - 0.2421, - 0.3260, - 0.2744, - 0.2812, - 0.2456, - 0.2240; 95% confidence interval - 0.4032 to - 0.0176, - 0.4235 to - 0.0420, - 0.4955 to - 0.1326, - 0.4515 to - 0.0765, - 0.4573 to - 0.0838, - 0.4266 to - 0.0458, - 0.4076 to - 0.0229; p < 0.05, p < 0.05, p < 0.001, p < 0.01, p < 0.01, p < 0.05, p < 0.05). Accordingly, the contents of V, Cr, Mn and Se showed lower in HbA1c ≥ 7.0% group in contrast to HbA1c < 7.0% group. No correlation of HbA1c (or FBG) and trace elements was found in the healthy subjects. Trace element levels and metabolic abnormalities of blood glucose may be mutually affected. The extra supplement of trace elements needs to be cautious.

Analysis of Eight Nutrient Elements in Whole Blood of Children and Adolescents Using Inductively Coupled Plasma-Mass Spectrometry

Few researches have been conducted on elements in whole blood of young people. Our study was to investigate the influence of age, gender and season on the contents of magnesium (Mg), calcium (Ca), iron (Fe), copper (Cu), zinc (Zn), manganese (Mn), selenium (Se), and strontium (Sr) as well as to establish reference intervals (RIs). We conducted a retrospective study of 589 apparently healthy children and adolescents. Quantitative analysis had been carried out using inductively coupled plasma-mass spectrometry (ICP-MS). Test results were analyzed using and MannWhitney U test, Spearman and Pearson statistical analyses. RIs were defined by using 95% confidence interval. Differences between contents of Mg, Fe, Cu, and Zn in girls' and boys' whole blood were found. Positive correlations for Fe, Zn, Se, and Sr, while negative for Ca and Cu were found with age. Increasing trends were found for Fe, Zn, and Se, while for Ca and Cu, changes were even decreasing for children and teenagers. The most frequently correlating element pairs were FeZn, MgSe, and FeSe in five successive age groups. Lower contents of Mg, Ca, Fe, Zn, and Se were found in summer. Finally, the reference interval of each element was initially established according to age and gender grouping. The contents of elements in whole blood vary depending mainly on the gender and age of children and adolescents. The reference intervals of elements in whole blood grouped by age and gender provide a reference basis for clinical diagnosis and treatment of element-related diseases.

Selenium Status in Paediatric Patients with Neurodevelopmental Diseases

Neurodevelopmental diseases are often associated with other comorbidities, especially inflammatory processes. The disease may affect the trace element (TE) status, which in turn may affect disease severity and progression. Selenium (Se) is an essential TE required for the biosynthesis of selenoproteins including the transporter selenoprotein P (SELENOP) and extracellular glutathione peroxidase (GPX3). SELENOP deficiency in transgenic mice resulted in a Se status-dependent phenotype characterized by impaired growth and disturbed neuronal development, with epileptic seizures on a Se-deficient diet. Therefore, we hypothesized that Se and SELENOP deficiencies may be prevalent in paediatric patients with a neurodevelopmental disease. In an exploratory cross-sectional study, serum samples from children with neurodevelopmental diseases (n = 147) were analysed for total serum Se, copper (Cu), and zinc (Zn) concentrations as well as for the TE biomarkers SELENOP, ceruloplasmin (CP), and GPX3 activity. Children with epilepsy displayed elevated Cu and Zn concentrations but no dysregulation of serum Se status. Significantly reduced SELENOP concentrations were found in association with intellectual disability (mean ± SD (standard deviation); 3.9 ± 0.9 mg/L vs. 4.4 ± 1.2 mg/L, p = 0.015). A particularly low GPX3 activity (mean ± SD; 172.4 ± 36.5 vs. 192.6 ± 46.8 U/L, p = 0.012) was observed in phacomatoses. Autoantibodies to SELENOP, known to impair Se transport, were not detected in any of the children. In conclusion, there was no general association between Se deficiency and epilepsy in this observational analysis, which does not exclude its relevance to individual cases. Sufficiently high SELENOP concentrations seem to be of relevance to the support of normal mental development. Decreased GPX3 activity in phacomatoses may be relevant to the characteristic skin lesions and merits further analysis. Longitudinal studies are needed to determine whether the observed differences are relevant to disease progression and whether correcting a diagnosed TE deficiency may confer health benefits to affected children.

Evaluation of Essential and Toxic Elements in the Blood of 0–14-Year-Old Children in Hunan, China From 2013 to 2019: A Retrospective Analysis

Objective

The aim was to investigate the distribution and correlation of Ca, Mg, Zn, Cu, Fe, Pb, and Cd in the blood of children aged 0–14 years in Hunan, China, which may serve to provide a basis for clinical guidance on child health.

Study Design

A retrospective analysis was carried out. Concentrations of all elements were determined by atomic absorption spectrophotometry. Distributions were analyzed and compared among different age, sex, and year groups by the Kruskal–Wallis test, the chi-square test, and the Fisher's exact test. Spearman's rank correlation coefficient was used to evaluate the association between every pair of elements.

Results

A total of 46,951 children were involved in this study from 2013 to 2019. The median blood levels of elements were 13.51 μmol/L (Cu), 58.69 μmol/L (Zn), 1.70 mmol/L (Ca), 1.40 mmol/L (Mg), 7.46 mmol/L (Fe), 35.00 μg/L (Pb), and 1.00 μg/L (Cd). Girls had a higher level of Ca and lower levels of Pb and Cd than boys. Cu and Ca showed an upward trend, and Mg and Pb showed a downward trend by year. Zn and Fe increased and Ca decreased significantly with age. The deficiency rates of Fe and Zn decreased significantly by year, while Ca and Cu increased significantly by year. Cd exposure in this area was relatively low.

Conclusion

Most children had normal levels of the essential elements Ca, Cu, and Mg and the toxic elements Pb and Cd. Severe deficiencies in Zn and Fe were observed in the relatively younger children but improved with age. Persistent efforts in reducing Pb exposure might still be needed.

Serum Trace Element Levels and Their Correlation with Picky Eating Behavior, Development, and Physical Activity in Early Childhood

Trace elements are vital components for healthy growth, development, and physical activity. The aim of this study was to investigate the relationship between trace element (iron, zinc, copper) deficiencies and picky eating behavior, development level, and physical activity level. This cross-sectional study involved 203 children aged 4-7 years; picky eating behavior, development level, and physical activity level were assessed through questionnaires. Zinc deficiency has the highest prevalence (37.4%); 67.5% of the children were assessed as picky eaters. Children with picky eating behaviors, poor development level, or poor physical activity level have significantly lower zinc levels, and higher prevalence of zinc deficiency. Pearson's correlation coefficient indicated a positive correlation between serum zinc level and development scores (r = 0.221, p = 0.002) and physical activity scores (r = 0.469, p < 0.001). In multivariate analysis, zinc deficiency independently related to picky eating (OR = 2.124, p = 0.037, CI = 1.042-4.312), developmental level (OR = 0.893, p = 0.022, CI = 0.810-0.984), and physical activity level (OR = 0.785, p < 0.001, CI = 0.700-0.879). In conclusion, the prevalence of zinc deficiency in children aged 4-7 was high, especially in picky eaters. Zinc deficiency was significantly associated with low development and poor physical activity in early childhood.

Elemental composition of blood of infertile patients participating in assisted reproduction programs

The association between levels of trace elements, endocrine diseases and reproductive impairments is actively investigated currently. In this connection, it seems relevant to study elemental status (elemental composition of blood and amounts of elements therein) of infertile patients enlisted in programs employing assisted reproductive technologies (ART). This study aimed to analyze trace elements in blood of infertile patients, relationship between the level of such trace elements and parameters of the ART programs they are in. The study included 30 infertile patients aged 18–39 years. Relying on inductively coupled plasma mass spectrometry, we identified concentrations of 31 chemical element in blood of the participants. Two elements out of 31 (antimony and beryllium) were not found in any blood sample; 10 elements (titanium, chromium, cobalt, nickel, arsenic, mercury, barium, gold, vanadium) were detected in some blood samples, the remaining 19 elements were found in all samples. Age of the patients correlated negatively with the level of silicon (r = –0.384; p = 0.036) and positively with the level of molybdenum (r = 0.384; p = 0.036). The level of anti-mullerian hormone was in a significant negative correlation with the level of lithium (r = –0.367; p = 0.046). The level of free thyroxine was in a significant negative correlation with the level of boron (r = –0.402; p = 0.028) and a positively correlated with the levels of iron (r = 0.410; p = 0.024) and silver (r = 0.432; p = 0.017). Considering the embryological cycle, we noted a positive correlation between the level of silicon and the number of blastocysts obtained (r = 0.387; p = 0.034). There was no statistical relationship registered between elemental composition of blood the frequency of pregnancy in ART cycles.

Trace Element Levels in Serum Are Potentially Valuable Diagnostic Markers in Dogs

The objective of this study was to obtain information about the role of trace element imbalance in the pathogenesis of certain diseases in dogs and to evaluate the suitability of trace element profiling as an additional tool in the diagnosis. Serum trace element concentrations (copper, molybdenum, selenium and zinc) were measured in a cohort of healthy (control) dogs (n = 42) and dogs affected by hepatic (n = 25), gastrointestinal (n = 24), inflammatory/infection (n = 24), and renal (n = 22) diseases. These data were analyzed together with data on basic biochemical parameters (alanine aminotransferase, alkaline phosphatase, blood urea nitrogen, creatinine, albumin, globulin, and glucose) by using chemometric techniques. The chemometric analysis revealed distinctive association patterns between trace elements and biochemical parameters for each clinical disorders. The findings provide clear evidence for the important role of trace elements in disease, particularly in relation to acute phase reactions, with serum copper providing an indirect measurement of ceruloplasmin (positive acute-phase protein) and serum selenium and zinc acting as negative acute phase reactants. Molybdenum may also be a suitable marker of incipient renal disease. Thus, the analysis of trace element profiles, by multielement techniques, in a single serum sample would be a valuable additional tool for the diagnosis of certain diseases.

Minerals in Pregnancy and Their Impact on Child Growth and Development

During pregnancy, women undergo metabolic and physiological changes, and their needs are higher, to maintain growth and development of the fetus. If the nutritional status of the expectant mother is not satisfactory, some maternal and neonatal complications can occur. In the second and third trimester of pregnancy, there is a reserve of nutrients in the fetus that can be utilized after birth; thereby, children present an accelerated growth in the first years of life, which is a proven response to the available nutrition pattern. However, if such a pattern is insufficient, there will be deficits during development, including brain function. Therefore, despite many recent published works about gestational nutrition, uncertainties still remain on the mechanisms of absorption, distribution, and excretion of micronutrients. Further elucidation is needed to better understand the impacts caused either by deficiency or excess of some micronutrients. Thus, to illustrate the contributions of minerals during prenatal development and in children, iodine, selenium, iron, zinc, calcium, and magnesium were selected. Our study sought to review the consequences related to gestational deficiency of the referred minerals and their impact on growth and development in children born from mothers with such deficiencies

Recent aspects of the effects of zinc on human health

Zinc (Zn) is one of the most important essential nutrients of great public health significance. It is involved in numerous biological functions and it is considered as a multipurpose trace element, due to its capacity to bind to more than 300 enzymes and more than 2000 transcriptional factors. Its role in biochemical pathways and cellular functions, such as the response to oxidative stress, homeostasis, immune responses, DNA replication, DNA damage repair, cell cycle progression, apoptosis and aging is significant. Zn is required for the synthesis of protein and collagen, thus contributing to wound healing and a healthy skin. Metallothioneins are metal-binding proteins and they are potent scavengers of heavy metals, including Zn, and protect the organism against stress. Zn deficiency is observed almost in 17% of the global population and affects many organ systems, leading to dysfunction of both humoral and cell-mediated immunity, thus increasing the susceptibility to infection. This review gives a thorough insight into the most recent evidence on the association between Zn biochemistry and human pathologies, epigenetic processes, gut microbial composition, drug targets and nanomedicine.