Clinical, biochemical and nutritional spectrum of zinc deficiency in human subjects: an update

Association between Dietary Zinc and Selenium Intake, Oxidative Stress-Related Gene Polymorphism, and Colorectal Cancer Risk in Chinese Population - A Case-Control Study

Zinc and selenium may protect against colorectal cancer (CRC) progression through their anti-oxidative effects. This study examined the independent and combined effect of dietary zinc and selenium intake, and polymorphisms of the oxidative stress-related genes (superoxide dismutase 1, superoxide dismutase 2, glutathione peroxidase, and catalase) on CRC risk in a Chinese case-control study. A total of 493 cases and 498 sex and age-matched controls were randomly selected from an ongoing case-control study. Dietary information was assessed through face-to-face interviews using a validated food frequency questionnaire. Multiplex PCR-ligase detection reaction was used for genotyping the target SNPs. Multivariable logistic regression was used to estimate the odds ratios (ORs) and 95% confidence interval (CI). Intake of selenium was found to be inversely associated with CRC risk, while zinc was not associated with CRC risk. The ORs (95% CI) for the highest vs. the lowest quartile were 0.42 (95% CI 0.28, 0.64, P_trend < 0.001) for selenium and 0.96 (95% CI 0.63, 1.47, P_trend = 0.505) for zinc. Combined effect was observed between zinc and SOD1 rs4998557 on CRC risk (P_interaction < 0.05). This study identified a novel diet-gene interaction in the oxidative stress pathway on CRC risk in Chinese population.

Zinc Promotes Osteoblast Differentiation in Human Mesenchymal Stem Cells Via Activation of the cAMP-PKA-CREB Signaling Pathway

The crucial trace element zinc stimulates osteogenesis in vitro and in vivo. However, the pathways mediating these effects remain poorly understood. This study aimed to investigate the effects of zinc on osteoblast differentiation in human bone marrow-derived mesenchymal stem cells (hBMSCs) and to identify the molecular mechanisms of these effects. In hBMSCs, zinc exposure resulted in a dose-dependent increase in osteogenesis and increased mRNA and protein levels of the master transcriptional factor RUNX2. Analyzing the upstream signaling pathways of RUNX2, we found that protein kinase A (PKA) signaling inhibition blocked zinc-induced osteogenic effects. Zinc exposure increased transcriptional activity and protein levels of phospho-CREB and enhanced translocation of phospho-CREB into the nucleus. These effects were reversed by H-89, a potent inhibitor of PKA. Moreover, zinc exposure led to dose-dependent increases in levels of intracellular cyclic adenosine monophosphate (cAMP). These findings indicate that zinc activates the PKA signaling pathway by triggering an increase in intracellular cAMP, leading to enhanced osteogenic differentiation in hBMSCs. Our results suggest that zinc exerts osteogenic effects in hBMSCs by activation of RUNX2 via the cAMP-PKA-CREB signaling pathway. Zinc supplementation may offer a promise as a potential pharmaceutical therapy for osteoporosis and other bone loss conditions.

Alterations in the Gut ( Gallus gallus) Microbiota Following the Consumption of Zinc Biofortified Wheat ( Triticum aestivum)-Based Diet

The structure and function of cecal microbiota following the consumption of a zinc (Zn) biofortified wheat diet was evaluated in a well-studied animal model of human nutrition ( Gallus gallus) during a six-week efficacy trial. Using 16S rRNA gene sequencing, a significant increase in β- but not α-microbial diversity was observed in the animals receiving the Zn biofortified wheat diet, relative to the control. No significant taxonomic differences were found between the two groups. Linear discriminant analysis revealed a group of metagenomic biomarkers that delineated the Zn replete versus Zn deficient phenotypes, such that enrichment of lactic acid bacteria and concomitant increases in Zn-dependent bacterial metabolic pathways were observed in the Zn biofortified group, and expansion of mucin-degraders and specific bacterial groups able to participate in maintaining host Zn homeostasis were observed in the control group. Additionally, the Ruminococcus genus appeared to be a key player in delineating the Zn replete microbiota from the control group, as it strongly predicts host Zn adequacy. Our data demonstrate that the gut microbiome associated with Zn biofortified wheat ingestion is unique and may influence host Zn status. Microbiota analysis in biofortification trials represents a crucial area for study as Zn biofortified diets are increasingly delivered on a population-wide scale.

Perturbed bone composition and integrity with disorganized osteoblast function in zinc receptor/Gpr39-deficient mice

Changes in bone matrix composition are frequently found with bone diseases and may be associated with increased fracture risk. Bone is rich in the trace element zinc. Zinc was established to play a significant role in the growth, development, and maintenance of healthy bones; however, the mechanisms underlying zinc effects on the integrity of the skeleton are poorly understood. Here, we show that the zinc receptor (ZnR)/Gpr39 is required for normal bone matrix deposition by osteoblasts. Initial analysis showed that Gpr39-deficient ( Gpr39^-/-) mice had weaker bones as a result of altered bone composition. Fourier transform infrared spectroscopy analysis showed high mineral-to-matrix ratios in the bones of Gpr39^-/- mice. Histologic analysis showed abnormally high numbers of active osteoblasts but normal osteoclast numbers on the surfaces of bones from Gpr39^-/- mice. Furthermore, Gpr39^-/- osteoblasts had disorganized matrix deposition in vitro with cultures exhibiting abnormally low collagen and high mineral contents, findings that demonstrate a cell-intrinsic role for ZnR/Gpr39 in these cells. We show that both collagen synthesis and deposition by Gpr39^-/- osteoblasts are perturbed. Finally, the expression of the zinc transporter Zip13 and a disintegrin and metalloproteinase with thrombospondin motifs family of zinc-dependent metalloproteases that regulate collagen processing was downregulated in Gpr39^-/- osteoblasts. Altogether, our results suggest that zinc sensing by ZnR/Gpr39 affects the expression levels of zinc-dependent enzymes in osteoblasts and regulates collagen processing and deposition.-Jovanovic, M., Schmidt, F. N., Guterman-Ram, G., Khayyeri, H., Hiram-Bab, S., Orenbuch, A., Katchkovsky, S., Aflalo, A., Isaksson, H., Busse, B., Jähn, K., Levaot, N. Perturbed bone composition and integrity with disorganized osteoblast function in zinc receptor/Gpr39-deficient mice.

Low zinc levels may contribute to gynecomastia in puberty

This study aimed to determine whether there were any differences in trace element levels between adolescent boys with gynecomastia and control boys and to determine the correlations between the levels of trace elements and body mass index (BMI) and sex hormones. The pubertal gynecomastia group comprised of 41 patients (mean age=13.2 ±0.9 years), who were admitted to Hacettepe University İhsan Doğramacı Children's Hospital in Ankara. Control group comprised of 21 healthy male children. Analyses of trace element levels were performed atomic absorption spectrometry. The mean zinc level of control group was 101.33±16.87μg/dL and the mean zinc level of gynecomastia group was 81.36±17,43μg/dL (20% lower in gynecomastia patients, p=0.0001). However, the mean copper and manganese levels of gynecomastia patients were not statistically different than the control group. There were significant positive correlations between plasma zinc and total testosterone levels in gynecomastia group (r=0.592; p<0.05). There was a significant negative correlation between plasma zinc levels and BMI (r=-0.311; p<0.05). These results indicate that zinc deficiency might be one of the underlying factors of gynecomastia, the importance of which needs to be further elucidated.

A short-term zinc-deficient diet decreases bone formation through down-regulated BMP2 in rat bone

We investigated the effects of a short-term dietary zinc deficiency on bone metabolism. Zinc deficiency increased the mRNA expression of zinc uptake transporters such as Zip1, Zip13, and Zip14 in bone. However, zinc deficiency might not maintain zinc storage in bone, resulting in a decrease in bone formation through downregulation of the expression levels of osteoblastogenesis-related genes.

Reference range of zinc in adult population (20-29 years) of Lahore, Pakistan

OBJECTIVE

To determine the reference range of zinc in adult population (age range 20 to 29 years) of Lahore.

METHODS

It was a descriptive cross sectional study which was carried out from Jan- August 2012 in Chemical Pathology Department of University of Health Sciences, Lahore. Serum zinc concentration was measured by flame atomic absorption spectrometry in randomly selected 450 healthy adults aged 20 to 29 years. After application of exclusion criteria reference values were determined in apparently healthy subjects according to guidelines of International Federation of Clinical Chemistry. The data was entered & analyzed using SPSS version 20.0. Serum Zn levels was expressed as Mean ± SD.

RESULTS

A total of 450 healthy subjects were included in this study. Out of these, 234 were females. Mean age was 25±0.13years. The mean concentration of zinc in serum of healthy individual was 24.02±7.03 µmol/L (range11.47-36.72). The mean±SD for males subjects were 22.33±6.42 µmol/L(range11.93-32.4). Similarly the mean±SD for females were 21.72±7.34 µmol/L (range9.94-36.87).

CONCLUSION

This study presents reference range for serum zinc concentration in adult population of Lahore. The results showed that there is significant difference in serum level of zinc among different countries. This study will help us in establishing reference ranges of trace elements on larger population in future.

Comparing school lunch and canteen foods consumption of children in kayseri, Turkey

Objective: School Nutrition Programs (SNPs) may have positive effects on children’s food choices through high nutritional quality meals. This cross-sectional & descriptive study was conducted to determine nutritional quality of school lunch and to compare lunch consumption of students who participated in SNP and who did not, at the first governmental school serving school lunch in Kayseri, Turkey.

Methods: One hundred and sixteen students aged 9-14 years were divided into two groups after being matched according to gender, age, grade; 58 participants (school lunch group; SL-G) and 58 nonparticipants (school canteen group; SC-G) were recruited. Energy-nutrient content of 5-day school lunch was determined by recipes. Socio-demographic data and lunch consumption on 5 consecutive weekdays with weighed left overs were obtained. Lunch energy-nutrient intakes and anthropometric measurements were compared.

Results: School lunch was adequate for vitamins (E & C), fibre, iron, inadequate for energy, carbohydrate, folate, calcium. Contribution of fat (36.6±6.8%) and saturated fat (12.2±3.5%) to energy and sodium content was high (1001 mg) in school lunch. SL-G consumed significantly higher protein, vitamin C, thiamine, vitamin B₆, potassium, magnesium, iron, zinc (p<0.001 for each) than SC-G. Energy (p<0.001), carbohydrate (p<0.001), fat (p<0.05), vitamin E (p<0.001) intakes of SC-G were significantly higher than SL-G. Body weights, height, body mass index of groups were similar.

Conclusions: Foodservice at school should be revised with collaboration of school management, catering firm, dietetic professionals. Policy should focus on reducing fat, saturated fat, sodium content and meeting energy-nutrient requirements of school aged children.

Association between zinc intake and risk of digestive tract cancers: a systematic review and meta-analysis

BACKGROUND & AIMS

Association between zinc intake and digestive tract cancers risk has been reported in several epidemiological studies, while the results were controversial. The aim of our study was to get a systemic review of this issue.

METHODS

PUBMED and EMBASE were searched up to April 2013, supplemented with manual-screening for relevant articles. Two independent reviewers independently extracted data from eligible studies, risk ratio (RR) or odds ratio (OR) with 95% CIs for the highest versus lowest categories of zinc intake was adopted. Either a fixed- or a random-effects model was adopted to estimate overall odds ratios. Besides, dose-response, subgroup, and publication bias analyses were applied.

RESULTS

Nineteen studies with approximately 400,000 participants were included in this meta-analysis. The pooled relative risk (RR) of overall digestive tract cancers for the highest versus lowest categories of zinc intake was 0.82 (95% CI: 0.70-0.96; p = 0.013). Comparing the highest with lowest categories, higher zinc intake was significantly associated with reduced colorectal cancer risk (pooled RR = 0.80, 95% CI: 0.70-0.92; p = 0.002), while zinc intake was not statistically associated with gastric cancer risk (pooled RR = 0.91, 95% CI: 0.64-1.29; p = 0.581) or esophageal cancer risk (pooled RR = 0.72, 95% CI: 0.44-1.17; p = 0.187). However, subgroup analyses showed that zinc intake was significantly associated with esophageal cancer risk and gastric cancer risk in Asia, but not in America and Europe.

CONCLUSIONS

Dietary zinc intake was inversely associated with digestive tract cancers, especially colorectal cancer risk in this study.

Radioprotective agents for the prevention of side effects induced by radioiodine-131 therapy

Radioiodine 131 (131I) has been used worldwide for the ablation of remnant thyroidal tissue after surgery or as the first-line treatment for Graves’ disease. Although the use of 131I is becoming increasingly prevalent, there is evidence suggesting that this treatment is associated with side effects such as salivary gland dysfunction and an increased risk of leukemia. This article aims to review the potential use of radioprotective agents and the side effects induced by 131I therapy. Several synthetic and natural compounds have been investigated in preclinical and clinical studies. The protective agents reduced the toxicity of 131I, mainly in the salivary glands, and mitigated the genetic damage through different mechanisms. There are limited clinical studies evaluating the use of radioprotective agents in patients undergoing radioiodine therapy. However, lemon candies, lemon juice and sugarless chewing gum have been proposed to be beneficial for minimizing the side effects of radioiodine within the salivary glands.

Zinc supplements for treating thalassaemia and sickle cell disease

BACKGROUND

Haemoglobinopathies, inherited disorders of haemoglobin synthesis (thalassaemia) or structure (sickle cell disease), are responsible for significant morbidity and mortality throughout the world. The WHO estimates that, globally, 5% of adults are carriers of a haemoglobin condition, 2.9% are carriers of thalassaemia and 2.3% are carriers of sickle cell disease. Carriers are found worldwide as a result of migration of various ethnic groups to different regions of the world. Zinc is an easily available supplement and intervention programs have been carried out to prevent deficiency in people with thalassaemia or sickle cell anaemia. It is important to evaluate the role of zinc supplementation in the treatment of thalassaemia and sickle cell anaemia to reduce deaths due to complications.

OBJECTIVES

To assess the effect of zinc supplementation in the treatment of thalassaemia and sickle cell disease.

SEARCH METHODS

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of most recent search: 01 February 2013.

SELECTION CRITERIA

Randomised, placebo-controlled trials of zinc supplements for treating thalassaemia or sickle cell disease administered at least once a week for at least a month.

DATA COLLECTION AND ANALYSIS

Two review authors assessed the eligibility and risk of bias of the included trials, extracted and analysed data and wrote the review. We summarised results using risk ratios or rate ratios for dichotomous data and mean differences for continuous data. We combined trial results where appropriate.

MAIN RESULTS

We identified nine trials for inclusion with all nine contributing outcome data. Two trials reported on people with thalassaemia (n = 152) and seven on sickle cell anaemia (n = 307).In people with thalassaemia, in one trial, the serum zinc level value showed no difference between the zinc supplemented group and the control group, mean difference 47.40 (95% confidence interval -12.95 to 107.99). Regarding anthropometry, in one trial, height velocity was significantly increased in patients who received zinc supplementation for one to seven years duration, mean difference 3.37 (95% confidence interval 2.36 to 4.38) (total number of participants = 26). In one trial, however, there was no difference in body mass index between treatment groups.Zinc acetate supplementation for three months (in one trial) and one year (in two trials) (total number of participants = 71) was noted to increase the serum zinc level significantly in patients with sickle cell anaemia, mean difference 14.90 (95% confidence interval 6.94 to 22.86) and 20.25 (95% confidence interval 11.73 to 28.77) respectively. There was no significant difference in haemoglobin level between intervention and control groups, at either three months (one trial) or one year (one trial), mean difference 0.06 (95% confidence interval -0.84 to 0.96) and mean difference -0.07 (95% confidence interval -1.40 to 1.26) respectively. Regarding anthropometry, one trial showed no significant changes in body mass index or weight after one year of zinc acetate supplementation. In patients with sickle cell disease, the total number of sickle cell crises at one year were significantly decreased in the zinc sulphate supplemented group as compared to controls, mean difference -2.83 (95% confidence interval -3.51 to -2.15) (total participants 130), but not in zinc acetate group, mean difference 1.54 (95% confidence interval -2.01 to 5.09) (total participants 22). In one trial at three months and another at one year, the total number of clinical infections were significantly decreased in the zinc supplemented group as compared to controls, mean difference 0.05 (95% confidence interval 0.01 - 0.43) (total number of participants = 36), and mean difference -7.64 (95% confidence interval -10.89 to -4.39) (total number of participants = 21) respectively.

AUTHORS' CONCLUSIONS

According to the results, there is no evidence from randomised controlled trials to indicate any benefit of zinc supplementation with regards to serum zinc level in patients with thalassaemia. However, height velocity was noted to increase among those who received this intervention.There is mixed evidence on the benefit of using zinc supplementation in people with sickle cell disease. For instance, there is evidence that zinc supplementation for one year increased the serum zinc levels in patients with sickle cell disease. However, though serum zinc level was raised in patients receiving zinc supplementation, haemoglobin level and anthropometry measurements were not significantly different between groups. Evidence of benefit is seen with the reduction in the number of sickle cell crises among sickle cell patients who received one year of zinc sulphate supplementation and with the reduction in the total number of clinical infections among sickle cell patients who received zinc supplementation for both three months and for one year.The conclusion is based on the data from a small group of trials,which were generally of good quality, with a low risk of bias. The authors recommend that more trials on zinc supplementation in thalassaemia and sickle cell disease be conducted given that the literature has shown the benefits of zinc in these types of diseases.

Clinical Correlation between Gastric Cancer Type and Serum Selenium and Zinc Levels

Purpose

We conducted this study to study the clinical correlation between the characteristics of gastric cancer and serum selenium and zinc levels.

Materials and Methods

The following data were measured in the baseline serum selenium and zinc levels of 74 patients with curative gastrectomy subsequent to confirmed gastric cancer, from March 2005 to August 2012.

Results

Among the 74 gastric cancer patients, 53 patients were male. Mean serum selenium and zinc levels were 118.7±33.1 ug/L and 72.2±24.3 ug/dl, respectively. Seven patients (9.5%) showed lower selenium level, and 33 patients (44.6%) showed lower zinc level. Serum Selenium level was 99.1±31.8 ug/L in cardia cancer group (10 cases) and 121.8±32.4 ug/L in non-cardia cancer group (64 cases)(P=0.044). According to tumor gross type, zinc level was 78.7±29.6 ug/dl in early gastric cancer (33) and 66.9±17.8 ug/dl in advanced gastric cancer (41) (P=0.064).

Conclusions

The serum selenium level was highly correlated with the location of gastric cancer. The serum zinc level was lower in advanced gastric cancer.

Environmental pollution levels of lead and zinc in Ishiagu and Uburu communities of Ebonyi State, Nigeria

Water and soil samples from the area were therefore analyzed for their lead and zinc content. Computation of pollution statuses of lead and zinc revealed topsoil lead geoaccumulation indices of -0.143 and -0.069 and zinc geoaccumulation indices of 1.168 and 0.713 for Ishiagu and Uburu respectively. The pollution indices were determined to be 0.499 and 0.3564 for soil in Ishiagu and Uburu respectively and also 5.11 and 2.42 for water in Ishiagu and Uburu communities respectively. Water/soil concentration ratio were found to be 0.0018 and 0.0014 for lead in Ishiagu and Uburu respectively. On the other hand, the water/soil concentration ratio for zinc was computed to be 0.001 and 0.0008 for Ishiagu and Uburu respectively. These results seem to suggest that the pollution of the environment by these heavy metals in the areas were as a result of the water being contaminated by lead and zinc not necessarily their concentrations in the soil.

Uptake and retention of 65Zn in lithium-treated rat liver: role of zinc

AIM

To evaluate the effects of zinc on the biokinetics of (65)Zn in rat and its distribution in various organs and in subcellular compartment following lithium therapy.

METHODS

Female wistar rats received either lithium treatment at a dose of 1.1g/kg in diet, zinc alone at a dose of 227 mg/L in drinking water, and combined lithium plus zinc for duration of four months.

RESULTS

After four months of lithium treatment, liver enzymes increased significantly (glutamic oxaloacetic transaminase, +66.73%; glutamic pyruvic transaminase, +63.70%; alkaline phosphatase, +40.28%; p< or =0.001); zinc supplementation to lithium-treated rats significantly reduced liver enzymes (glutamic oxaloacetic transaminase, -13.11%; glutamic pyruvic transaminase, -21.78%; alkaline phosphatase, -11.77%; p< or =0.001). The biological half-lives of (65)Zn showed an initial fast component (Tb(1)) and a slower component (Tb(2)). A significant increase in Tb(2) (38.82%, p< or =0.001) in liver was observed following lithium treatment, which significantly decreased following zinc treatment (21.71%, p< or =0.001). A significant decrease in the uptake of (65)Zn (53.93%, p< or =0.01) in liver was observed and in nuclear (p< or =0.01), mitochondrial (p< or =0.01), and microsomal (52.67%, p< or =0.001) fractions. A significant increase in the uptake of (65)Zn (82.92%, p< or =0.05) in liver microsomal fraction (34.09%, p< or =0.001) was observed in lithium-treated rats receiving zinc supplementation.

CONCLUSION

The study suggests that zinc has the potential to regulate the biokinetics of (65)Zn and its subcellular distribution in rat liver following lithium therapy.

Effect of resveratrol and zinc on intracellular zinc status in normal human prostate epithelial cells

To evaluate the influence of resveratrol on cellular zinc status, normal human prostate epithelial (NHPrE) cells were treated with resveratrol (0, 0.5, 1, 2.5, 5, and 10 microM) and zinc [0, 4, 16, and 32 microM, representing zinc-deficient (ZD), zinc-normal (ZN), zinc-adequate (ZA), and zinc-supplemented (ZS) conditions, respectively]. A progressive reduction in cell growth was observed in cells treated with increasing amounts of resveratrol (2.5-10 microM). Resveratrol at 5 and 10 microM resulted in a dramatic increase in cellular total zinc concentration, especially in ZS cells. Flow cytometry indicated that 10 microM resveratrol induced arrest of the cell cycle at the G(2)/M phase in association with the observed cell growth inhibition. Data from an in vitro experiment using zinquin as an indicator of intracellular free Zn(II) status demonstrated complex interactions between resveratrol and Zn(II). Fluorescence spectrofluorometry and fluorescence microscopic analyses revealed that intracellular free labile zinc was progressively elevated from nearly twofold in ZS cells with no resveratrol to multifold in ZA and ZS cells with 10 microM resveratrol compared with the corresponding ZN cells. Furthermore, increases in cellular zinc status were associated with elevated levels of reactive oxygen species and senescence, as evidenced by morphological and histochemical changes in cells treated with 2.5 or 10 microM resveratrol, especially in ZA and ZS cells. Taken together, the interaction between resveratrol and zinc in NHPrE cells increases total cellular zinc and intracellular free labile zinc status and, subsequently, reactive oxygen species production and senescence.

Interaction of dietary zinc and intracellular binding protein metallothionein in postnatal bone growth

Zinc and its binding protein, metallothionein (MT), are important in regulating growth and development, and yet it is unclear how dietary Zn and MT interact in regulating bone growth. Here, 3.5-week female MT-I&II knockout (MT(-/-)) and wild type (MT(+/+)) mice were fed diets containing 2.5 (limiting, Zn-L), 15 or 50 mg Zn/kg (Zn adequate) for 5 or 9 weeks, and effects were analysed on structure and function of growth plate and metaphysis, two structures important for bone growth. Zn limitation did not affect bone growth in MT(+/+) mice. However, MT(-/-) mice, having lower Zn concentrations in plasma and long bone, showed growth retardation as demonstrated by lower body length gain, shorter and smaller tibia/femur, lower chondrocyte proliferation, reduced metaphysis heights, but increased osteoclast densities on trabecular bone, particularly in mice fed Zn-L diet. Interestingly, mRNA expression of MT-I&II was induced in the growth plate of MT(+/+) mice fed the Zn-L diet possibly compensating for Zn limitation. Growth plate MT-III expression increased in MT(-/-) mice fed the adequate Zn diet, whereas metaphyseal MT-III was significantly upregulated in MT(-/-) mice fed Zn-L diet, possibly as a compensatory mechanism or exacerbating effects of Zn limitation. Consistent with the increased osteoclast numbers, a higher ratio of RANKL/OPG gene expression was found in bone of mutant mice fed lower Zn diets. These results indicate that interaction between dietary Zn and endogenous MT is important for maximal bone growth, and MT is particularly important in the regulation of Zn pool for bone growth during moderate Zn limitation.

Role of zinc in mitigating the toxic effects of chlorpyrifos on hematological alterations and electron microscopic observations in rat blood

The present study determined the protective potential of zinc in attenuating the toxicity induced by chlorpyrifos in rat blood. Male Sparque Dawley (SD) rats received either oral chlorpyrifos (13.5 mg/kg body weight) treatment every alternate day, zinc alone (227 mg/l in drinking water) or combined chlorpyrifos plus zinc treatment for a total duration of 8 weeks. The effects of different treatments were studied on various parameters in rat blood including haemoglobin (Hb) levels, total leukocyte count (TLC), differential leukocyte count (DLC), zinc protoporphyrins (ZPP), serum trace elemental concentrations and Scanning Electron Microscopic (SEM) observation of the blood cells. Chlorpyrifos treatment to normal control animals resulted in a significant decrease in TLC and ZPP concentration after 4 and 8 weeks. Chlorpyrifos treated animals also showed significant neutrophilia and lymphopenia after 8 weeks of toxicity. In addition, a significant decrease in serum zinc and iron concentrations were observed following chlorpyrifos intoxication, however, these animals responded with increased serum copper levels following the toxic treatment with this organophosphate. SEM studies of the red blood cells from chlorpyrifos treated animals indicated marked alterations in the topographical morphology of the various cell types, with the prominent feature being common aniscocytosis of the erythrocytes. Oral zinc treatment to the chlorpyrifos treated animals significantly improved the total leukocyte, neutrophil and lymphocyte counts, as well as the otherwise reduced concentrations of ZPP and the levels of various serum trace elements. Protective effects of zinc were also evident in the electron microscopic observations where most blood cell types depicted reverted to a close to the normal appearance. Based upon these data, the present study is first of its kind and suggests that zinc treatment considerably attenuates chlorpyrifos induced toxicity induced in restoring the altered hematological indices and morphological changes.

The mineral depletion of foods available to us as a nation (1940-2002)--a review of the 6th Edition of McCance and Widdowson

Over the past 60 years there have been fundamental changes in the quality and quantity of food available to us as a nation. The character, growing method, preparation, source and ultimate presentation of basic staples have changed significantly to the extent that trace elements and micronutrient contents have been severely depleted. This trend, established in a review of the 5th Edition of McCance & Widdowson's The Composition of Foods, is still apparent in this review of the 6th edition of the same work. Concurrently there has been a precipitous change towards convenience and pre-prepared foods containing saturated fats, highly processed meats and refined carbohydrates, often devoid of vital micronutrients yet packed with a cocktail of chemical additives including colourings, flavourings and preservatives. It is proposed that these changes are significant contributors to rising levels of diet-induced ill health. Ongoing research clearly demonstrates a significant relationship between deficiencies in micronutrients and physical and mental ill health.

131I induced hematological alterations in rat blood: protection by zinc

The present study was planned to determine the potential of zinc in attenuating the toxicity induced by 131I in rat blood. Female wistar rats were segregated into four main groups. Animals in Group I served as normal controls; Group II animals were administered a dose of 3.7 Mbq of 131I (carrier free) intraperitoneally, Group III was supplemented with Zinc in the form of ZnSo4.7H2O (227 mg/l drinking water), and Group IV was given a combined treatment of Zinc as well as 131I, in a similar way as was given to Groups IV and II animals, respectively. The effects of different treatments were studied on various parameters in rat blood including hemoglobin (Hb) levels, % hematocrit, zinc protoporphyrins (ZPP), activities of enzymes which included aminolevulinic acid dehydratase (delta-ALAD) and Na+ K+ ATPase and uptake of 65Zn in blood. The study revealed an increase in the levels of hemoglobin, % hematocrit, activities of delta-ALAD, Na+ K+ ATPase and uptake of 65Zn, 7 days after the 131I treatment. On the contrary, the levels of ZPP were found to be significantly decreased after 131I treatment. However, zinc treatment to 131I-treated animals significantly attenuated the various biochemical and hematological indices. Moreover, zinc treatment to the 131I-treated animals could significantly decrease the uptake of 65Zn, which was increased after 131I treatment. Based upon these data, the present study suggests that zinc has the potential to attenuate 131I induced toxicity by restoring the altered hematological indices and biochemical changes.

Growth impairment in beta-thalassemia major: the role of trace element deficiency and other potential factors

A serious problem in thalassemia major is growth impairment for which several possible etiologies have been proposed. Sixty-seven patients with thalassemia were randomly enrolled into the study, divided into 2 groups with and without growth failure and the correlation between growth failure and the following parameters was evaluated: age, sex, serum ferritin level, serum zinc and copper concentrations, serum copper-zinc ratio, regularity of blood transfusion, and the regularity and duration of chelation therapy. Among all studied parameters, only age, duration, and type of chelation therapy and age of beginning chelation therapy were significantly different between the 2 groups. Binomial multivariate logistic regression showed that the only significant independent correlation was between age and growth failure. A 1-year increase in age is associated with a 1.57-fold increase in the risk of growth impairment. The results of this study indicated that a temporally cumulative damage to growth-mediating mechanisms except those considered here is responsible for growth failure in thalassemia major.

Serum-induced expression of metallothionein isoforms in K-562 cells

The metallothionein (MT) expression was studied in the hematopoietic precursor cell line K-562, after serum deprivation and reconstitution of the cells in medium with 10% (v/v) FCS. Serum deprivation for 72 h markedly downregulated the MT mRNA expression, only the isoforms most abundant in normal K-562 cells were clearly detectable. Within 1-1.5 h after serum supplementation however, a definite induction of MT mRNA was noticed, and all isoforms were induced. Forty-eight hours after serum stimulation, the MT mRNA expression of all isoforms decreased again. Also MT protein levels increased twofold 24 h after serum stimulation. These results suggest that MT has a function in the re-entry of resting cells into the cell cycle, this function however could not be assigned to a specific MT isoform. The induction of MT after serum stimulation was independent of protein synthesis, but dependent on phosphorylation.

Detection of reactive oxygen species in the skin of live mice and rats exposed to UVA light: a research review on chemiluminescence and trials for UVA protection

The harmful effects of ultraviolet (UV) exposure on the skin are associated with the generation of reactive oxygen species (ROS) such as superoxide anion radical ( O(2)(-)), hydrogen peroxide (H(2)O(2)), hydroxyl radical ( OH), and singlet oxygen ((1)O(2)) as well as with lipid peroxides and their radicals (LOOH and LOO ). To give direct proof that such ROS are generated in UV-exposed skin, we proposed the in vivo detection and imaging method in which both a sensitive and specific chemiluminescence (CL) probe, such as CLA, and an ultralow-light imaging apparatus with a CCD camera were used. With this method we found that O(2)(-) is formed intrinsically and that (1)O(2) and O(2)(-) are generated in the UVA-exposed skin of mice. In addition, we indicated that antioxidative ability against ROS in the skin of hairless rats decreased as age increased. Using these findings, we demonstrated the protective abilities of sodium ascorbate, caffeic acid, essential aroma oils, and zinc(ii) ion and its complexes, which we administered to mice both topically and orally. We present a review for the current state of our research proposing the sensitive CL method as a useful in vivo tool in photobiological research for the detection of oxidative stress as well as for the evaluation of antioxidative agents to the skin.

Effects of iron and multimicronutrient supplementation on geophagy: a two-by-two factorial study among Zambian schoolchildren in Lusaka

Geophagy has been associated with iron deficiency and anaemia, but no causal relationship has been established. To clarify this, we conducted a two-by-two factorial randomised, controlled trial on the effect of iron and multimicronutrient supplementation on geophagy in Zambian schoolchildren in Lusaka, from February to December 2001. Of the 406 children, 212 (52.2%) were girls and the mean (range) age was 10.2 (7-15) years. Geophagy was reported by 302 (74.4%) and more often in girls than in boys (80.2 vs. 67.7%, P = 0.007). The mean (range) daily earth intake was 25.2 (1-200) g. Geophageous children had more often geophageous relatives than non-geophageous children (79.5 vs. 1.9%, P < 0.001). Geophageous children had lower serum ferritin (20.5 vs. 25.0 microg/l, P = 0.032) but not haemoglobin (Hb) (129.2 vs. 130.4 g/l, P = 0.59), than non-geophageous. Among those with Hb < 130 g/l, geophageous children had significantly higher prevalence (53.7 vs. 30.6%, P = 0.024) of Ascaris lumbricoides infection than non-geophageous. The prevalence of geophagy (74.4 to 51.6%) and the intake of earth (25.3 to 15.0 g/day) declined (P = 0.001 and P < 0.001, respectively) among the 220 (54.2%) children followed-up. In bivariate analysis, non-iron supplementation reduced the prevalence of geophagy more than iron supplementation did, but this was not confirmed in the multiple logistic regression analysis. Multimicronutrients had no effect on either geophagy prevalence or earth intake. Geophagy was prevalent and associated with iron deficiency, but iron supplementation had no effects on geophageous behaviour. Geophagy could be a copied behaviour and the association between geophagy and iron deficiency due to impaired iron absorption following earth eating.

Alteration of zinc concentrations in the brain implanted with C6 glioma

The uptake of zinc, an essential element, is critical not only for cell proliferation but also cell functions. On the basis of the evidence suggesting that preferential uptake of 65Zn in brain tumors may be associated with avid cell proliferation, alteration of zinc concentrations in the brain implanted with C6 glioma was studied by brain autoradiography using 65Zn. After implantation of C6 glioma cells into the hippocampus, 65Zn concentrations in the brain were compared between 1 h and 6 days after intravenous injection of 65ZnCl(2). The 65Zn concentration in the tumor 1 h after the injection was approximately twice as high as that 6 days after the injection. However, the 65Zn concentration in the tumor 6 days after the injection was higher than in any other brain region. These results suggest that zinc taken up in the tumor may be utilized for tumor cell proliferation and that there is greater potential in the use of 69mZn, a short-half life gamma-emitter, for evaluation of the viability of brain tumors.

Zinc deficiency reduces leptin gene expression and leptin secretion in rat adipocytes

The present study was conducted to measure ob mRNA abundance in the zinc-deficient (ZD) rats and the secretion of leptin from adipose tissue obtained from ZD, zinc-adequate (ZA), and pair-fed (PF) rats. It was found that ob mRNA abundance was greatest (P < 0.05) in adipose tissue obtained from ZA and PF rats. Ob mRNA abundance was similar in PF and ZD rats. To study leptin secretion from adipose tissue in a cell culture model, a method was developed to use excised epididymal adipose tissue from ZD, ZA, and PF rats. Tissue was incubated in Opti-modified Eagle's medium (MEM) cell culture medium in which concentrations of zinc and insulin were manipulated. It was observed that leptin secretion was higher (P < 0.05) in adipose tissue obtained from ZA than ZD and PF rats. Secretion of leptin was higher in adipose tissue of PF than ZD rats (P < 0.05). Surprisingly, media zinc content in this ex vivo model tended to suppress secretion of leptin. This suppression seems to be zinc specific and might be caused by the sequestration of insulin in the culture medium. Our results indicate that the reduction in serum leptin observed in ZD rats is likely caused by not only a reduction in body fat, but also by a decrease in leptin synthesis and secretion per gram of adipose tissue. Taking these results into account along with a prior study (1), it is possible that even a marginal zinc deficiency could affect leptin secretion and serum leptin concentrations. Impaired leptin secretion caused by zinc deficiency might be one factor contributing to hypogonadism observed in zinc deficiency.

Metallothionein isogene transcription in red blood cell precursors from human cord blood

The in vitro transcription patterns for 10 functional metallothionein (MT) isogenes have been investigated in red blood cell (RBC) precursors from human cord blood. Active transcription status of the isogenes, MT-0, MT-1A, MT-1B, MT-1E, MT-1G, MT-1X, and MT-2A, was detected in both ex vivo expanded RBC precursors (burst-forming unit-erythroid) and glycophorin A(+) and CD71(+) cells separated by magnetic cell sorting. Transcription patterns of these isogenes were analyzed at different times of incubation with the addition of Zn supplement. In neither the ex vivo expanded precursors nor glycophorin A(+) and CD71(+) cells could MT-1F and MT-3 be detected. Transcripts of MT-4 were detected in glycophorin A(+) and CD71(+) cells. Erythropoietin-responsive constitutive transcription of MT-1X and possible interleukin-3-responsive downregulation of MT-2A in ex vivo expanded precursors reveal their effect on MT biosynthesis. Biosynthesis and induction of MT at the protein level in the RBC precursors was also demonstrated by immunoblotting.

Hepatic zinc response via metallothionein induction after tumor transplantation

Based on previous findings that liver zinc and metallothionein (MT) levels increase after tumor transplantation, zinc metabolism in tumor-bearing mice was studied to clarify the role of zinc-MT in host defense systems. Zinc in the hepatic cytosolic MT fraction did not increase in tumor-bearing mice fed a zinc-deficient diet, suggesting that dietary zinc is necessary for apo-MT induction in the liver after tumor transplantation and is then incorporated into the apo-MT. When (65)ZnCl(2) was intravenously injected, liver (65)Zn levels in the tumor-bearing mice were higher than those in control mice for 72 h after the injection. Pancreatic and blood (65)Zn levels in tumor-bearing mice were lower than those in controls for 24 h (pancreas) and 6 h (blood) after the injection. These findings indicate that the hepatic zinc response via MT induction influences zinc metabolism in the body after tumor transplantation. Moreover, (65)Zn uptake in the liver of MT-deficient tumor-bearing mice was lower than that in control tumor-bearing mice 1 h after injection. (65)Zn uptake in the tumor and blood (65)Zn levels in the MT-deficient tumor-bearing mice were higher than those in the control tumor-bearing mice. Tumor weight increased more in MT-deficient mice than in control mice. The formation of zinc-MT in the liver of tumor-bearing mice might decrease blood zinc availability for tumors and other tissues, such as the pancreas.

A two-compartment model for zinc in humans

The oral absorption of zinc, from a test meal of minced beef, mashed potatoes and peas, have been measured in 19 healthy adults using the radiotracer 65Zn. The oral absorption, expressed as a percentage of the administered dose, was 20 +/- 5% (mean +/- 1 SD) in good agreement with previous results. In a subset of 9 subjects, tracer retention in whole body and whole blood was followed out to one year. The data were fitted to a simple two compartment model yielding total body zinc (TBZn), the zinc content in each of the 2 compartments and zinc turnover. The TBZn values ranged from 15.5 to 35.9 mmol while zinc turnover ranged from 0.043 to 0.073 mmol/d in keeping with results reported for significantly more complicated compartmental models applied to more comprehensive 65Zn tracer data sets. Additionally, TBZn correlated well with total body potassium, a measure of lean body mass, measured by whole body counting of the naturally-occurring potassium radioisotope, 40K. The zinc content of the more rapidly turning over compartment ranged from 3.2 to 5.6 mmol in reasonable agreement with exchangeable zinc pool estimations reported for short term studies using stable zinc isotopes. Therefore, the simple dataset and model employed in the present study yielded information on the short- and long-term behaviour of zinc compatible with both more complex radiotracer studies and analytically more demanding stable isotope studies.

The effect of zinc-supplemented bread consumption on school children with asymptomatic zinc deficiency

BACKGROUND

Zinc deficiency has been seen in developing countries in which grain-based vegetable protein is consumed more often than animal protein. This study was done to emphasize the importance of zinc-fortified foods and to investigate bioavailability of zinc in zinc-fortified bread.

METHODS

Serum zinc concentrations in healthy 7- to 11-year-old school children were determined. In 24 of 101 children serum zinc concentrations were below 65 micrograms/ul. These 24 children with asymptomatic zinc deficiency were divided into two equal groups. The 12 children with low serum zinc concentrations received the zinc-fortified bread providing 2 mg/kg/day elemental zinc acetate for 90 days (zinc-supplemented group), whereas the other 12 children received the same quality bread with no zinc fortification (control group).

RESULTS

By the end of the period, the zinc-supplemented group had significantly higher serum and leukocyte zinc concentrations (p < 0.01) and the weight, serum albumin levels, and alkaline phosphatase increased (p < 0.01). Immune functions improved, evidenced by conversion of delayed hypersensitivity skin reactions. Zinc-fortified bread (2 mg/kg/day) caused no side effects or manifestations of zinc toxicity.

CONCLUSIONS

The results indicate that the bioavailability of zinc in the bread is satisfactory. The use of zinc-fortified bread was found to be an economical and readily accessible method to eliminate zinc deficiency and to prevent further occurrence.

Zinc intake and plasma zinc level are maintained in men consuming cholesterol-lowering diets

OBJECTIVE

Reduced zinc intake has been reported when cholesterol-lowering diets are adopted. This study examined whether such diets compromise the zinc status of men with hypercholesterolemia.

DESIGN

Zinc intake on baseline 4-day food records and baseline plasma zinc levels were compared with intake and levels 12 and 24 months after subjects adopted a low-fat, increased-fiber diet. Dietary fiber intake, supplement use, alcohol intake, and exercise were evaluated as possible confounding variables.

SUBJECTS

Subjects were free-living men (n = 365) with baseline cholesterol level above the 75th percentile who were participants in a randomized trial comparing cholesterol-lowering diets with goals of 30%, 26%, 22%, and 18% of energy from fat and 300, 200, 100, and 100 mg cholesterol, respectively.

STATISTICAL ANALYSES

Data were analyzed using two sample t tests, multiple linear regression, and analysis of variance.

RESULTS

For all subjects combined, mean fat and cholesterol intakes approached or met the guidelines of the National Cholesterol Education Program step 2 diet, with approximately 30 g fiber per day. Density (mg/1,000 kcal) of zinc intake was unchanged from the baseline value. We found a slightly positive relationship between fiber and zinc intakes; no relationship between fiber intake and plasma zinc level; no effect of supplement use (category included all types of supplements), alcohol use, or level of exercise on plasma zinc levels; and no difference by dietary assignment in zinc intake or plasma zinc levels.

APPLICATION

Zinc status does not appear to be at risk in adult men who adopt cholesterol-lowering diets. These results may not be generalized to higher-risk population groups or situations in which dietary counseling is less comprehensive.

Decreased natural killer (NK) cell activity in zinc-deficient rats

1. In the study, the effect of zinc deficiency, a natural killer (NK), and lipopolysaccharide (LPS) activated NK cell activity were investigated. 2. Rats were fed with zinc-deficient and normal diet for 3 weeks. 3. NK and LPS activated NK cell activity was 7.2 +/- 1.8%/10(6) cells (n = 10) and 9.5 +/- 4.3%/10(6) cells (n = 10), respectively, in the zinc deficient group. In the control group fed with normal diet, NK and LPS activated NK cell activity was 22.2 +/- 3.3%/10(6) cells (n = 10) and 32.5 +/- 3.5%/10(6) cells (n = 10), respectively. 4. Plasma zinc concentration was 131.7 +/- 8.8 micrograms/dl in the zinc-deficient group and 206 +/- 17.7 micrograms/dl in the control group. 5. The results suggest that decreased NK and LPS activated NK cell activity is associated with zinc deficiency.

Serum trace metals in chronic viral hepatitis and hepatocellular carcinoma in Thailand

This study was conducted to determine and compare serum trace metal levels in viral hepatitis-associated chronic liver disease. Of 98 patients aged 43 (+/- 13) [mean (+/- SD)] years, 83 (85%) were seropositive for hepatitis B surface antigen (HBsAg) and 15 (15%) were seropositive for anti-hepatitis C virus (HCV). Twenty-five patients had chronic persistent hepatitis, 32 chronic active hepatitis, 21 post-necrotic cirrhosis, and 20 hepatocellular carcinoma. Determination of fasting serum trace metal levels (zinc, copper, calcium, magnesium, and phosphorus) was performed after the patients had been on a 2-day diet containing 10-12 mg zinc/day. Compared to healthy volunteers (n = 30), serum zinc levels were significantly decreased in patients with chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (P < or = 0.0001), and copper levels were significantly elevated only in patients with hepatocellular carcinoma (P < 0.0001). The overall serum levels of calcium, magnesium, and phosphorus were within normal ranges, and levels of calcium and magnesium correlated with serum zinc (P = 0.01-0.03). Serum zinc levels correlated with bilirubin, albumin, and cholesterol (P = 0.0004 < or = 0.0001), but not with daily urinary zinc excretion. Serum copper levels correlated with alkaline phosphatase and gamma-glutamyltransferase (P = 0.008-0.0001). These results suggested that changes in liver cell pathology compounded by functional impairment may alter the metabolism of trace metals, in particular, zinc and copper. The possible relationship of these changes to the pathogenesis of chronic liver disease is discussed.

Induction by zinc of specific metallothionein isoforms in human monocytes

A low-molecular-mass zinc-containing protein was isolated by gel permeation and anion-exchange chromatography of lysates of human monocytes induced with zinc acetate. Characterization by sodium dodecyl sulphate/polyacrylamide gel electrophoresis and amino acid sequencing identified the two major charge-separable fractions and an occasionally occurring third fraction as metallothionein-1, metallothionein-2 and metallothionein-0, respectively. Metallothionein-1 was shown to consist of a mixture of isoforms, confirmed as metallothionein-1e, metallothionein-1g and metallothionein-1l by comparison with cDNA sequences obtained by screening a human monocyte cDNA library. We can find no previous observation in the literature of metallothionein-1g at both the protein and RNA level in a non-tumour cell, and of metallothionein-0 in a non-fetal cell or tissue. Since isoform-specific polymerase-chain-reaction amplification showed the presence of metallothionein-0 mRNA in zinc-induced but not in untreated monocytes, these cells can be used as an in vitro system to investigate the expression of this previously considered fetal isoform.

Acquired zinc deficiency in association with anorexia nervosa: case report and review of the literature

Zinc deficiency, whether a result of an acquired or inherited abnormality of zinc metabolism, is associated with characteristic cutaneous findings. The inherited variety is known as acrodermatitis enteropathica. We present a case of zinc deficiency secondary to starvation induced by anorexia nervosa. Since the cutaneous stigmata of zinc deficiency and anorexia nervosa can initially be subtle and occasionally overlap, we believe that screening zinc levels in patients with anorexia nervosa with prominent cutaneous findings should be considered.

Mitogenic effect of zinc on lymphocytes from strains of mice that are either high or low-responder to T-cell mitogens

We have studied the in vitro mitogenic effect of ZnCl2 in cultures of lymphocytes from Balb/c or C57BL/6 mice which are high-responder or low-responder to T-cell mitogens respectively. Zn induced proliferation of spleen cells from Balb/c mice cultured without 2-ME. Higher levels of proliferation were observed in cultures with 2-ME. In contrast, Zn only induced proliferation of spleen cells from C57BL/6 mice in the presence of 2-ME. No response to Zn was observed in cultures without 2-ME, of spleen cells from either Balb/c or C57BL/6 mice depleted of plastic adherent cells. However, in cultures with 2-ME, Zn induced proliferation of non-adherent as well as plastic adherent cells from either strain of mice. In cultures without 2-ME, Zn induced proliferation of thymocytes from Balb/c mice, whereas did not show constant mitogenic effect on thymocytes from C57BL/6 mice. In contrast, Zn determined higher levels of proliferation of thymocytes from either strain of mice when cultured with 2-ME. Zn had earlier and stronger mitogenic effect on mature thymocytes of either strain of mice than in total thymocytes, both in cultures with or without 2-ME. However, Zn did not induced proliferation in cultures of immature thymocytes of either strain of mice.

Physiological and pharmacological regulation of biological calcification

Biological calcification is a highly regulated process which occurs in diverse species of microorganisms, plants, and animals. Calcification provides tissues with structural rigidity to function in support and protection, supplies the organism with a reservoir for physiologically important ions, and also serves in a variety of specialized functions. In the vertebrate skeleton, hydroxyapatite crystals are laid down on a backbone of type I collagen, with the process being controlled by a wide range of noncollagenous proteins present in the local surroundings. In bone, cells of the osteoblast lineage are responsible for the synthesis of the bone matrix and many of these regulatory proteins. Osteoclasts, on the other hand, are continually resorbing bone to both produce changes in bone shape and maintain skeletal integrity, and to establish the ionic environment needed by the organism. The proliferation, differentiation, and activity of these cells is regulated by a number of growth factors and hormones. While much has already been discovered over the past few years about the involvement of various regulators in the process of mineralization, the identification and functional characterization of these factors remains an area of intense investigation. As with any complex, biological system that is in a finely tuned equilibrium under normal conditions, problems can occur. An imbalance in the processes of formation and resorption can lead to calcification disorders, and the resultant diseases of the skeletal system have a major impact on human health. A number of pharmacological agents have been, and are being, investigated for their therapeutic potential to correct these defects.(ABSTRACT TRUNCATED AT 250 WORDS)

Zinc metabolism in patients treated with captopril versus enalapril

Several zinc parameters were assessed in 13 patients with essential hypertension who were chronically taking only captopril (six subjects) or enalapril (seven subjects), as well as in six untreated hypertensives, and nine healthy controls. Serum zinc levels were comparable in all groups. Twenty-four-hour urinary zinc excretion was significantly increased in the captopril-treated patients compared with the other three groups. The zinc:creatinine ratio in 24-hour urine was significantly increased in both captopril and enalapril groups, but was significantly greater in the former. Although plasma zinc concentrations were comparable in all groups, red blood cell (RBC) zinc values were significantly decreased in the captopril group compared with the other three groups. We conclude that (1) although both captopril and enalapril produce renal zinc loss, this loss is far greater in patients receiving captopril; and (2) captopril administration over 3 months or more generates RBC zinc depletion.