Expression analysis of zinc-metabolizing enzymes in the saliva as a new method of evaluating zinc content in the body: two case reports and a review of the literature

BACKGROUND

The activity level of alkaline phosphatase, a zinc-requiring enzyme in the serum, is used to indicate zinc nutritional status; however, it does not correlate with serum zinc levels or subjective symptoms of taste disorder in many cases. Hence, this study focused on the total activity of alkaline phosphatase, a zinc-requiring enzyme. The total alkaline phosphatasa activity level in the saliva was measured before and after zinc supplementation, and the results were compared with serum zinc levels.

CASE PRESENTATION

This study included patients with hypozincemia, specifically a patient with zinc-deficient taste disorder (patient 1: a 69-year-old Japanese woman) and a patient with glossodynia with zinc deficiency (patient 2: an 82-year-old Japanese woman). Saliva samples were collected, and blood tests were performed before and after zinc supplementation. Subjective symptoms and serum zinc levels were simultaneously evaluated. Zinc supplementation was performed using zinc acetate hydrate or Polaprezinc.

CONCLUSIONS

Total alkaline phosphatase activity levels were found to be associated with serum zinc levels and subjective symptoms. A further study with a higher number of patients is necessary to confirm whether total alkaline phosphatase activity levels more accurately reflect the amounts of zinc in the body than serum zinc levels.

Determination of Serum Zinc and Phosphorus Levels in Patients with Hypothyroidism

Various studies reported that serum zinc (Zn) and phosphorus (P) levels altered in patients with hypothyroidism and vice versa, but results were found inconsistent. It was aimed to find the association between serum Zn and P in patients with hypothyroidism. In this case-control study, a total of 100 subjects (50 newly diagnosed patients of hypothyroidism and 50 controls) were enrolled aged between 25 and 60 years. Biochemical parameters such as thyroid profile, serum Zn, and P were estimated in each subject. A p < 0.05 was considered statistically significant. The mean level of body mass index (BMI), thyroid-stimulating hormone (TSH), and serum P was found significantly elevated in cases compared to controls (p < 0.001). However, the mean level of total triiodothyronine (T3), thyroxine (T4), and serum Zn was found significantly reduced in cases compared to controls (p < 0.001). The serum Zn has shown a significant negative correlation with T3 and BMI among cases (r =  - 0.313 p < 0.05, r =  - 0.338 p < 0.05, respectively). However, serum P has shown a significant positive correlation with TSH and BMI among cases (r = 0.310 p < 0.05, r = 0.449 p < 0.01, respectively). Regression analysis indicated that serum Zn significantly predicted hypothyroidism (p < 0.00). Similarly, serum P significantly predicted hypothyroidism (p < 0.007). Results showed that serum Zn levels were significantly reduced and serum P levels were significantly elevated in cases compared to controls. The serum Zn and serum P both significantly associated with hypothyroidism.

Circulating ACE2 level and zinc/albumin ratio as potential biomarkers for a precision medicine approach to COVID-19

Highly mutable influenza is successfully countered based on individual susceptibility and similar precision-like medicine approach should be effective against SARS-COV-2. Among predictive markers to bring precision medicine to COVID-19, circulating ACE2 has potential features being upregulated in both severe COVID-19 and predisposing comorbidities. Spike SARS-CoVs were shown to induce ADAM17-mediated shedding of enzymatic active ACE2, thus accounting for its increased activity that has also been suggested to induce positive feedback loops leading to COVID-19-like manifestations. For this reason, pre-existing ACE2 activity and inhibition of ACE2/ADAM17 zinc-metalloproteases through zinc chelating agents have been proposed to predict COVID-19 outcome before infection and to protect from COVID-19, respectively. Since most diagnostic laboratories are not equipped for enzymatic activity determination, other potential predictive markers of disease progression exploitable by diagnostic laboratories were explored. Concentrations of circulating albumin, zinc, ACE2 protein and its activity were investigated in healthy, diabetic (COVID-19-susceptible) and SARS-CoV-2-negative COVID-19 individuals. ACE2 both protein levels and activity significantly increased in COVID-19 and diabetic patients. Abnormal high levels of ACE2 characterised a subgroup (16-19%) of diabetics, while COVID-19 patients were characterised by significantly higher zinc/albumin ratios, pointing to a relative increase of albumin-unbound zinc species, such as free zinc ones. Data on circulating ACE2 levels are in line with the hypothesis that they can drive susceptibility to COVID-19 and elevated zinc/albumin ratios support the therapeutic use of zinc chelating inhibitors of ACE2/ADAM17 zinc-metalloproteases in a targeted therapy for COVID-19.

Association between serum copper, zinc and their ratio and handgrip strength among adults: a study from National Health and Nutrition Examination Survey (NHANES) 2011-2014

Evidence for the association between serum copper and zinc status and handgrip strength is very limited only in several observational studies with study participants of specific population or a narrower age range. The aim of this study was to evaluate the association between serum copper, zinc and their ratio and handgrip strength in the general population. This study included adult participants aged 20-80 years with complete data of serum copper and zinc status and handgrip strength from NHANES 2011-2014. Handgrip strength was calculated as the average of the maximum measure obtained in each hand with a grip strength dynamometer and corrected using BMI. Serum copper and zinc levels were measured using inductively coupled plasma dynamic reaction cell mass spectrometry, and their ratios were calculated. The multivariable linear regression and restricted cubic spline models were used. Serum copper level was inversely associated with BMI-corrected handgrip strength, and the beta coefficients (95% confidence intervals) comparing the second, third, and fourth to the lowest quartiles of serum copper level were - 0.17 kg (- 0.26; - 0.08), - 0.22 kg (- 0.32; - 0.13), and - 0.36 kg (- 0.44; - 0.28), respectively (P for trend < 0.001). Non-linear association was detected between serum copper level and BMI-corrected handgrip strength (P < 0.01). Consistent with serum copper, serum copper/zinc ratio was inversely associated with BMI-corrected handgrip strength. However, no significant associations were observed between serum zinc level and BMI-corrected handgrip strength (all P > 0.05). Higher serum copper level and copper/zinc ratios were significantly associated with lower handgrip strength. Further research is needed to address related issues.

Comparative evaluation of serum zinc level in head and neck cancer patients before and after radiation therapy

Background

Head and neck cancers (HNCs) include 5.3% of all cancers and they are the cause of the same 5.3% of cancer deaths. Oxidative stress has a crucial role in cancer progression and cancer therapy. Ionizing radiation causes cell malfunction and death by creating reactive oxygen species. Due to its antioxidant activity, immune system power enhancement and role in apoptosis, zinc is a crucial trace element in oncology including HNCs. We decided to compare serum zinc level of HNC patients before and after RT, to assess the potential effects of ionizing radiation therapy on serum zinc.

Methods

Fifty-seven HNC patients, who were candidates for curative radiation therapy (RT), were enrolled and their serum zinc level just before and 2 months after completion of RT were checked in a single laboratory. RT was prescribed by linear accelerator with 60 to 70 Gy by conventional method. Data were analyzed by SPSS 20.

Results

Mean serum zinc prior to RT and following RT were 77.64±13.45 mg/dl and 68.28±11.93 mg/dl, respectively, which was lower following RT (p<0.001). Patients' sex, age and duration from diagnosis to treatment and site of disease didn't have any impact on serum zinc difference.

Conclusion

This study showed that RT of HNCs leads to serum zinc reduction, which is greater in nodal disease because of either larger field or higher dose of radiation. Taking zinc supplements while being treated by RT, may be necessary.

Serum Copper-to-Zinc Ratio and Risk of Chronic Obstructive Pulmonary Disease: A Cohort Study

PURPOSE

Serum copper (Cu), zinc (Zn), and Cu/Zn-ratio have emerged as ageing-related biomarkers. We sought to assess the association between Cu/Zn-ratio and chronic obstructive pulmonary disease (COPD) risk.

METHODS

Serum Cu and Zn were measured using atomic absorption spectrometry in 2,503 men aged 42-61 years.

RESULTS

During a median follow-up of 27.1 years, 210 COPD cases occurred. Serum Cu/Zn-ratio and Cu concentrations were linearly associated with COPD risk, whereas the relationship was curvilinear for Zn and COPD risk. A unit increase in Cu/Zn-ratio was associated with an increased COPD risk in multivariable analysis (hazard ratio, HR 1.81; 95% CI 1.08-3.05). The corresponding adjusted HR (95% CI) was 3.17 (1.40-7.15) for Cu. Compared to the bottom tertile of Zn, the HRs (95% CIs) were 0.68 (0.48-0.97) and 1.01 (0.73-1.41) for the middle and top tertiles of Zn, respectively.

CONCLUSIONS

Increased serum Cu/Zn-ratio and Cu concentrations were linearly associated with an increased COPD risk in men.

Association between Serum Zinc Levels and Clinicopathological Characteristics in Patients with Gastric Cancer

Introduction

Although it was reported that serum zinc levels were lower in patients with various malignancies, serum zinc levels of patients with gastric cancer were not well documented.

Objectives

This study aimed to evaluate the association between clinicopathologic features and serum zinc levels in preoperative patients with gastric cancer.

Methods

The study enrolled 83 patients scheduled for gastric cancer surgery at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level <80 μg/dL.

Results

The median zinc level of the 83 patients was 73 μg/dL (range, 20-152 μg/dL), and serum zinc deficiency was present in 66.3% of patients. Albumin was significantly lower in the zinc low level group than in the normal group (3.9 g/dL vs. 4.4 g/dL, p < 0.001), and the median serum zinc level was significantly lower in the albumin <4.1 g/dL group than in the albumin ≥4.1 g/dL group (69 μg/dL vs. 82 μg/dL, p < 0.001). Lymphocyte count was significantly lower in the zinc low level group than in the normal group (1,500 vs. 1810 years, p = 0.041). The median serum zinc level was significantly lower in the age ≥74 group than in the age <74 (71 μg/dL vs. 76 μg/dL, p = 0.002). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.637, p = 0.009).

Conclusion

Serum zinc deficiency was found in 66.3% of preoperative patients with gastric cancer, which was highly correlated with serum albumin.

Serum copper-to-zinc ratio and risk of incident pneumonia in caucasian men: a prospective cohort study

Serum copper (Cu) and zinc (Zn), essential micronutrients that have important immunomodulatory and antimicrobial properties, are biomarkers of ageing. Serum Cu/Zn-ratio may be a more reliable marker for age-related degenerative conditions compared with serum Cu or Zn alone. We aimed to assess the association between Cu/Zn-ratio and the risk of incident pneumonia in a prospective cohort study. Serum levels of Cu and Zn were measured at baseline using atomic absorption spectrometry in 2503 men aged 42–61 years in the Kuopio Ischemic Heart Disease prospective cohort study. Hazard ratios (HRs) with confidence intervals (CIs) were calculated for incident pneumonia using Cox regression models. A total of 599 cases of pneumonia occurred during a median follow-up of 26.1 years. Serum Cu/Zn-ratio and Cu were each linearly associated with incident pneumonia. A unit increase in Cu/Zn-ratio was associated with an increased risk of pneumonia in analysis adjusted for potential confounders including C-reactive protein (HR 1.65; 95% CI 1.17–2.33). The corresponding adjusted HR (95% CI) was 2.04 (1.22–3.40) for serum Cu. The association between serum Zn and pneumonia was curvilinear. Compared to the bottom tertile of Zn, the multivariable adjusted HRs (95% CIs) for incident pneumonia were 0.68 (0.55–0.83) and 0.96 (0.79–1.16) for the middle and top tertiles of Zn, respectively. Further analysis in the same participants showed that Cu/Zn-ratio might be a stronger risk indicator for pneumonia than serum C-reactive protein. In middle-aged and older Finnish men, increased serum Cu/Zn-ratio and Cu concentrations are each linearly associated with an increased risk of incident pneumonia.

No evidence of a prospective relationship between serum zinc and venous thromboembolism in Caucasian men: a cohort study

Serum zinc has been implicated as an important mediator of haemostasis and thrombosis. However, the nature and magnitude of any potential relationship between serum zinc and venous thromboembolism (VTE) is unknown. We aimed to evaluate the prospective association between serum zinc and VTE risk. We analyzed data involving 2472 men aged 42-61 years without a history of VTE in the Kuopio Ischemic Heart Disease population-based cohort study, with the assessment of serum zinc concentrations using atomic absorption spectrometry. Hazard ratios (95% confidence intervals [CIs]) for incident VTE were estimated. A total of 166 VTE cases occurred during a median follow-up of 27.1 years. The risk of VTE per 1 standard deviation increase in serum zinc in analysis adjusted for systolic blood pressure, body mass index, total cholesterol, triglycerides, smoking status, histories of type 2 diabetes and coronary heart disease, medication for dyslipidaemia, alcohol consumption, physical activity, and socioeconomic status was (HR 1.03; 95% CI 0.86-1.22), which remained similar (HR 1.04; 95% CI 0.87-1.23) following further adjustment for inflammation and history of cancer. Comparing the extreme tertiles of serum zinc, the corresponding adjusted HRs (95% CIs) were 0.92 (0.63-1.36) and 0.94 (0.64-1.39), respectively. Imputed results based on 2682 participants and 176 VTE events were consistent with the observed results. In middle-aged and older Finnish men, serum zinc is not associated with future VTE risk. Other large-scale prospective studies conducted in other populations are needed to confirm or refute these findings.

J-shaped relationship between serum zinc levels and the severity of hepatic necro-inflammation in patients with MAFLD

BACKGROUND AND AIMS

Zinc is an essential trace element that plays an important role in maintaining health, and affecting gene expression, signal transduction and regulation of apoptosis. It is uncertain whether serum zinc levels are altered in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). We aimed to investigate the association between serum zinc levels and the severity of hepatic necro-inflammation (HN) in patients with MAFLD.

METHODS AND RESULTS

Liver disease severity was graded histologically using the NAFLD activity score. HN was defined as the sum of ballooning and lobular inflammation. We used a smooth function regression model to analyze the relationship between serum zinc levels and HN. A total of 561 (76.5% men) patients with biopsy-confirmed MAFLD were enrolled. They had a mean age of 41.3 years, and a mean serum zinc level of 17.0 ± 4.1 μmol/L. Compared to those with mild hepatic necro-inflammation (MHN, grades 0-2; n = 286), patients with severe hepatic necro-inflammation (SHN, grades 3-5; n = 275) had lower serum zinc concentrations (16.3 ± 4.2 vs. 17.6 ± 4.0 μmol/L; p < 0.001). However, a threshold saturation effect analysis showed that there was an inflection in serum zinc levels at 24 μmol/L. After adjustment for potential confounders, serum zinc levels <24 μmol/L were inversely associated with SHN (adjusted-odds ratio 0.88, 95%CI 0.83-0.93; p < 0.001), whereas serum zinc levels >24 μmol/L were positively associated with SHN (adjusted-odds ratio 1.42, 95%CI: 1.03-1.97; p = 0.035).

CONCLUSIONS

There is a J-shaped relationship between serum zinc levels and the severity of hepatic necro-inflammation in patients with biopsy-proven MAFLD.

Serum Copper and Zinc Concentrations and Cognitive Impairment in Older Adults Aged 60 Years and Older

Epidemiological evidence on serum zinc and copper and cognitive impairment in older adults are not consistent. Results on serum zinc and copper and cognitive impairment in older adults from the National Health and Nutrition Examination Survey (NHANES) have not been reported. Data on serum zinc and copper and cognitive impairment from individuals ≥ 60 years of age were obtained from the 2011-2014 NHANES. Serum zinc and copper concentrations were determined with inductively coupled plasma dynamic reaction cell mass spectrometry. Cognitive impairment was assessed with four cognitive tests: the Digit Symbol Substitution Test (DSST), the Animal Fluency (AF), the Consortium to Establish a Registry for Alzheimer's Disease Delayed Recall (CERAD-DR), and the Word Learning (CERAD-WL) tests. Compared with the lowest tertile of serum copper, the multivariate-adjusted odds ratios of scoring low on the AF were 0.86 (0.44-1.68) in tertile 2 and 0.46 (0.25-0.82) in tertile 3, and the inverse association was also found in women. No association was found between serum copper and the DSST, CERAD-DR, and CRAD-WL, respectively. Compared with the lowest tertile of serum zinc, the multivariate-adjusted odds ratios of scoring low on the DSST were 0.83 (0.37-1.90) in tertile 2 and 0.42 (0.22-0.80) in tertile 3, and the inverse association was also found in men. No association was found between serum zinc and the AF, CERAD-DR, and CRAD-WL, respectively. In conclusion, serum copper and zinc were associated with certain cognitive performance tests among older adults, and the causality deserves to be confirmed further.

Serum zinc concentrations and prediabetes and diabetes in the general population

The association between serum zinc and diabetes development remains uncertain. We examined the associations between serum zinc and prediabetes and diabetes, and adult participants (≥ 20 years) from the 2011-2016 National Health and Nutrition Examination Survey. Serum zinc concentrations were measured with inductively coupled plasma dynamic reaction cell mass spectrometry. Prediabetes and diabetes were defined through questionnaires and fasting plasma glucose and hemoglobin A_1c levels. Weighted logistic regression and restricted cubic splines were adopted to explore the dose-response relationships between serum zinc concentrations and prediabetes and diabetes. Comparing the highest to lowest quartile of serum zinc concentrations, the multivariable-adjusted odds ratio (95% confidence interval) of prediabetes and diabetes was 3.24 (2.33-4.52, P_{for trend} < 0.01) and 1.64 (1.27-2.11, P_{for trend} < 0.01), respectively. In stratified analysis by sex, the association between serum zinc concentrations and prediabetes was found in both men (3.83 (2.60-5.66), P_{for trend} < 0.01) and women (2.41 (1.51-3.87), P_{for trend} < 0.01), and the association between serum zinc concentrations and diabetes was also found in both men (2.05 (1.34-3.13), P_{for trend} < 0.01) and women (1.65 (1.07-2.56), P_{for trend} = 0.15). The association between serum zinc and prediabetes was consistent in stratified analyses by body mass index and hypertension, and the association with diabetes was also found in subjects with hypertension. Restricted cubic splines showed that the relationships between serum zinc concentrations and prediabetes and diabetes were linear, respectively. In conclusion, serum zinc concentrations were positively associated with prediabetes and diabetes in the general population, and the associations were linear. The findings need to be confirmed by prospective cohort studies.

Role of Zinc in Neonatal Sepsis

Sepsis emerges as a complex clinical syndrome with activation of an innate host response to infections. Despite advancement in therapeutic approaches, infants with sepsis remain hospitalized for longer durations and it remains to be a major health problem in today's world. Zinc as a trace element, has the potential to improve the host's defence mechanism against various pathogenic diseases. During sepsis, a redistribution of zinc from serum into the liver has been observed and earlier studies imply a correlation between serum zinc levels and the outcome of sepsis. Zinc also appears to have a potential to be used as a biomarker of sepsis outcome. There are only few reports available to show the efficacy of zinc supplements in the management of neonatal sepsis.

Serum zinc deficiency in patients after gastrectomy for gastric cancer

PURPOSE

Zinc is an essential dietary component for humans and the second most prevalent trace element; however, serum zinc levels after gastrectomy have not been fully elucidated. This study aimed to evaluate the correlation between clinicopathologic features and serum zinc levels in patients who underwent gastrectomy for gastric cancer.

METHODS

The study enrolled 617 patients who underwent gastrectomy for gastric cancer at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level < 80 μg/dL.

RESULTS

The median zinc level of the 617 patients was 73 μg/dL (range, 31-144 μg/dL), and serum zinc deficiency was present in 68.6% of patients. Median age was significantly higher in the zinc low level group than in the normal group (69 vs. 66 years, P < 0.001). Albumin was significantly lower in the zinc low level group than in the normal group (3.9 vs. 4.2 g/dL, P < 0.001). C-reactive protein level was significantly higher in the zinc low level group than in the normal group (0.12 vs. 0.10 mg/dL, P = 0.014). The median serum zinc level was significantly lower in the patients who received chemotherapy after gastrectomy than in those who were not received chemotherapy (72 vs. 76 μg/dL, P < 0.001). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.505, P = 0.044). Multivariate analysis showed that serum albumin level was significantly associated with serum zinc level (β = 0.489, P < 0.001).

CONCLUSIONS

Serum zinc deficiency was found in 68.6% of postoperative patients who underwent gastrectomy for gastric cancer, which was highly correlated with serum albumin.

Associations Between Serum Zinc Levels and Alanine Aminotransferase Elevation in Adults

Recent findings showed that zinc might be linked to alanine aminotransferase (ALT) elevation. This analysis aimed to explore the association between serum zinc levels and ALT elevation in adults. Data on serum zinc and ALT levels from adults aged 20 years and older who participated in the 2011-2016 National Health and Nutrition Examination Surveys were analyzed (N = 4138). Individuals with excessive alcohol consumption and hepatitis B or C infection were excluded. ALT elevation was defined as any value above normal of ALT (> 33 IU/L for males and > 25 IU/L for females). The multivariate logistic model and restricted cubic splines were adopted to assess the non-linear relationship. In a fully adjusted model, the odds ratio and 95% confidence interval of ALT elevation for quartile 4 (Q4) vs. quartile 1 (Q1) of serum zinc levels were 1.68 and 1.29-2.20 (per quartile: 1.20 (1.10-1.31)). In subgroup analysis, the association between serum zinc levels and ALT elevation was found in females (Q4 vs Q1: 1.95 (1.20-3.15)), obese individuals (Q4 vs Q1: 1.80 (1.19-2.74)), and young adults (Q4 vs Q1: 1.72 (1.09-2.72)), while the association was not evident in males, non-obese individuals, and adults older than 50 years old. A linear dose-response relationship between serum zinc levels and ALT elevation was found (P_{for non-linearity} = 0.77). In conclusion, serum zinc was positively associated with ALT elevation in adults, and the association was mainly observed in females, obese individuals, and young adults.

Analysis of the predictive factors for a critical illness of COVID-19 during treatment － relationship between serum zinc level and critical illness of COVID-19

OBJECTIVES

Because most severely ill patients with COVID-19 in our hospital showed zinc deficiency, we aimed to examine the relationship between the patient's serum zinc level and severe cases of COVID-19.

METHODS

Serum zinc <70 μg/dL was defined as the criterion for hypozincemia, and patients continuously with serum zinc <70 μg/dL were classified in the hypozincemia cohort. To evaluate whether hypozincemia could be a predictive factor for a critical illness of COVID-19, we performed a multivariate analysis by employing logistic regression analysis.

RESULTS

Prolonged hypozincemia was found to be a risk factor for a severe case of COVID-19. In evaluating the relationship between the serum zinc level and severity of patients with COVID-19 by multivariate logistic regression analysis, critical illness can be predicted through the sensitivity and false specificity of a ROC curve with an error rate of 10.3% and AUC of 94.2% by only two factors: serum zinc value (P = 0.020) and LDH value (P = 0.026).

CONCLUSIONS

Proper management of the prediction results in this study can contribute to establishing and maintaining a safe medical system, taking the arrival of the second wave, and the spread of COVID-19 in the future into consideration.

Adjusting serum zinc concentration for inflammation based on the data of Malawian preschool children and women of reproductive age

OBJECTIVES

Serum zinc negatively reacts to inflammation yet to our knowledge only a few studies have attempted to adjust it for inflammation. The aim of this study, based on the data of Malawi Micronutrient Survey, was to correct zinc concentration for inflammation in preschool children (n = 1081) and women of reproductive age (n = 799) and to evaluate the effects of the adjustment on the prevalence of zinc deficiency (ZD).

METHODS

Based on C-reactive protein (CRP) and α-1-acid glycoprotein (AGP), inflammation status was grouped into four categories: no inflammation, incubation, early convalescence, and late convalescence. The association between zinc and inflammation was examined using linear regression analysis and correction was made by six approaches: exclusion, internal correction factor, and four regression adjustments.

RESULTS

The unadjusted prevalence of ZD was 58.9% in children and 62% in women. Inflammation was observed in 57.6% of children and 17.1% of women. Zinc demonstrated negative correlations with inflammation markers (P < 0.05). Among children, zinc showed marginally insignificant (P = 0.072) decline during incubation (β= -8.25; 95% confidence interval [CI], -17.28 to 0.78) and significant decline during early convalescence inflammation (β= -4.92; 95% CI, -7.00 to -2.31). Among women, significant change was only observed in late convalescence inflammation (β= -4.10; 95% CI, -8.06 to -0.14). However, all the corrections resulted in modest decline in the prevalence of ZD (1.4-2.1 and 0-2.6 percentage points in children and women).

CONCLUSIONS

The study observed statistically significant negative correlations between serum zinc concentration and inflammation markers (AGP and CRP). However, correction of serum zinc for inflammation using multiple options including exclusion, internal correction factor, and regression adjustment resulted in very marginal changes in the prevalence of ZD. Although inflammation adjustment may enable more precise estimation of ZD, it only resulted in modest changes in the actual prevalence of ZD in Malawi.

Seasonal Variations of Serum Zinc Concentration in Adult Population: Tehran Lipid and Glucose Study

BACKGROUND

Zinc, an essential trace element, plays a key role in many biological human body functions. Serum zinc concentration is the most widely used indicator of zinc status for general populations. Considering the limited data available on seasonal fluctuation of serum zinc concentration, we aimed at determining seasonal variations in serum zinc concentrations of Tehranian adults.

METHODS

The current study was conducted within the framework of the Tehran Lipid and Glucose Study, on 4698 subjects, aged ≥20 years. Serum zinc samples of subjects were obtained from all four seasons over three years (from 2009 to 2011); samples of similar seasons over three years were placed in one group and the geometric means of serum zinc concentration of four seasons were compared to determine possible seasonal variations.

RESULTS

Participants with mean age 46.3 yr and geometric mean of serum zinc concentration 116.3 μg/dl, were studied for almost three years through four seasons. Serum zinc concentrations in spring and summer were significantly higher than those in autumn and winter (112.2 and 114.4 vs. 106.7 and 104.8 μg/dl; P<0.001, respectively). Moreover, monthly serum zinc concentration of all subjects differed, with the lowest and highest levels found in October and August (98.5 vs. 122.7; P<0.001).

CONCLUSION

This study demonstrates the difference in serum zinc concentration in Iranian adults of both genders in different months and seasons during the year.

Relationship of Dietary and Serum Zinc with Depression Score in Iranian Adolescent Girls

Zinc deficiency, which is common among Iranian populations, is believed to play a crucial role in the onset and progression of mood disorders such as depression in different stages of life. We have therefore investigated the relationship between serum/dietary zinc status and depression scores among adolescent girls living in northeastern Iran. Serum zinc was measured by flame atomic absorption (Varian AA240FS) and the mean zinc intake was assessed using 3-day food record. A validated Persian version of the Beck Depression Inventory (BDI) was used to determine the severity of depressive symptoms for all subjects. Data were analyzed using SPSS 18 software. There was a statistically significant correlation between dietary zinc intake and serum zinc concentration (r = 0.117, p = 0.018). Dietary intake of zinc (7.04 ± 4.28 mg/day) was significantly lower among subjects with mild to severe depression symptoms than those with no or minimal depression symptoms (8.06 ± 3.03 mg/day). Dietary zinc intake was inversely correlated with depression score (r = 0.133, p = 0.008). However, there was no significant difference in serum zinc concentrations among individuals with no or minimal and mild to severe depression symptoms (p = 0.5). Dietary zinc intake, but not serum zinc concentration, was inversely associated with depression symptoms. Therefore, controlled clinical trials are needed to determine the efficacy of zinc supplementation in the treatment of depression disorders.

Relationship Between Serum Zinc Level and Metabolic Syndrome: A Meta-Analysis of Observational Studies

Objective: This research sought to summarize the evidence regarding the relationship between serum zinc level and metabolic syndrome (MetS).Methods: The electronic databases of PubMed, Web of Science, and Embase were searched up to October 2017 for observational studies on the association between serum zinc level and MetS. The standard mean difference (SMD) and its corresponding 95% confidence interval (CI) of the serum zinc level for MetS versus control participants were calculated. In addition, the pooled odds ratio (OR) and relative risk (RR) of MetS for the highest versus lowest category of serum zinc level, as well as their corresponding 95% CI, were also calculated.Results: A total of 11 observational studies (8 cross-sectional, 1 case-control, and 2 cohort studies) were included in this meta-analysis. The combined SMD demonstrated that the serum zinc level in MetS was higher than that in control participants (SMD = 0.11; 95% CI, 0.03-0.19; p = 0.009). Moreover, the overall multivariable-adjusted RR showed that the increased serum zinc level was associated with a higher risk of MetS (RR = 1.82; 95% CI, 1.33-2.50; p < 0.001). On the contrary, the overall multivariable-adjusted OR showed that there was no significant relationship between serum zinc level and MetS (OR = 1.00; 95% CI, 0.99-1.01; p = 0.841).Conclusions: Although the serum zinc level in participants with MetS was significantly higher than that in control ones, the existing evidence was still insufficient to conclude a definite relationship between serum zinc level and MetS. More well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Zinc, copper, CD4 T-cell count and some hematological parameters of HIV-infected subjects in Southern Nigeria

Background

Low concentration of trace elements has been associated with poor prognosis and mortality in HIV infection.

Methods

A cross sectional study was conducted among 100 HIV-infected subjects (70 were on ART treatment, while 30 were ART naïve). Fifty (50) apparently healthy controls were enrolled. Concentration of serum levels of zinc and copper was done using atomic absorption spectrometric method, while complete blood count was determined using automated blood analyzer. CD4⁺ T-cell count was done using cyflow cytometer.

Aim and setting

The aim of this study was to investigate the level of some trace elements and some hematological parameters of HIV-seropositive subjects attending University of Calabar Teaching Hospital Clinic as well as prevalence of trace elements deficiency and anemic status and compare same with HIV-seronegative control.

Results

Mean serum zinc, CD4⁺ T-cell count, Hb, PCV, RBC, MXD, were significantly (p < 0.05) reduced in the HIV-infected subjects, while copper/zinc ratio, MCV, MCH and platelet count were significantly (p < 0.05) raised in the HIV-infected subjects. The serum Cu level was comparable (p > 0.05) with the control. ART treatment had no effect on all the parameters assessed except CD4⁺ T-cell count. Twenty five percent (25%), 3% and 56% of the HIV-infected subjects were zinc deficient, copper deficient and anemic, respectively. Gender was found as a predictor of zinc deficiency. Copper and zinc showed weak positive correlation with CD4⁺ T-cell count.

Conclusion

ART treatment did not complement zinc status in HIV infection while improving CD4⁺ T-cell count, hence the need to consider supplementation.

Association of divalent cations and insulin resistance with thyroid hormones in patients with type 2 diabetes mellitus

AIM

The study was primarily aimed at investigating the association of Magnesium and Zinc levels in the serum of adult Non- obese and Obese type 2 diabetic patients, with particular reference to thyroid comorbidity.

METHODS

108 patients with T2DM of both genders (24 Non obese and 84 Obese) were enrolled from a tertiary health care unit in Puducherry. The cardio-metabolic risk factors were assessed through body mass index, Waist hip ratio, blood pressure, fasting blood glucose, lipid profile and glycated haemoglobin. Zinc and Magnesium were quantitated. Insulin resistance was by Homeostasis model assessment. Serum free T4, T3 and TSH were also measured.

RESULTS

In non-obese type 2 diabetic group, Glycated haemoglobin had a strong positive correlation with free T4(r=0.784; p=0.003).TSH also depicted a positive association with HOMA-IR (r=0.924; p<0.001); whereas,T3 and Insulin had negative correlation with Magnesium (r=-0.599* and r=-0.620*; p 0.04 and 0.031). The levels of Zinc and Magnesium in the serum of obese diabetic patients had a positive correlation among them (r=0.565#; p<0.001). TAG/HDL ratio a measure of small dense LDL is positively correlated with LDL in both groups (r=0.881 and 0.912) with p value<0.001 for both.

CONCLUSION

Correlation among Glycemic control, Insulin resistance, Thyroid hormones, divalent cations and dyslipidemia depict differential characteristics in obese and non-obese type2 diabetes with Thyroid comorbidity.

Association between serum zinc and later development of metabolic syndrome in middle aged and older men: The Kuopio Ischaemic Heart Disease Risk Factor Study

OBJECTIVE

The aim of this study was to investigate associations of serum zinc with incident metabolic syndrome and its components in middle-aged and older Finnish men.

METHODS

An 11-y prospective follow-up study conducted among 683 men from the Kuopio Ischaemic Heart Disease Risk Factor Study who were 42 to 60 y old at baseline in 1984 to 1989. The main outcome was incident metabolic syndrome, defined by the National Cholesterol Education Program (NCEP) criteria. Other outcomes were the individual components of the NCEP metabolic syndrome: Fasting blood glucose, serum triacylglycerols, serum high-density lipoprotein (HDL) cholesterol, hypertension, and waist circumference.

RESULTS

During the average follow-up of 11 y, 139 men (20.4%) developed metabolic syndrome. Those in the highest tertile of serum zinc had 84% higher risk (95% confidence interval 12 to 201%, P trend across tertiles = 0.015) to develop metabolic syndrome compared with those in the lowest tertile, after adjustment for several potential confounders. The association between serum zinc and incident metabolic syndrome was attenuated by adjustment for waist circumference, serum HDL cholesterol, or hypertension. Serum zinc was also directly associated with higher waist circumference and hypertension and inversely associated with HDL cholesterol at the 11 y examinations.

CONCLUSIONS

We found a direct association between serum zinc and incidence of metabolic syndrome in middle-aged and older eastern Finnish men. Further studies are warranted to explore the mechanisms.

Serum zinc and risk of type 2 diabetes incidence in men: The Kuopio Ischaemic Heart Disease Risk Factor Study

OBJECTIVES

Zinc may play a role in the development of type 2 diabetes (T2D), because it is involved in antioxidant and anti-inflammatory activities. However, the role of zinc in the etiology of T2D has been poorly investigated. This study was conducted to study the association of serum zinc on T2D risk in middle-aged and older Finnish men.

METHODS

This was a 20-year prospective follow-up study on 2220 Finnish men from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) who were 42 to 60 years old at baseline in 1984-1989. The main outcome was incident T2D. Serum zinc, body mass index (BMI), fasting blood glucose (FBG), serum insulin, C-reactive protein (CRP) and, in a subset of 751 participants, insulin-like growth factor-binding protein-1 (IGFBP-1), were measured. Also, the homeostatic model assessment (HOMA) was used to quantify insulin resistance (HOMA-IR), beta-cell function (HOMA-β) and insulin sensitivity (HOMA-IS).

RESULTS

At baseline, serum zinc was associated with higher BMI, serum insulin, HOMA-IR, HOMA-β and IGFBP-1 and lower HOMA-IS. During the average follow-up of 19.3 years, 416 men developed T2D. Men in the highest quartile of serum zinc had 60% higher risk (95% CI 20-113%; P-trend<0.001) for incident T2D compared with the men in the lowest quartile, after multivariate adjustments. This association was attenuated after adjustment for BMI (HR=1.39, 95% CI 1.04-1.85; P-trend=0.013) or HOMA-IS (HR=1.38, 95% CI 1.04-1.83; P-trend=0.015), whereas adjustment for the other factors had only modest impact on the association.

CONCLUSION

Higher serum zinc was associated with higher risk of T2D; effects of zinc on BMI and insulin sensitivity may partly explain the association. Further prospective studies are warranted to confirm our results and explore potential mechanisms.

[Validation of an in-house method for the determination of zinc in serum: Meeting the requirements of ISO 17025]

OBJECTIVE

The aim of this report is to propose a scheme for validation of an analytical technique according to ISO 17025.

MATERIAL AND METHODS

According to ISO 17025, the fundamental parameters tested were: selectivity, calibration model, precision, accuracy, uncertainty of measurement, and analytical interference.

RESULTS

A protocol has been developed that has been applied successfully to quantify zinc in serum by atomic absorption spectrometry.

CONCLUSION

It is demonstrated that our method is selective, linear, accurate, and precise, making it suitable for use in routine diagnostics.

Serum zinc levels of cord blood: relation to birth weight and gestational period

BACKGROUND

Zn-deficiency has been associated with numerous alterations during pregnancy including low birth weight; however, the research relating neonatal zinc status and birth weight has not produced reliable results.

OBJECTIVE

To compare the serum Zn-levels of cord blood in healthy newborns and low birth weight newborns, and to assess a possible relationship between zinc concentration and neonatal birth weight and gestational age.

MATERIAL AND METHODS

123 newborns divided in "study group" (n=50) with <2500g birth weight neonates and "control group" (n=73) with ≥2500g birth weight neonates were enrolled. Study group was subdivided according to gestational age in preterm (<37 weeks) and full-term (≥37 weeks). Serum cord blood samples were collected and the Zn-levels were analyzed using flame Atomic Absorption Spectrophotometry method and the result was expressed in μmol/L. The Zn-levels were compared between the groups (Mann-Whitney-U test) and the Zn-levels were correlated with the birth weight and gestational age (Spearman's rank correlations).

RESULTS

Statistically significant low positive correlation between Zn-levels and birth weight (ρ=0.283; p=0.005) was found. No statistically significant difference between Zn-levels of study and control groups [17.00±0.43 vs. 18.16±0.32 (p=0.053)] was found. Statistically significant low positive correlation between Zn-levels and gestational age (ρ=0.351; p=0.001) was found. No statistically significant difference between Zn-levels of preterm as compare to full-term newborns [16.33±0.42 vs. 18.43±0.93 (p=0.079)] was found. Zn-level of preterm subgroup was significantly lower compared to control group (p=0.001).

CONCLUSIONS

Despite low birth weight preterm neonates had significantly lower serum zinc levels of cord blood than healthy term neonates, the correlation between cord blood zinc levels and birth weight and gestational age was lower. The results are not enough to relate the change in cord blood zinc concentration to the birth weight values or gestational period. In relation to complicated pregnancies, further studies regarding zinc levels in blood in our population are required.

Study of serum zinc in low birth weight neonates and its relation with maternal zinc

OBJECTIVE

Assessment of serum Zinc in LBW (Low Birth Weight) and appropriate for gestational age (AGA) neonates in relation to their maternal zinc level.

MATERIALS AND METHODS

A prospective study was conducted in a tertiary care teaching hospital of central India between August 2011 to July 2012. Serum samples were collected from the eligible LBW (preterm & term IUGR) and term AGA healthy neonates and their mothers for zinc level estimation. Serum zinc was measured by atomic absorption spectrophotometer. Newborn of mothers having any medical illness, on any medication, with anaemia (Hb <10 gm/dl) were excluded from the study. Neonates with any perinatal insult were also excluded.

RESULTS

Out of 100 newborn-mother pairs enrolled in the study, 46 newborns (18 preterm and 28 term IUGR) with birth weight <2.5kg comprised the case group and rest 54 term AGA newborns (birth weight >2.5kg) were categorized as control group. Mean serum zinc level was significantly low in LBW neonates (83.45±16.74 μg/dl) in comparison to term AGA newborns (93.74±19.95 μg/dl), (p-value <0.05). Similarly, zinc level was also low in mothers of LBW babies (67.02±15.99 μg/dl) in comparison to mothers of term AGA newborns (83.59±18.46 μg/dl), (p-value < 0.05). Low maternal zinc levels were significant correlated with lower serum zinc in LBW neonates (Pearson correlation value - 0.938). However, maternal zinc levels have shown no significant correlation with neonatal serum zinc levels in term AGA (0.029).

CONCLUSION

LBW neonates and their mothers have significant zinc deficiency as compared to term AGA neonates and their mothers and this deficiency is correlated with zinc deficiency in mothers of these LBW neonates.

Effect of probiotic L. plantarum IS-10506 and zinc supplementation on humoral immune response and zinc status of Indonesian pre-school children

A 90-day randomized, double-blind, placebo-controlled, pre-post trial was conducted in four groups of Indonesian children aged 12-24 months: placebo, probiotic, zinc, and a combination of probiotic and zinc (n=12 per group). Microencapsulated Lactobacillus plantarum IS-10506 of dadih origin was supplemented at a dose of 10(10)CFU/day as a probiotic. Zinc was supplemented as 20mg zinc sulfate monohydrate (8mg zinc elemental). Blood and stool samples were collected at baseline and at the end of the study period. Fecal sIgA was assessed by ELISA and serum zinc concentrations by ICP-MS. Fecal sIgA increased significantly in the probiotic group (30.33±3.32μg/g; p<0.01) and in the combination probiotic and zinc group (27.55±2.28μg/g; p<0.027), as compared with the placebo group (13.58±2.26μg/g). Changes in serum zinc concentrations in the combination probiotic and zinc group showed the highest elevation at the end of the study period. A combination of probiotic L. plantarum IS-10506 at a dose of 10(10)CFU/day and 8mg of elemental zinc supplementation showed a potential ability to improve the zinc status of pre-school children. Taken together, supplementation with the probiotic L. plantarum IS-10506 and zinc for 90 days resulted in a significantly increased humoral immune response, as well as improved zinc status, in young children.

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.

Effects of zinc supplementation on serum zinc and leptin levels, BMI, and body composition in hemodialysis patients

PROJECT

The aim of this study was to determine the effects of zinc supplementation on serum zinc and leptin levels as well as on anthropometric status and some biochemical parameters in hemodialysis (HD) patients.

PROCEDURE

In this randomized, double-blind, and placebo-controlled trial, sixty HD patients were randomly divided into groups to receive a daily supplement of 100mg elemental Zn (supplemented group) or placebo (control group) for 60 days. Anthropometric measurements were taken using standard calibrated instruments. Serum zinc and leptin levels were determined by atomic absorption and ELISA method respectively before and after intervention.

RESULTS

Zinc supplementation resulted in significant increase in the mean serum zinc level in the experimental group while changes observed in the placebo group were not significant. The mean serum leptin in women part of the experimental group was decreased significantly after supplementation. After adjusting for age, BMI, body fat (%), serum zinc and dietary Zn intake, a negative and significant association was observed between serum zinc and leptin levels in all subjects (β=-0.33, P=0.03) as a result of Zn supplementation.

CONCLUSIONS

More studies are needed to clarify the mechanisms by which serum leptin level is influenced as a result of zinc supplementation in HD patients.

Comparison of Serum Zinc and Copper levels in Children and adolescents with Intractable and Controlled Epilepsy

OBJECTIVE

Trace elements such as zinc and copper have physiological effects on neuronal excitability that may play a role in the etiology of intractable epilepsy. This topic has been rarely discussed in Iranian epileptic patients. This study with the analysis of serum zinc and copper levels of children and adolescents with intractable and controlled epilepsy may identifies the potential role of these two trace elements in the development of epilepsy and intractability to antiepileptic drug treatment.

MATERIALS & METHODS

Seventy patients between the ages of 6 months to 15 years that referred to Children's Medical Center with the diagnosis of epilepsy, either controlled or intractable to treatment enrolled in the study. After informed parental consent the levels of serum zinc and copper were measured with atomic absorption spectrophotometer and analyzed with SPSS version 11.

RESULTS

35 patients were enrolled in each group of intractable (IE) and controlled epilepsy (CE). 71.45% of the IE and 25.72% of the CE group had zinc deficiency that was statistically significant. 48.58% of the IE and 45.72 of the CE group were copper deficient, which was not statistically significant.

CONCLUSION

Our findings showed significant low serum zinc levels of patients with intractable epilepsy in comparison with controlled epilepsy group. We recommend that serum zinc level may play a role in the etiology of epilepsy and intractable epilepsy therefore its measurement and prescription may be regarded in the treatment of intractable epilepsy.

Effect of Consuming Zinc-fortified Bread on Serum Zinc and Iron Status of Zinc-deficient Women: A Double Blind, Randomized Clinical Trial

After iron deficiency, zinc deficiency is the major micronutrient deficiency in developing countries, and staple food fortification is an effective strategy to prevent and improve it among at-risk-populations. No action has been taken to reduce zinc deficiency via flour fortification so far in Iran, and little is known about the influence of zinc fortification of flour on serum zinc and the iron status, and also about the optimum and effective amount of zinc compound that is used in food fortification. The objective of this study is to evaluate the influence of consuming zinc-fortified breads on the zinc and iron status in the blood serum. In this study, three types of bread were prepared from non-fortified and fortified flours, with 50 and 100 ppm elemental zinc in the form of sulfate. Eighty zinc-deficient women aged 19 to 49 years were randomly assigned to three groups; The volunteers received, daily, (1) a non-fortified bread, (2) a high-zinc bread, and (3) a low-zinc bread for one month. Serum zinc and iron were measured by Atomic Absorption before and after the study. Results showed a significant increase in serum zinc and iron levels in all groups (p < 0.001) except in the control (p > 0.05). Absorption of zinc and iron in the group that consumed high-zinc bread was significantly greater than that in the group that received low-zinc bread (p < 0.01). It was concluded that fortification of flour with 50-100 ppm zinc was an effective way to achieve adequate zinc intake and absorption in zinc-deficient people. It also appeared that consuming zinc-fortified bread improved iron absorption.

Assessment of zinc concentration in random samples of the adult population in shiraz, iran

BACKGROUND

Zinc is an essential micronutrient for human health. However, little is known about concentration of this mineral among Iranian population. This study was carried out to determine the current zinc status, evaluate the impact of certain factors like age, sex and Body Mass Index (BMI), and to verify the prevalence of zinc deficiency among Iranian adult population in Shiraz, southern Iran.

METHODS

Serum samples from 374 randomly selected healthy individuals living in Shiraz, Iran, aged 19-82 years (143 males, 231 females) were collected and the serum zinc concentration was measured by Flame-Atomic Absorption Spectrometry. We considered the subjects with serum zinc concentration less than 100 μg/dl as zinc deficient.

RESULTS

The serum zinc levels in females were lower than those of males with no statistically significant difference. Serum zinc concentrations were unrelated to age and BMI. It also did not change among different ages and BMI intervals.

CONCLUSION

About 42.5% of our cases had serum zinc concentration below the cut off value of 100 μg/dl in the serum. Designing appropriate strategies for overcoming this public health problem is necessary.

Evaluation of Serum Zinc Level Under Malignant Condition and its Possible Implication on Improving Cell-Mediated Immunity During Cancer Progression

Background

Zinc is an essential trace element required for different biological functions in a living body. Evaluating its concentration and effect during malignancy is important not only to assess the disease activity but also to evaluate its role in some important biological activities like immunity.

Methods

The experiments were carried out in transplanted, chemically induced and spontaneous tumors in mice. The serum zinc concentration (SZC) was determined under malignant condition and following treatment of solid tumor with anti-cancer agents. The importance of evaluating Cu/Zn ratio (CZR) was also determined. To evaluate its role in immune response during malignancy, studies were carried out on induced tumor bearing animals.

Results

The results showed that SZC had an inverse correlation with the progression of the disease. It was significantly reduced in all forms of malignancy, more so in spontaneous and induced forms of the disease. Extensive studies done with the solid form of induced tumor, established the importance of estimating the concentration of Zn, in addition to that of copper, in assessing the disease activity following treatment with anti-cancer agents. With regression of the tumor mass, there was a significant elevation in the SZC and depression in the serum copper concentration (SCC) compared to their levels prior to treatment. This was also reflected on the value of copper zinc ratio (CZR); with the onset of tumor regression, a significant reduction in CZR was noted in the tumor bearing animals compared to their untreated levels. As the state of ‘regression’ in the tumor mass was maintained for a considerable period of time following treatment with anti-cancer agents along with elevated zinc levels, we considered the role of zinc in controlling the tumor growth, indirectly. We observed that zinc is able to stimulate lymphocyte proliferation that may directly impact on the immune response of tumor bearing host.

Conclusions

Zinc appears to play a role in tumor progression and regression and in stimulating lymphocyte proliferation. It is hypothesized that supplementing zinc to malignant subjects prior to and following therapeutic intervention with anti-cancer agents could help improve immune response of the host against existing tumor.

The relationship between serum zinc level and preeclampsia

BACKGROUND

Preeclampsia is one of the commonest causes of prenatal and maternity related death in the world. Preeclampsia is caused by multiple factors and finding any factor related to this disorder can help on time prevention of this disease, which reduces the mortality of mothers and infants. Zinc deficiency is a possible risk factor for risky pregnancies and the results of studies on this subject are controversial. This study investigated the relationship between mothers' serum zinc and risky pregnancies.

METHODS

This was a case-control study on 48 normal pregnancies as controls and 48 preeclamptic pregnancies as case group. The women were studied in their third month of pregnancy. Simple random sampling was done based on inclusion and exclusion criteria. The two groups were matched in mothers' age, pregnancy age, number of childbirth, and socioeconomic status. Data were collected by blood sampling and a questionnaire. Serum zinc level was assessed by atomic absorption spectrometry method. Data were analyzed using SPSS Software.

RESULTS

The level of serum zinc in most women in both groups was under 50 mg/dl (62.5% in normal pregnancy group and 79.2% in preeclamptic group). There was no significant difference between the mean (SD) serum zinc concentration of the two groups (47.83 (12.72) for normal pregnancy and 43.66 (11.98) for preeclampsia). There was an association between serum zinc concentration and the severity of preeclampsia (p = 0.04, r = -0.12). We did not find any significant relation between serum zinc level and the following variables: mothers' age (p = 0.15, r = -0.11), pregnancy age (p = 0.07, r = -0.24), and parity (p = 0.02, r = -0.39).

CONCLUSIONS

The findings of this study showed that the assessment of serum zinc level does not have any clinical values for managing preeclampsia. However, based on the relationship between serum zinc concentration and the severity of preeclampsia in this study, we recommend assessment of serum zinc concentration as an index for predicting the severity of preeclampsia.