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Objective:To explore the serum levels of copper and zinc and the application value of the ratio in assessing disease activity in patients with inflammatory bowel disease (IBD).Methods:From March 2019 to April 2020, 200 patients with IBD hospitalized at the Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University were selected by prospective random direct sampling method, including 100 patients with Crohn′s disease (CD) and 100 patients with ulcerative colitis (UC). The Crohn′s disease activity index (CDAI) and the modified Mayo score were used to evaluate the disease activity of CD patients and UC patients. In the same period 100 healthy individuals in the routine physical examination were selected as healthy control group. The serum levels of copper and zinc of the healthy control group, the CD group and the UC group were determined by atomic absorption spectrometry. The levels and the ratio of serum copper to zinc of three groups were compared. The ratio of serum copper to zinc of CD patients and UC patients with different disease activity were compared. The correlation between the ratio of serum copper to zinc and IBD activity indexes were analyzed, which included fecal calprotectin (FC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), CDAI and Mayo score. Receiver operating characteristic curve was drawn to analyze the value of the ratio of serum copper to zinc, CRP and ESR in predicting disease activity of patients with IBD. Independent sample t test, least significant difference- t test and Pearson correlation analysis were performed for statistical analysis. Results:The serum copper levels and the ratio of serum copper to zinc of the CD group and the UC group were both higher than that of the healthy control group, however the serum zinc levels were lower than that of the healthy control group ( (32.27±7.69) and (29.80±9.68) mol/L vs. (20.16±6.67) mol/L; 2.81±1.57 and 2.29±1.09 vs. 0.68±0.36; (14.64±7.11) and (15.65±8.17) mol/L vs. (34.29±16.40) mol/L), and the differences were statistically significant ( t=2.81, 5.87, 1.47, 7.21, 1.73 and 2.56, all P<0.05). Among CD patients, the the ratio of serum copper to zinc of patients at remission stage (29 cases), mild activity stage (23 cases), moderate activity stage (30 cases) and severe activity stage (18 cases) was 2.61±1.43, 2.75±1.35, 3.15±2.37 and 4.17±1.77, respectively, and the ratios of serum copper to zinc of patients at mild activity stage, moderate activity stage and severe activity stage were all higher than that of patients at the remission stage, and the differences were statistically significant ( t=3.41, 7.92 and 5.84, all P<0.05). There were statistically significant differences in the ratios of serum copper to zinc between patients at mild activity stage and moderate activity stage, severe activity stage, and between patients at moderate activity stage and severe activity stage ( t=5.82, 6.23 and 3.45, all P<0.05). Among UC patients, the ratio of serum copper to zinc of patients at remission stage (10 cases), mild activity stage (30 cases), moderate activity stage (45 cases) and severe activity stage (15 cases) was 1.52±0.44, 1.74±0.58, 2.38±0.83 and 3.80±1.19, respectively, the ratio of serum copper to zinc of patients at moderate activity stage was higher than that of patients at remission stage and mild activity stage, and the ratio of serum copper to zinc of patients at severe activity stage was higher than those of patients at remission stage, mild activity stage and moderate activity stage, and the differences were statistically significant ( t=7.92, 5.83, 3.21, 9.54 and 2.83, all P<0.05). There was no statistically significant difference in serum copper to zinc ratio between patients at remission and at mild activity stage ( P>0.05). The ratio of serum copper to zinc of CD patients was positively correlated with FC and CRP ( r=0.697 and 0.586, P=0.014 and 0.001), however was not correlated with ESR or CDAI score (both P>0.05). The ratio of serum copper to zinc of UC patients was positively correlated with FC, ESR and Mayo score ( r=0.488, 0.452 and 0.331, P=0.001, P<0.01 and P=0.041), however was not correlated with CRP ( P>0.05). The cut-off value of the ratio of serum copper to zinc, CRP and ESR for the diagnosis of CD activity was 1.76, 8 mg/L and 20 mm/1 h, respectively. Among them, ESR was the most effective in the diagnosis of CD activity with an area under the curve (AUC) value of 0.830, and to the sensitivity and specificity was 69.0% and 86.2%, respectively. The cut-off value of the ratio of serum copper to zinc, CRP and ESR for the diagnosis of UC activity was 1.63, 8 mg/L and 20 mm/1 h, respectively; among which the the ratio of serum copper to zinc had the highest efficacy in the diagnosis of UC activity, with an AUC value of 0.862, sensitivity and specificity of 73.0% and 90.9%, respectively. Conclusion:The the ratio of serum copper to zinc is correlated with the disease activity of IBD, which may become a new auxiliary indicator for the evaluation of disease activity.
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Background: A seizure is a paroxysmal time-limited change in motor activity and or behavior that results from abnormal electrical activity in the brain. Seizures are common in the pediatric age group and occur in approximately 10% of children. Most seizures in children are provoked by somatic disorders originating outside the brain such as high fever, infection, syncope, head trauma, hypoxia, or toxins. To determine whether children with febrile convulsion have decreased serum zinc level when compared to normal children and children with fever without convulsions.Methods: The study included children admitted with bronchiolitis in between during the period of September 2018 to January 2019 at Department of Pediatrics, Raja Muthiah Medical College and Hospital. It is a case-control study. A sample size of 50 was selected for each group Totally 3 Groups, 1. Children with febrile convulsions,2. Children with fever without convulsions, 3. Normal Children.Results: The mean serum zinc level in children with febrile convulsions was 42.9 mcg/dl. The serum zinc level in children with fever and normal children was 70 mcg/dl and 71 mcg/dl respectively. On comparing the serum zinc level among the three groups statistical significance was obtained between children with febrile convulsions and the other two groups namely normal children and children with fever alone. Thus, decreased serum zinc level is a significant predisposing factor for febrile convulsions. By using Posthoc Multiple comparisons test we came to know that the Fever convulsion group is significantly different from fever and normal group. There is no significant difference between fever and normal group.Conclusions: This study shows that serum zinc levels are decreased in children with febrile convulsions, thus indicating that zinc deprivation plays a significant role in the pathogenesis of febrile convulsions.
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Background: Type 2 diabetes mellitus is becoming one of themajor health problems worldwide. Especially in South EastAsia, type 2 diabetes has gained critical significance. Asprediabetes prevalence is increasing worldwide, it has becomean important concern to prevent diabetes at an early stage inBangladesh.Objectives: Estimation of serum zinc level and establishmentof its relation with glycemic status in individuals with prediabetes.Materials and Methods: This cross-sectional studyencompassed 126 (age: 35.09±9.96 years, mean ± SD; Sex:16/110, M/F) subjects with prediabetes and 126(age:29.08±9.28 years, mean ± SD; Sex: 22/104, M/F) healthynondiabetic controls from the out-patient department ofEndocrinology, BSMMU consecutively. Serum zinc wasmeasured by using Atomic Absorption Spectrophotometry.Height, weight, waist circumference, acanthosis nigricans,hypertension, SGPT& serum creatinine were recorded asconfounding variables.Results: Serum zinc level in persons with prediabetes waslower than that in control (0.76±0.01 vs. 0.78±0.01mg/L,M±SEM, p=0.28). There was statistically significant differencefor zinc level in gender groups (M vs. F: 0.84±0.02 vs.0.75±0.01 mg/L, M±SEM, p<0.001) and monthly family incomegroups (p=0.02). Also zinc level was statistically similar amongglycemic status groups apart from zinc level in between controland combined glucose intolerance (CGI) groups (control vs.CGT: 0.78±0.01 vs. 0.72±0.02mg/L, M±SEM, p=0.03). Amongcases comparisons between groups with or without risk factorslike: smoking (0.72±0.03 vs. 0.76±0.10 mg/L, p=0.42),smokeless tobacco (0.73±0.03 vs. 0.76±0.01mg/L, p=0.46),hypertension (0.80±0.03 vs. 0.75±0.01 mg/L, p= 0.14), familyhistory of DM (0.75±0.02 vs. 0.77±0.02mg/L, p=0.52), familyhistory of CVD (0.74±0.02vs.0.77±0.01mg/L,p=0.28), overweight (0.76±0.01 vs.0.74±0.05mg/L, P=0.59), waistcircumference (0.75±0.01 vs. 0.79±0.04mg/L, p=0.40) andacanthosis nigricans (0.75±0.02 vs. 0.76±0.02mg/L, p=0.70),showed no statistically significant difference. None of thevariables like age (r= -0.02, p=0.19), BMI (r= 0.14, p=0.12),FPG (r= -0.05, p=0.60) and PG 2h after 75g glucose (r=0.10,p=0.28), HbA1c (r=0.04, p=0.64), serum creatinine (r=0.01,p=0.87) showed significant relationship with the level of zincexcept SGPT which showed significant relation with zincamong cases (r= 0.28, p=0.002) and among all participants(r=0.17, p=0.008) but not in control group (r=0.07, p=0.43).Conclusion: It is concluded that persons with prediabetes hadserum zinc level within normal limit and there was found nostatistically significant relationship between HbA1c and zinc
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Background: Acute Lower Respiratory Tract Infection (ALRI) is an important cause of morbidity and mortality in the developing world. Pneumonia is a severe form of ALRI that cause over 2 million deaths annually among children younger than 5 years of age. About 19% of all deaths, pneumonia is the leading cause of child mortality. Malnutrition is known to be associated with greater intensity of lower respiratory tract infections, higher the frequency of complications, longer episodes of infections. This study is to assess the plasma zinc levels in normal and malnourished children with LRI aged 2 months to 5 years.Methods: This is a case control study, which was carried out in the Department of Paediatrics, Sree Balaji Medical College and Hospital, the study period is one year from July 2016 to July 2017. 100 children between 2 months to 5 years of age with LRI was included in the study and children less than 2 months and more than 5 years. 50 Children with normal nutrition were taken as controls and 50 children with moderate and severe malnutrition were taken as cases. Age and sex were matched among cases and controls. Blood samples were collected for zinc estimation in both the cases and controls. All children were investigated and treated as per the department protocol for the particular condition. All statistical procedures were performed using SPSS v 21.0.Results: In present study, 66% of children had normal zinc levels, 34% of children had low zinc levels. The mean zinc level in our cases was 54.84'18.31 and in controls was 76.84'15.2, which was statistically significant (p = 0.000). Mean plasma zinc levels with respect to age and sex were not significant.Conclusions: Total 34% of children with LRI had low plasma zinc levels. Plasma zinc level were significantly low in malnourished children than normally nourished children with LRI, which is one of the most important cause of high childhood mortality in developing countries.
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BACKGROUND: It has been reported that some alopecia areata patients have zinc deficiency. There have also been several reports published concerning oral zinc sulfate therapy, with encouraging results, in some alopecia areata patients. OBJECTIVE: The purpose of this study was to evaluate the therapeutic effects of oral zinc supplementation for twelve weeks in alopecia areata patients who had a low serum zinc level. METHODS: Oral zinc gluconate (50 mg/T/day) supplementation was given to alopecia areata patients without any other treatment for twelve weeks. The serum zinc level was measured before and after zinc supplementation. A four- point scale of hair regrowth was used to evaluate the therapeutic effect of oral zinc supplementation in these patients. RESULTS: Fifteen alopecia areata patients were enrolled in this study. After the therapy, the serum zinc levels increased significantly from 56.9 microg/ to 84.5 microg/dl. Positive therapeutic effects were observed for 9 out of 15 patients (66.7%) although this was not statistically significant. The serum zinc levels of the positive response group increased more than those of the negative response group (p=0.003). CONCLUSION: Zinc supplementation needs to be given to the alopecia areata patients who have a low serum zinc level. We suggest that zinc supplementation could become an adjuvant therapy for the alopecia areata patients with a low serum zinc level and for whom the traditional therapeutic methods have been unsuccessful.
Subject(s)
Humans , Alopecia , Alopecia Areata , Gluconates , Hair , Zinc , Zinc SulfateABSTRACT
BACKGROUND: It has been reported that some alopecia areata patients have zinc deficiency. There have also been several reports published concerning oral zinc sulfate therapy, with encouraging results, in some alopecia areata patients. OBJECTIVE: The purpose of this study was to evaluate the therapeutic effects of oral zinc supplementation for twelve weeks in alopecia areata patients who had a low serum zinc level. METHODS: Oral zinc gluconate (50 mg/T/day) supplementation was given to alopecia areata patients without any other treatment for twelve weeks. The serum zinc level was measured before and after zinc supplementation. A four- point scale of hair regrowth was used to evaluate the therapeutic effect of oral zinc supplementation in these patients. RESULTS: Fifteen alopecia areata patients were enrolled in this study. After the therapy, the serum zinc levels increased significantly from 56.9 microg/ to 84.5 microg/dl. Positive therapeutic effects were observed for 9 out of 15 patients (66.7%) although this was not statistically significant. The serum zinc levels of the positive response group increased more than those of the negative response group (p=0.003). CONCLUSION: Zinc supplementation needs to be given to the alopecia areata patients who have a low serum zinc level. We suggest that zinc supplementation could become an adjuvant therapy for the alopecia areata patients with a low serum zinc level and for whom the traditional therapeutic methods have been unsuccessful.
Subject(s)
Humans , Alopecia , Alopecia Areata , Gluconates , Hair , Zinc , Zinc SulfateABSTRACT
Acrodermatitis enteropathica is a rare autosomal recessive disorder characterized by alopecia, acral and periorificial dermatitis and gastro-intestinal disturbances such as diarrhea. This syndrome is caused by malabsorption of zinc. The mean serum zinc level is usually low in untreated patients and the oral administration of zinc sulfate can clear the skin lesions and other symptoms. We report a three-month-old female baby with acrodermatitis enteropathica showing a normal serum zinc level in whom diapnosis was confirmed by typical skin lesions, clinical symptoms and response to oral zinc therapy.
Subject(s)
Female , Humans , Acrodermatitis , Administration, Oral , Alopecia , Dermatitis , Diarrhea , Skin , Zinc Sulfate , ZincABSTRACT
0.05),but the 24h urine zinc level increased markedly(P