ABSTRACT
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.
ABSTRACT
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
ABSTRACT
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.