Variants of SLC39A4 cause acrodermatitis enteropathica in Tibetan, Yi, and Han families in Sichuan region of southwestern China: a case report series.

Acrodermatitis enteropathica (AE, OMIM 201100) is a rare autosomal recessive dermatosis characterized by periorificial dermatitis, diarrhea, alopecia, and hypozincaemia due to pathogenic variants of SLC39A4. Herein, we present a case series describing four unrelated patients with AE from Han, Yi, and Tibetan ethnicities in Sichuan region of southwestern China, speculate the hotspot variants of SLC39A4 causing AE in Sichuan region and highlight physicians should be alerted to unusual presentations of AE, such as the absence of hypozincaemia and the presence of acne-like lesions. Serum alkaline phosphatase and genetic testing should be considered to accurately evaluate the zinc deficiency in human body and help make the correct diagnosis.

Association Between Serum Zinc and Non-Alcoholic Fatty Liver Disease and Advanced Liver Fibrosis: NHANES 2011-2016.

Limited and inconclusive evidence exists regarding the correlation between serum zinc levels and non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis. The objective of this cross-sectional study was to investigate the association between serum zinc concentration and both NAFLD and advanced liver fibrosis among the United States (US) adults. 3398 subjects from National Health and Nutrition Examination Survey (NHANES) 2011-2016 were included. Serum zinc concentration was measured by inductively coupled plasma dynamic reaction cell mass spectrometry (ICP-DRC-MS). NAFLD was diagnosed with Hepatic Steatosis Index (HSI), and advanced fibrosis risk was assessed by NAFLD Fibrosis Score (NFS). Weighted logistic regression and restricted cubic splines (RCS) were used to examine the association between serum zinc concentration and NAFLD and advanced fibrosis. Linear trend tests were conducted by incorporating the median of serum zinc quartiles as a continuous variable in the models. We employed sensitivity analysis and subgroup analysis to enhance the robustness of our results. The results from the RCS regression revealed no evident nonlinear relationship between serum zinc concentration and the presence of NAFLD and advanced fibrosis (p-nonlinear > 0.05). Compared with those in the lowest quartile (Q1) of serum zinc concentrations, the odds ratios (95% confidence intervals) of NAFLD were 1.49 (0.89,2.49) in Q2, 0.99 (0.68,1.45) in Q3, and 2.00 (1.40,2.86) in Q4 (p-trend = 0.002). Similarly, the odds ratios (95% confidence intervals) for advanced fibrosis in Q2-4 compared to Q1 were 0.86 (0.50,1.47), 0.60 (0.26,1.39), and 0.41 (0.21,0.77), respectively (p-trend = 0.006). Subgroup analyses and sensitivity analyses reinforce the same conclusion. The investigation revealed a positive linear relationship between serum zinc concentrations and the probability of developing NAFLD. Conversely, an inverse correlation was observed between serum zinc concentrations and the incidence of advanced liver fibrosis among individuals diagnosed with NAFLD.

Serum zinc levels in hemodialysis and peritoneal dialysis patients: A retrospective observational study.

Background: Zinc is vital for cellular functions, but kidney failure increases zinc deficiency risk. We compared zinc levels in hemodialysis (HD) and peritoneal dialysis (PD) patients in Isfahan, Iran. Materials and Methods: A retrospective study included 150 patients (75 PD and 75 HD). Serum zinc levels were assessed through photometry. Statistical analysis employed Chi-square, independent t-test, and correlation. Results: Serum zinc was below normal in both groups (P < 0.01). HD patients had lower zinc levels (70.85 ± 7.68 mg/dL) compared to PD (75.04 ± 13.55 mg/dL, P = 0.021), remaining significant after adjusting for confounders (P = 0.011). Conclusion: Zinc levels in PD and HD patients are lower than in the general population, with HD patients having lower levels than PD patients.

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.

Serum Zinc Levels in Women with Polycystic Ovarian Syndrome are Lower as Compared to Those without Polycystic Ovarian Syndrome: A Cohort Study.

Background: Zinc is an essential micronutrient, a vital stabiliser and a cofactor in many enzymes such as superoxide dismutase and phospholipase C and also acts as an antioxidant by protecting the sulfhydryl groups of different proteins and enzymes against free radicals. It is unclear if serum zinc levels are correlated with polycystic ovary syndrome (PCOS) and its pathophysiology, although relation between diabetes and insulin resistance has been established. Aims: This study aimed to investigate circulating serum zinc levels in PCOS subjects compared with non-PCOS subjects. Settings and Design: In this cohort study, PCOS subjects were compared with normal subjects aged between 18 and 35. Materials and Methods: All the included subjects underwent measurement of anthropometric parameters, fasting insulin, luteinising hormone, follicle-stimulating hormone, thyroid-stimulating hormone, prolactin, progesterone, oestrogen and serum zinc levels. These values were taken on days 2-5 of the menstrual cycle. Statistical Analysis Used: Univariate analysis and linear regression were performed for serum zinc levels and fasting insulin levels in PCOS subjects and non-PCOS subjects using SPSS (version 21) and Microsoft Excel (2019). Results: Serum zinc levels in the PCOS group were lower than in the control group (P = 0.012). Fasting insulin levels in the PCOS group were higher than in non-PCOS subjects (P = 0.001). We found a negative correlation between zinc and fasting insulin (r = -0.580, P < 0.0001) in the normal group and (r = -0.332, P = 0.019) in the PCOS group. A positive correlation was found between body mass index (BMI) and fasting insulin levels in both the PCOS group (r = 0.227, P = 0.112) and normals (r = 0.612, P < 0.0001). A negative statistically significant correlation between BMI and zinc in both the PCOS group (r = -0.378, P = 0.007) and the non-PCOS group (r = -0.7452, P < 0.0001) was seen. Conclusion: The data suggest that serum zinc levels were found to be lower in PCOS subjects as compared to normal controls and evaluation of these levels may indicate that zinc has a vital role in PCOS pathophysiology.

Zinc status and indicators of intestinal health in enterotoxigenic Escherichia coli F18 challenged newly weaned pigs fed diets with different levels of zinc.

This study investigated the impact of an enterotoxigenic Escherichia coli (ETEC) F18 challenge on newly weaned pigs when fed one of three Zn levels (150, 1,400, or 2,500 ppm) on performance, Zn status, ETEC shedding, and diarrhea. The ETEC challenge was hypothesized to have a more pronounced negative impact on pigs fed a diet containing 150 ppm Zn compared to 1,400 or 2,500 ppm Zn for 14 d after weaning. The study included 72 ETEC F18 susceptible pigs weaned at ~28 d of age (d 0 of the study). The pigs were distributed according to initial weight and litter to one of the three dietary Zn levels. Half of the pigs were challenged with ETEC on d 1 and 2. The challenge reduced (P ≤ 0.03) feed intake and average daily gain (ADG) during d 3 to 5. Challenged pigs fed 150 ppm Zn had lower (P = 0.01) ADG during d 5 to 7 compared to those fed 1,400 or 2,500 ppm Zn, whereas control pigs' ADG were not affected by dietary Zn content. Challenged pigs fed 150 ppm Zn also showed lower (P < 0.01) fecal dry matter (DM) on d 5 compared to control pigs fed 150 ppm Zn and challenged pigs fed 1,400 or 2,500 ppm Zn. Challenge increased (P < 0.01) ETEC shedding in all groups, but challenged pigs fed 150 ppm Zn showed higher (P ≤ 0.05) fecal shedding of ETEC and toxins than when fed 1,400 or 2,500 ppm. On d 3, C-reactive protein concentration in plasma was lower (P < 0.03) for pigs fed 1,400 and 2,500 compared to 150 ppm Zn. Plasma haptoglobin and pig major acute phase protein were unaffected by dietary Zn content. On d 0, the serum Zn concentration was 586 ±â€…36.6 µg/L, which pigs fed 150 ppm Zn maintained throughout the study. The serum Zn concentration increased (P ≤ 0.07) in pigs fed 1,400 or 2,500 ppm Zn. The challenge decreased (P < 0.01) the serum Zn concentration in pigs fed 2,500 ppm Zn. On d 5 and 7, serum Zn concentration was similar for challenged pigs fed 1,400 and 2,500 ppm Zn, while control pigs fed 2,500 ppm Zn had higher (P < 0.01) serum Zn concentration than 1,400 ppm Zn. On d 7, serum Zn concentration tended (P = 0.08) to be lower for pigs with diarrhea (fecal DM ≤ 18%). In summary, these results indicate that newly weaned pigs fed 150 ppm Zn are more susceptible to ETEC F18 colonization and its adverse consequences such as diarrhea and reduced growth, even though challenge did not increase acute phase proteins.

At weaning, the immune system of pigs is not fully developed, leaving them more susceptible to infections such as enterotoxigenic Escherichia coli (ETEC) F18. This study investigated the effect of dietary zinc content on newly weaned pigs infected with ETEC in terms of performance, serum zinc status, diarrhea, E. coli shedding, and systemic inflammation markers. Challenged pigs had reduced growth the first 3 d after the challenge when fed 150 ppm dietary Zn compared to non-challenged pigs. Moreover, the challenge increased E. coli fecal shedding and resulted in more liquid feces, and a greater risk of diarrhea in pigs fed 150 ppm zinc compared to 1,400 and 2,500 ppm zinc. The challenge was not able to induce a response in the acute phase proteins. The serum zinc concentration was lowest when feeding 150 ppm, and the ETEC challenge caused a reduction in the serum Zn concentration only when feeding 2,500 ppm zinc. These findings suggest that newly weaned pigs fed 150 ppm zinc are less capable of withstanding an ETEC challenge based on impaired growth performance and increased diarrhea and E. coli shedding.

Serum Zinc Concentrations by Inflammation Status, Time of Day, and Fasting Status for Estimating Zinc Deficiency in 6-59-Mo-Old Children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019).

BACKGROUND: Serum zinc concentration (SZC) is considered the best biomarker of zinc status in population-level evaluations. However, zinc deficiency (ZD) estimations can be biased if they do not consider blood collection timing, inflammation, and fasting status. OBJECTIVES: The objectives of this study were to determine SZC without and with adjustment for inflammation, according to blood collection timing and fasting status, estimate ZD prevalence, and evaluate the associated factors with ZD in a representative sample of Brazilian children aged <5 y. METHODS: Population-based study with 7597 children aged 6-59 mo surveyed by the Brazilian National Survey on Child Nutrition. SZC was adjusted for inflammation using the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia regression correction approach, with high-sensitive C-reactive protein, assessed according to blood collection timing (morning/afternoon) and fasting status (<8 and ≥8 h). SZC <65 µg/dL (morning collection) or SZC <57 µg/dL (afternoon collection) were classified as ZD. The analysis between associated factors and ZD used the adjusted prevalence ratio (PR). RESULTS: After adjusting for inflammation, SZC was higher in all percentiles and varied according to collection timing and fasting status. Children who had blood collected in the morning without fasting or in the afternoon had lower SZC than those assessed in the morning with fasting. The differences in adjusted SZC according to the timing of collection and fasting status were greater in the higher percentiles of the distribution, with the greatest absolute difference observed when comparing the 95th percentile of morning fasting compared with nonfasting (20.3 µg/dL). The prevalence of ZD estimated without and with adjusting SZC for inflammation was 17.8% and 13.8%, respectively. The occurrence of diarrhea, fever, or respiratory symptoms in the 15 d before blood collection was associated with a higher prevalence of ZD (PR: 1.42; 95% confidence interval: 1.04, 1.94). CONCLUSIONS: Adjusting SZC for inflammation and considering fasting status is important to avoid overestimating the prevalence of ZD.

Zinc Supplementation and an Improved Quality of Life in Patients with Autoimmune Hepatitis.

Objecive Patients with autoimmune hepatitis (AIH) reportedly have an impaired quality of life (QOL), mainly due to depression, even during remission. In addition, hypozincaemia has been demonstrated in patients with chronic liver disease, including AIH, and is known to be related to depression. Corticosteroids are known to cause mental instability. We therefore investigated the longitudinal association between zinc supplementation and changes in the mental status among AIH patients treated with corticosteroids. Materials This study enrolled 26 patients with serological remission of AIH routinely treated at our facility after excluding 15 patients who either discontinued polaprezinc (150 mg/day) within 24 months or interrupted treatment. Two questionnaires, the Chronic Liver Disease Questionnaire (CLDQ) and SF-36, were adopted to evaluate the QOL before and after zinc supplementation. Results Serum zinc levels were significantly elevated after zinc supplementation (p<0.0001). The CLDQ worry subscale significantly improved after zinc supplementation (p=0.017), but none of the SF-36 subscales was affected. Multivariate analyses demonstrated that daily prednisolone dosing was inversely related to both the CLDQ worry domain score (p=0.036) and the SF-36 mental health component (p=0.031). There was a significant negative correlation between the changes in the daily steroid dose and the CLDQ worry domain scores before and after zinc supplementation (p=0.006). No serious adverse events occurred during the observation period. Conclusion Zinc supplementation safely and efficiently improved mental impairment, possibly caused by continuous treatment with corticosteroids, in patients with AIH.

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.

Determination of the optimal dietary zinc content for pigs between 10 and 30 kg body weight.

The Zn requirement of pigs immediately after weaning is more investigated compared to the Zn requirement in the growth period between 10 and 30 kg. Unabsorbed and excessive dietary Zn is excreted mainly through feces, and spreading pig slurry to fields can cause environmental issues because high levels of Zn can impair plant growth and contribute to the development of antimicrobial resistance genes in microorganisms. Therefore, more precise knowledge of Zn requirements and dietary Zn recommendations is important. The present study investigated the optimal dietary Zn content for 10- to 30-kg pigs. The study used 150 pigs weaned at 28 d of age (day 0) and supplied with 1,474 mg dietary Zn/kg the first 2 wk post-weaning. After 2 wk, pigs were randomly distributed according to body weight (BW; 10.1 ±â€…0.3 kg) and sex, to individually housing, and fed a diet supplemented with either 0, 30, 60, 120, or 240 mg Zn/kg (from ZnO), resulting in total dietary Zn contents of 80, 92, 117, 189, and 318 mg/kg until week 6 post-weaning. BW, feed intake, and fecal scores were recorded, and samples of blood (weeks 2, 3, 5, and 6) and tissues (week 6) were collected. The feed intake, growth, feed efficiency, relative weight of the pancreas and liver, Zn concentration in the liver, and pancreatic digestive enzyme activity were unaffected by dietary Zn content (P > 0.12). The serum Zn level decreased (P < 0.01) by up to 24% from weeks 2 to 3. The serum Zn concentrations in weeks 5 and 6 were similar to in week 2 when 117, 189, and 318 mg Zn/kg were provided, while with 80 and 92 mg Zn/kg the serum Zn concentration was lower (P < 0.01) than in week 2. The serum Zn concentration reached a plateau in weeks 5 and 6, and breakpoints were calculated at 126 ±â€…17 and 102 ±â€…6 mg Zn/kg, respectively. Bone Zn status was greater (P < 0.01) with 189 than 80 mg Zn/kg and a breakpoint was calculated at 137 ±â€…19 mg Zn/kg. According to performance, the Zn requirement for 10- to 30-kg pigs can be fulfilled with 80 mg total Zn/kg, but based on serum and bone Zn status, the optimal total dietary Zn content is 102 to 137 mg/kg. The latter corresponds to a daily Zn intake (requirement) of 103 to 138 mg when calculated from the average feed intake during weeks 3 to 6 (1,005 g/d). Importantly, the presented results are obtained in pigs supplied with 1,474 mg Zn/kg from ZnO the first 2 wk post-weaning and a high level of phytase (1,000 phytase units) in the diet throughout the experiment.

It is important to ensure that the dietary zinc (Zn) content fulfills the Zn requirement of pigs. The unabsorbed proportion of dietary Zn is excreted mainly through feces and supplying pigs with more Zn than they need increases the excretion, which may be an environmental issue. This study investigated the optimal dietary Zn content in 10- to 30-kg pigs. From weaning until 10 kg (the first 2 wk post-weaning) pigs were fed a diet containing 1,474 mg Zn/kg. From the third to the sixth week post-weaning (10- to 30-kg) pigs were fed a basal diet supplemented with either 0, 30, 60, 120, or 240 mg Zn/kg from zinc oxide. Analysis of the five experimental diets showed total Zn contents of 80, 92, 117, 189, and 318 mg/kg. The feed intake, weight gain, and feed efficiency were unaffected by dietary Zn content. The Zn concentration in serum (blood) at the end of the experiment was lowest with 80 and 92 mg total Zn/kg compared to 117, 189, and 318 mg total Zn/kg, which resulted in similar serum Zn concentration. The Zn content in bone was lower at 80 compared to 189 mg total Zn/kg.

Assessment of Serum Zinc Levels in Patients With Decompensated Cirrhosis of the Liver and Its Association With Disease Severity and Hepatic Encephalopathy: A Prospective Observational Study From North India.

Background Zinc, an essential trace element, plays a vital role in cellular metabolism, and the liver is the main organ responsible for its metabolism. Because serum zinc levels are found to be lowered in chronic liver diseases, it has been hypothesized to be a precipitating factor for the development of hepatic encephalopathy. Methodology This prospective, observational study included patients with decompensated cirrhosis of the liver who were admitted to the medical intensive care unit of a tertiary care institute in northern India between September 2021 and April 2023. The diagnosis was based on history and detailed clinical examination. The serum zinc levels of patients were estimated using atomic absorption spectrometry at admission and compared to that of healthy controls. Serum zinc levels were correlated with the severity of liver disease and hepatic encephalopathy among the cases. Results A total of 100 cases of decompensated cirrhosis of the liver and 50 healthy controls were included. The mean serum zinc level of the cases was 40.5 ± 10.0 µg/dL which was significantly lower than the mean serum zinc level (104.0±9.1 µg/dL) of controls (p < 0.0001). Serum zinc level was significantly lower in patients with higher grades of hepatic encephalopathy (p = 0.000). Similarly, serum zinc level was significantly reduced among patients with higher Child-Pugh and Model for End-stage Liver Disease scores. Conclusions Serum zinc level is significantly reduced in patients with decompensated cirrhosis of the liver, and lower serum zinc level is associated with the increased severity of the disease and higher grades of hepatic encephalopathy. In patients with decompensated cirrhosis of the liver, maintenance of adequate serum zinc levels may prevent hepatic encephalopathy.

Low Serum Levels of Zinc, Selenium, and Vitamin D3 Are Biomarkers of Airway Inflammation and Poor Asthma Control: A Two-Centre Study.

Background Asthma is a chronic inflammatory disease with its control being affected by underlying oxidative stress. Trace elements, along with vitamin D3, play an important role in immune alterations leading to an imbalance of Th1/Th2 helper cells. However, their role in asthma pathogenesis and control is inconsistent and inconclusive. The objective of our study was to assess levels of serum trace elements like zinc, copper, selenium, iron, magnesium, vitamin D3 levels, IgE, and HsCRP in asthmatic children, compare with healthy controls, and assess their association with the level of asthma control. Methods A cross-sectional study was conducted from 2019 to 2021 enrolling 100 asthmatic children and 75 healthy controls. The level of asthma control was assessed as uncontrolled, partly controlled, and controlled asthma as per GINA Guidelines. Mean and standard deviation were calculated for each element and mean differences between groups were analyzed by student t-test. A p-value of <0.05 was considered significant. Results The mean age was 8.75±2.89 yrs in cases and 9.04±2.79 in controls. A total of 57.6% of cases had atopic comorbidities. The mean serum zinc levels were 51±12.8 mg/dl, which was very low in asthmatic children as compared to 60±18.2mg/dl (p-value 0.0002) in healthy controls. Serum selenium was 13±3 µg/dl in asthmatics vs. 15±4 µg/dl (p-value 0.0002) in healthy controls. Serum copper was 115.2±21.92µg/dl vs. 125.3±31.99µg/dl (p-value 0.015), Serum vitamin D3 levels were 13.07±7.82ng/ml vs. 17.82±14.62 ng/ml(p-value 0.006) in both groups, respectively. SIgE and HsCRP were high in asthmatic children suggestive of eosinophilic inflammation. Serum zinc was 49±5.45 mg/dl in the uncontrolled group, 53±6.1 in the partly controlled, and 58±8.0 in the well-controlled group (p<0.0001). Serum selenium was 10± 3.0 µg/dl in the uncontrolled group vs. 13± 2.0 and 14± 2.0 µg/dl in the partly controlled and well-controlled groups, respectively (p-value <0.0001). Vitamin D3 was significantly low (9.32±5.95ng/dl) in the uncontrolled group vs. 12.99±4.97 and 13.40±5.92 ng/dl(p<0.005) in the partly controlled and well-controlled groups respectively. Vitamin D3 showed a strong positive correlation with zinc (r=0.4,p< 0.0001) and a negative correlation with inflammatory markers like SIgE and HsCRP. Conclusion Children with asthma had low zinc, selenium, and vitamin D3 levels, and were associated with airway inflammation and poor asthma control.

Assessment of serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension: a case-control study.

Background: This study assessed serum, dietary zinc levels, and other risk factors during the third trimester among pregnant women with and without pregnancy-induced hypertension (PIH). Methods: This case-control study was conducted in 2022, in the three main Obstetrics and Gynecology departments in Gaza Strip, Palestine. One hundred sixty pregnant women, during the third trimester, aged ≥20 years, were selected using a convenient sampling method. Data were obtained using an interview-based questionnaire, food frequency questionnaire, anthropometric measures, and biochemical tests. Statistical analysis was performed using SPSS version 24. Results: The participants' mean age was 30.7 ± 5.6 years. A total of 47 (58.8%) of cases and 6 (7.5%) of controls were insufficiently active; and the mean of blood pressure (mmHg) was 133.3 ± 11.9/85.11 ± 10.0 for cases and 112.8 ± 9.5/68.02 ± 7.2 for controls with significant differences between the two groups (P = <0.005). The mean serum zinc level (µg/dl) was 67.15 ± 16.5 for cases and 68.45 ± 18.0 for controls without significant differences between the two groups (P = 0.636). For newborns, the mean birth weight (g) was 2,904.6 ± 486 for cases, and 3,128.3 ± 501 for controls, and the mean Apgar score was 8.03 ± 0.62 for cases and 8.30 ± 1.17 for controls, with significant differences between the two groups (P = <0.005). Furthermore, 43 (53.8%) of cases have family history of hypertension; 5 (6.2%) were primiparous; 19 (23.8%) have previous caesarian section; 33 (41.2%) have history of preeclampsia; and 62 (77.5%) have edema, with significant differences between the two groups (P = <0.005). Additionally, the total zinc dietary daily intake (mg/day) was 4.15 ± 2.10 for cases and 4.88 ± 3.02 for controls, with significant differences between the two groups (P = 0.041). After adjustment for confounding variables, participants in the case group have higher odds of having low total zinc dietary intake compared to those in the control group [OR = 1.185, 95% CI = (1.016-1.382), P = 0.030]. Conclusion: The current study showed the main risk factors of PIH among pregnant women in the Gaza Strip, Palestine. Furthermore, low maternal dietary zinc intake was associated with a high level of PIH. Moreover, having PIH could increase the risk of low birth weight and low Apgar scores. Therefore, reducing the main risk factors of PIH could reduce the adverse effect on both mother and birth outcomes.

Evaluation of Chemotherapy-induced Dysgeusia in Patients With Gastrointestinal Cancer: A Pilot Study.

BACKGROUND/AIM: Dysgeusia, one of the adverse effects of cancer chemotherapy, and anorexia due to taste disorder can significantly impair the quality of life of patients. However, an evaluation method for dysgeusia has not yet been established. The present prospective study aimed to utilize a combination of subjective and objective assessment methods to evaluate dysgeusia in patients with gastrointestinal cancer initiating chemotherapy, to determine chemotherapeutic drugs and regimens causing dysgeusia, and to assess whether dysgeusia was associated with zinc deficiency. PATIENTS AND METHODS: A total of 21 patients with newly diagnosed gastrointestinal cancer were registered between August 2020 to March 2021. The following regimens were also included in the evaluation if the patients did not develop dysgeusia. A total 30 regimens were administered to the patients during the study period. A salt-impregnated test paper (Salsave®) was used as a subjective assessment, and the chemotherapy-induced taste alteration scale was used as an objective assessment. RESULTS: Based on physician interviews, dysgeusia was diagnosed in 8 of 21 patients (38%) treated with 8 of 30 regimens (27%). All regimens that resulted in dysgeusia contained platinum-based drugs. The patients who developed dysgeusia had higher controlling nutritional status scores at the start of chemotherapy compared to those who did not develop dysgeusia. In both subjective and objective assessments, the patients with dysgeusia performed significantly worse than those without dysgeusia. Six of the eight patients who developed dysgeusia were administered Novelzine, which did not improve the taste disorder despite the improvement of serum zinc levels. CONCLUSION: The combined approach using subjective and objective taste assessment methods was useful in assessing chemotherapy-induced dysgeusia. Mechanisms other than hypozincemia should be considered as contributors to taste disorders caused by platinum-based drugs.

Frequency of low birth weight and its relationship with maternal serum zinc: a cross-sectional study.

Fetal and neonatal mortality and morbidity are connected to low birth weight (LBW), which is also associated with slow growth and cognitive development. Several factors, such as maternal nutrition, LBW deliveries, and additional dietary intake, contribute to pregnancy outcomes. This study aimed to compare the maternal serum zinc levels between the LBW and normal birth weight neonates. Moreover, we will also determine the frequency of LBW in the local population. Material and method: This cross-sectional study was conducted at a tertiary care hospital from June 2021 to June 2022. Three hundred eighty-two gravid females with active labor (≥2 uterine contractions in 10 min) were enrolled in the study. Neonates at birth were weighed and divided into two groups: LBW and average or normal birth weight. Maternal serum zinc levels were performed by serum multi-element spectrometry (ICP-DRC-MS method). The data were analyzed using SPSS software. Results: Three hundred eighty-two patients enrolled in this study. The results showed the mean age of patients was 24.04±3.49 years, and the mean maternal zinc levels were found to be 75.32±13.80 µg/dl, respectively. Babies delivered at LBW had low maternal mean serum zinc levels (63.88±10.95 mg/dl) compared to babies with normal birth weight whose levels were comparatively high (83.83±8.57 mg/dl). Conclusion: It can be concluded that maternal dietary factors and nutrition are essential during fetal development and have an important association with birth weight.Zinc supplementation and other minerals should be prioritized because they may increase these infants' birth weight. Increasing maternal zinc consumption has a significant positive linear relationship with infant birth weight.

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 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.

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.

Dietary Zinc Differentially Regulates the Effects of the GPR39 Receptor Agonist, TC-G 1008, in the Maximal Electroshock Seizure Test and Pentylenetetrazole-Kindling Model of Epilepsy.

The G-protein coupled receptor 39 (GPR39) is gaining increasing attention as a target for future drugs, yet there are gaps in the understanding of its pharmacology. Zinc is an endogenous agonist or an allosteric modulator, while TC-G 1008 is a synthetic, small molecule agonist. Zinc is also a positive allosteric modulator for the activity of TC-G 1008 at GPR39. Activation of GPR39 by TC-G 1008 facilitated the development of epileptogenesis in the pentylenetetrazole (PTZ)-induced kindling model of epilepsy. Congruently, TC-G 1008 decreased the seizure threshold in the maximal electroshock seizure threshold (MEST) test. Here, we investigated the effects of TC-G 1008 under the condition of zinc deficiency. Mice were fed a zinc-adequate diet (ZnA, 50 mg Zn/kg) or a zinc-deficient diet (ZnD, 3 mg Zn/kg) for 4 weeks. Following 4 weeks of dietary zinc restriction, TC-G 1008 was administered as a single dose and the MEST test was performed. Additional groups of mice began the PTZ-kindling model during which TC-G 1008 was administered repeatedly and the diet was continued. TC-G 1008 administered acutely decreased the seizure threshold in the MEST test in mice fed the ZnD diet but not in mice fed the ZnA diet. TC-G 1008 administered chronically increased the maximal seizure severity and the percentage of fully kindled mice in those fed the ZnA diet, but not in mice fed the ZnD diet. Our data showed that the amount of zinc in a diet is a factor contributing to the effects of TC-G 1008 in vivo.