[Vitamin A and zinc levels in gastroenterological surgical patients: Relation with inflammation and postoperative complications]. / Niveles de vitamina A y zinc en pacientes de cirugía gastroenterológica: relación con la inflamación y la aparición de complicaciones postoperatorias.

INTRODUCTION: It is accepted that even mild nutrient depletion may affect the evolution of the surgical patient. OBJECTIVE: To evaluate the influence of preoperative levels of plasma retinol and zinc on postoperative evolution of surgical patients; to evaluate the influence of inflammation on both level markers. METHODS: Plasma retinol and zinc were determined in 50 patients before programmed gastroenterological surgeries. To detect global malnutrition BMI and weight loss percentage (WL%) were included. C-reactive protein (CRP) was included as inflammation marker. During follow up postoperative complications were recorded. The present analysis was carried out in 43 patients with complete information. RESULTS: Low retinol values (< 20 µg/dl) were founded in 3 cases and low Zn values (< 85 µg/dl) in 20 cases, being 9 of them indicative of severe deficiency (< 70 µg/dl). Postoperative complications were recorded in 17 patients; patients with complications presented lower values of plasma Zn (78.4 ± 25.8 vs. 87.8 ± 25.7 µg/dl) and retinol (36.9 ± 14.5 vs. 49.7 ± 20.6; P = 0.0318) than those with no complications; the number of patients with complications decreased when retinol and Zn ranges increased. No relation between BMI or WL% and appearance of complications was founded; patients with higher WL% were those with higher usual weight. Inflammation affected both markers: retinol dropped from 50.1 ± 17.2 to 44.0 ±20.8 and to 23.7 ± 4.0 µg/dl for CRP ranges of < 0.5, 0.5-3.9 and ≥ 4 mg/dl, respectively (p = 0.0193); levels of zinc fell from 90.1 ± 17.8 to 85.2 ± 29.9 and to 55.0 ± 25.9 µg/dl for the same CRP ranges (P = 0.0195). Zn level influenced retinol level, dropping to 33.1 ± 11.7 µg/dl of retinol in the Zn severe deficiency group (P = 0.0386). CONCLUSIONS: The obtained results confirm the influence of vitamin A and zinc on postoperative evolution of the surgical patient, while alert about the interrelationships among vitamin A, zinc and inflammation, which lead to difficulty to establish the real source of deficiencies. Beyond these difficulties, retinol and zinc plasma levels determine the nutrient availability for the body and appear as promissory markers of surgical risk.

[Relation between erythrocyte free protoporphyrins and usual iron intake in a group of University of Buenos Aires students]. / Relación entre protoporfirinas libres en glóbulo rojo e ingesta habitual de hierro en un grupo de estudiantes de la Universidad de Buenos. Aires.

In order to analyze the interrelationships between free erythrocyte protoporphyrins and the usual iron intake in adult students, biochemical, and hematological values, and dietary daily intake, obtained using the recall method during seven days, were studied. Hematocrit (Hto.), hemoglobin (Hb) and free erythrocyte protoporphyrins (FEP) were determined in a group of 145 female university students, healthy according to the standard parameters of the Buenos Aires University Health Department. Mean iron intake was 23.0 +/- 1.5 mg per day, about 44% being provided by animal sources; 74.5% of the population was within the recommended daily intake according to FAO/WHO; only 0.7% of the population did not cover protein requirements while 35% did not cover energy needs. Hto. and Hb were below normal levels in 7.8% of the population when compared with standards according to ICNND. To obtain information about normal values to FEP, expressed as microgram/100 ml red cells (FEP% r.c.) and FEP/Hb ratio, the group of students with adequate intake of energy and proteins who had normal values for Hb and Hto. was selected. This group, including 94 women, had a mean FEP% r.c. of 15.71 +/- 7.26 and a mean FEP/Hb ratio of 0.44 +/- 0.21. There was observed an inverse correlation between FEP% r.c. and FEP/Hb with total iron intake (r = 0.80 and r = 0.78, respectively) and between FEP% r.c. and Hb concentration (r = 0.81). These results confirm the usefulness of the free erythrocyte protoporphyrins determination as a good index of iron stores and usual intake of this population.