BACKGROUND/AIMS: Studies on the micronutrient status of Asian patients with inflammatory bowel disease (IBD) are scarce. We evaluated the prevalence of micronutrient deficiency and verified the risk factors for micronutrient deficiency in Korean patients with IBD. METHODS: We measured the serum levels of 25-hydroxyvitamin D3 [25-(OH)D], zinc, and selenium to analyze the clinical risk factors for micronutrient levels below the reference values. In addition, we compared the 25-(OH)D levels of patients with IBD to those of age- and sex-matched healthy controls. RESULTS: Among the 83 patients, 74 (89.2%) had suboptimal serum 25-(OH)D levels. The mean plasma 25-(OH)D level in patients with IBD was significantly reduced compared to that of the healthy controls (12.3±6.2 ng/mL vs 20.0±6.7 ng/mL; p<0.001). The proportions of patients with lower serum zinc and selenium levels were 39.0% and 30.9%, respectively. Female sex (p=0.012) and Crohn’s disease (p=0.012) were associated with vitamin D deficiency. Patients younger than 40 years were at increased risk for zinc deficiency (p=0.045). Female sex (p=0.015) and low serum albumin level (<3.3 g/dL) (p=0.047) were risk factors for selenium deficiency. CONCLUSIONS: Many Korean patients with IBD have vitamin D, zinc, and selenium deficiencies, suggesting the necessity for monitoring levels of these micronutrients.
Asian Continental Ancestry Group ; Calcifediol ; Female ; Humans ; Inflammatory Bowel Diseases* ; Micronutrients ; Plasma ; Prevalence ; Reference Values ; Risk Factors* ; Selenium* ; Serum Albumin ; Vitamin D Deficiency ; Vitamin D* ; Vitamins* ; Zinc*

OBJECTIVETo detect pathogenic mutation of the SLC39A4 gene in a male patient with acrodermatitis enteropathica (AE).

METHODSPeripheral venous blood sample and clinical data from the patient and his parents were collected. One hundred unrelated healthy individuals were recruited as controls. All coding exons and flanking exon-intron sequences of the SLC39A4 gene were analyzed by PCR and direct sequencing.

RESULTSThe results revealed that the patient and his mother have both carried a novel frame-shift mutation c.1110InsG (p.Gly370GlyfsX47 to TGA) in exon 6. A novel nonsense mutation c.958C to T (p.Q320X) in exon 5 was also detected in the patient and his father and grandmother. This novel mutation was not detected in the unaffected family members and 100 unrelated healthy controls.

CONCLUSIONThe novel frame-shift mutation c.1110InsG (p.Gly370GlyfsX47 to TGA) derived from the mother and nonsense mutation c.958C to T (p.Q320X) of the SLC39A4 gene derived from the father may underlie the disease in the patient.

Acrodermatitis ; genetics ; Adolescent ; Base Sequence ; Cation Transport Proteins ; genetics ; Exons ; Homozygote ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Zinc ; deficiency

OBJECTIVETo investigate the effects of zinc deficiency on the relevant immune function in rats with LPS-induced sepsis.

METHODSSixty rats were divided into low zinc group (LZ), normal zinc pair-fed group (NP), and normal zinc control group (NC) according to the random number table, with 20 rats in each group. The rats in group LZ were fed with low zinc diet, and the rats in group NP were fed with normal zinc diet, with the same intake as that of group LZ by manual control, and the rats in group NC were fed with normal zinc diet freely. After being fed for 7 d, the rats all fasted and were further divide into the below subgroups named LZ-LPS, LZ-normal saline (NS), NP-LPS, NP-NS, NC-LPS, and NC-NS according to the random number table, with 10 rats in each subgroup. Rats in the LPS subgroups were intraperitoneally injected with 1 mg/mL LPS solution with the dosage of 5 mg/kg, rats in the corresponding NS subgroups were intraperitoneally injected with equivalent NS. The rats were sacrificed at post injection hour 6 to collect blood, spleen, and thymus. The serum level of zinc was detected by inductively coupled plasma mass spectrometry, and the serum alkaline phosphatase (ALP) activity was detected by automatic blood biochemical analyzer. The body weight and weight of spleen and thymus of rats were weighed, and the indices of spleen and thymus were calculated. Six routine blood indices were examined by automatic blood cell analyzer. The serum levels of interferon gamma (IFN-γ), TNF-α, IL-4, and IL-10 were determined with ELISA, and the ratio of IFN-γ to IL-4 was calculated. Data were processed with one-way analysis of variance and SNK test.

RESULTS(1) Serum levels of zinc and ALP activity in the LPS subgroups were significantly lower than those in the corresponding NS subgroups (with P values below 0.05). The two former indices in subgroups NP-NS and NC-NS were significantly higher than those in subgroup LZ-NS (with P values below 0.05). The two former indices in subgroups NP-LPS and NC-LPS were significantly higher than those in subgroup LZ-LPS (with P values below 0.05). (2) Body weight, spleen and thymus weight, indices of spleen and thymus in the LPS subgroups were similar with those in the corresponding NS subgroups (with P values above 0.05). The 4 former indices, except for body weight, in subgroups NP-NS and NC-NS were significantly higher than those in subgroup LZ-NS (with P values below 0.05). The 4 former indices, except for body weight, in subgroups NP-LPS and NC-LPS were significantly higher than those in subgroup LZ-LPS (with P values below 0.05). (3) Levels of leucocyte count in subgroups LZ-LPS and NP-LPS were significantly higher than those in the corresponding NS subgroups (with P values below 0.05). Level of leucocyte count in subgroup NC-NS was significantly higher than that in subgroup LZ-NS (P<0.05). Level of leucocyte count in subgroup NC-LPS was significantly lower than that in subgroup LZ-LPS (P<0.05). Levels of neutrophilic granulocyte count (NGC) and NG in the LPS subgroups were significantly higher than those in the corresponding NS subgroups (with P values below 0.05). The two former indices in subgroup NC-LPS were significantly lower than those in subgroup LZ-LPS (with P values below 0.05). Level of NG in subgroup NC-NS was significantly lower than that in subgroup LZ-NS (P<0.05). Levels of lymphocyte count and lymphocyte in subgroups LZ-NS, LZ-LPS, NP-NS, NP-LPS, NC-NS, and NC-LPS were respectively (1.8 ± 0.4) × 10⁹/L, (1.0 ± 0.3)× 10⁹/L, (2.6 ± 0.7) × 10⁹/L, (1.4 ± 0.4) × 10⁹/L, (3.3 ± 0.6) × 10⁹/L, (1.5 ± 0.5) × 10⁹/L, and 0.39 ± 0.10, 0.11 ± 0.03, 0.47 ± 0.12, 0.14 ± 0.04, 0.50 ± 0.09, 0.24 ± 0.07. The two former indices in the LPS subgroups were significantly lower than those in the corresponding NS subgroups (with P values below 0.05). The two former indices in subgroup NC-NS were significantly higher than those in subgroup LZ-NS (with P values below 0.05). The two former indices in subgroups NP-LPS and NC-LPS were significantly higher than those in subgroup LZ-LPS (with P values below 0.05). Level of lymphocyte count in subgroup NP-NS was significantly higher than that in subgroup LZ-NS (P<0.05). Levels of platelet count (PC) in subgroups NP-LPS and NC-LPS were significantly lower than those in the corresponding NS subgroups (with P values below 0.05). Levels of PC in subgroups NP-NS and NC-NS were significantly higher than those in subgroup LZ-NS (with P values below 0.05). Level of PC in subgroup NC-LPS was significantly higher than that in subgroup LZ-LPS (P<0.05). (4) Serum levels of TNF-α, IL-4, and IL-10 in each subgroup showed no significant differences (with P values above 0.05). Serum levels of IFN-γ and ratios of IFN-γ to IL-4 in subgroups LZ-NS, LZ-LPS, NP-NS, NP-LPS, NC-NS, and NC-LPS were respectively (75 ± 21), (233 ± 40), (80 ± 14), (345 ± 74), (66 ± 7), (821 ± 189) pg/mL, and 3.1 ± 1.0, 6.6 ± 1.7, 3.9 ± 1.7, 20.2 ± 8.3, 3.4 ± 1.5, 45.7 ± 7.6. The two former indices in the LPS subgroups were significantly higher than those in the corresponding NS subgroups (with P values below 0.05). The two former indices in subgroups NP-NS and NC-NS were similar with those in subgroup LZ-NS (with P values above 0.05). The two former indices in subgroups NP-LPS and NC-LPS were significantly higher than those in subgroup LZ-LPS (with P values below 0.05).

CONCLUSIONSZinc deficiency can induce the atrophy of spleen and thymus, and reduction of peripheral blood lymphocyte. In sepsis, zinc deficiency can further decrease the production of IFN-γ, thus making the cytokines of Th1/Th2 shift to Th2 and the immune imbalance worse.

Animals ; Cytokines ; Interferon-gamma ; Interleukin-10 ; Interleukin-4 ; Lipopolysaccharides ; pharmacology ; Rats ; Sepsis ; chemically induced ; Tumor Necrosis Factor-alpha ; metabolism ; secretion ; Zinc ; deficiency

This cross-sectional study assessed the zinc status of non-pregnant and pregnant women resident in the National Capital District (NCD), Papua New Guinea (PNG). Non-fasting morning blood samples were collected by venipuncture from consented women. Flame atomic absorption spectrometry was used to measure the serum zinc concentration in 27 non-pregnant and 100 pregnant women. C-reactive protein (CRP) in serum was measured by enzyme immunoassay and used to interpret the serum Zn data. For all the non-pregnant women, the median serum zinc concentration was 42.7 mug/dl with an interquartile range (IQR) of 27.6 to 91.2 mug/dl. Zinc deficiency was prevalent among 59% in this group of women. For those with normal CRP the median and IQR serum zinc concentrations were 48.9 mug/dl and 30.2 to 98.7 mug/dl, respectively. The median and IQR for all the pregnant women were 63.8 mug/dl and 40.9 to 93.2 mug/dl, respectively. Prevalence of zinc deficiency was 42% using the cut-off point of 56.0 mug/dl. Of the 100 pregnant women, 16 (16%) were in the first trimester, 51 (51%) in the second trimester and 33 (33%) in the third trimester. The median serum zinc concentrations of pregnant women in the first, second and third trimesters were 87.0 mug/dl, 61.6 mug/dl and 60.8 mug/dl, respectively. Using gestational period-specific cut-off points, zinc deficiency was prevalent among 31%, 39% and 36% of the pregnant women in the first, second and third trimesters, respectively. Our results clearly indicate suboptimal zinc status among non-pregnant and pregnant women in the NCD. According to the International Zinc Nutrition Consultative Group (IZiNCG) criteria, this should be considered as a public health problem among these groups of women in the NCD. To effectively address the issue, social mobilization, intensive education and awareness campaigns, with all relevant target groups and policy makers, are urgently required.
Zinc - deficiency, Pregnant Women

Children have been identified as the most nutritionally vulnerable group when disaster happens. The most common nutritional risks include protein-energy malnutrition, iron-deficiency anemia, and trace element deficiency in children after earthquake. During the disaster relief, effective nutritional interventions should be performed according to the nutritional conditions of children in the affected area, so as to prevent the common nutritional risks. Timely diagnosis and treatment should be provided for children at a high risk of malnutrition.
Anemia, Iron-Deficiency ; epidemiology ; prevention & control ; Child ; Earthquakes ; Humans ; Malnutrition ; epidemiology ; prevention & control ; Prevalence ; Protein-Energy Malnutrition ; epidemiology ; prevention & control ; Risk Factors ; Vitamin A Deficiency ; epidemiology ; prevention & control ; Zinc ; deficiency

BACKGROUND AND OBJECTIVES: The objective of this study was to determine whether the serum levels of zinc, vitamin B12, folic acid, iron, and fungus were correlated with symptoms of burning mouth syndrome (BMS) and to analyze the relationship between treatment responses and the results from serum examination. SUBJECTS AND METHOD: We analyzed data from 284 patients whose serum examination results recorded responses to treatment were available from June 2004 to November 2011. A total of 219 patients experienced burning sensation, while 65 patients experienced only globus symptoms or voice changes. RESULTS: Of the patients who experienced burning sensations, 5 (2.3%) had vitamin B12 deficiency, 23 (10.5%) had iron deficiency, 40 (24%) had zinc deficiency, but no patients had folic acid concentrations below the reference range. A total of 44 patients (25%) were fungus-positive. The comparison of the experimental and control treatment groups revealed that iron-deficient patients and fungal-positive patients were more frequently found in the experimental group (p=0.023 and p=0.010, respectively). Abnormalities in the serum or physical examinations were observed in 126 patients (57.5%). Symptomatic treatments were performed for both groups, which corrected abnormalities in serum examinations. CONCLUSION: The rates of fungus positivity and iron deficiency were higher in the BMS group. However, we did not identify a correlation between the response to treatment and serum examination of the analyzed elements or fungus examination. The total secondary oral burning rate was found to affect treatment modality.
Burning Mouth Syndrome ; Burns ; Folic Acid ; Fungi ; Humans ; Iron ; Physical Examination ; Reference Values ; Sensation ; Vitamin B 12 ; Vitamin B 12 Deficiency ; Voice ; Zinc

The disease course of children with persistent or chronic diarrhea lasts from two weeks to two months or over. Diarrhea is a clinical syndrome caused by a group of multiple etiologies. This paper reviews common causes of persistent or chronic diarrhea in children, including intestinal infections, nonspecific inflammatory bowel diseases, food allergy, lactose intolerance, antibiotic-associated diarrhea, neural regulation abnormality, immunodeficiency disease, malnutrition, Celiac disease and zinc deficiency.
Child ; Chronic Disease ; Diarrhea ; etiology ; Humans ; Infection ; complications ; Inflammatory Bowel Diseases ; complications ; Lactose Intolerance ; complications ; Malnutrition ; complications ; Zinc ; deficiency

BACKGROUND: As some parameters reflecting iron status were known to change with infection or inflammation, we examined the changes of these parameters in children with minor illnesses.METHODS: Hematologic tests were done in 42 young children with acute infection. Iron deficiency anemia (IDA) was defined as having Hb less than age-matched normal range, MCH <27 pg, and either Tfsat (transferrin saturation) <10% or TIBC >360 microg/dL. Iron deficiency (ID) was defined as having Hb equal or more than age matched normal low limit with MCH <27 pg, and either Tfsat <10% or TIBC >360 microg/dL. The others were classified as normal control (NC).RESULTS: The proportion of IDA, ID and NC were 16.6% (7/42), 33.3% (14/42) and 50.0% (21/42), respectively. Comparisons of means of Hb, MCV, MCH, and RDW between groups showed statistical difference in general, while levels of iron, ferritin and hs-CRP showed no statistical difference. Mean blood levels of zinc protoporphyrin (ZnPP) of IDA, ID and NC were 72.21 microg/dL, 57.02 microg/dL, and 45.62 microg/dL, respectively, but the difference was significant only between IDA and NC. ZnPP was inversely correlated with MCV (r=-0.518, P<0.01) and RDW (r=-0.640, P<0.01), but not with hs-CRP or ferritin.CONCLUSION: Combination of RBC indices with newly controlled Tfsat or TIBC can be available for an iron status assessment in children with minor infections. ZnPP levels in blood reflect some aspect of iron status, while ferritin and iron do not reflect it.
Anemia, Iron-Deficiency ; Child ; Communicable Diseases ; Erythrocyte Indices ; Ferritins ; Hematologic Tests ; Humans ; Inflammation ; Iron ; Protoporphyrins ; Reference Values ; Zinc

OBJECTIVEIn this study, a growing rat model of zinc deficiency was established to investigate the effect of zinc deficiency on intestinal mucosal morphology and digestive enzyme activity as well as to provide a scientific basis for zinc supplementation therapy in patients with diarrhea.

METHODThree-week-old weaned Sprague-Dawley male rats (n = 30) were randomly divided into 3 groups with 10 in each: rats in the control group (ZA) were fed with a normal diet containing 30 µg/g zinc; rats in the zinc deficient group (ZD) were fed with a zinc-deficient diet containing 0.4 µg/g zinc (refer to AIN-76 formula); and rats in the paired fed group (PF) were fed with a normal diet, but the food intake was limited to intake of rats in ZD group in the previous day. All rats were provided with deionized water for drinking. Their body weight was measured and the food intake during the previous day was recorded early in the morning of the following day. Symptoms of zinc deficiency, such as anorexia, diarrhea, dermatitis, and growth retardation, were observed. Two weeks later, the rats were sacrificed and serum zinc concentration was measured. Jejunal mucosa was taken for biopsy and was stained with hematoxylin and eosin (HE). The height ratio of the jejunal mucosal villi and crypts was measured. In addition, the activity of lactase in the jejunal mucosal brush border, γ-glutamyl peptidase (GGT), and aminopeptidase N (APN) were measured.

RESULTThe average weight of the rats in the ZA, ZD, and PF groups at the beginning of the experiment was (67.4 ± 5.3) g, (64.7 ± 4.8) g, and (66.5 ± 4.1) g, respectively, and the average daily food intake was (11.2 ± 1.0) g, (11.6 ± 1.6) g, and (11.2 ± 1.4) g, respectively. The intergroup differences were not significant. On the 7(th) day of experiment, no significant differences in average food intake were observed between the ZD group and the ZA and PF groups, but the average body weight in the ZD group was significantly lower than that in the ZA and PF groups (P < 0.01). At the end of the experiment (2 weeks), the average weight in the ZD group (112.0 ± 11.5) g was significantly lower than that in the ZA (164.0 ± 15.9) g and PF groups (137.5 ± 16.2) g. The average food intake in the ZD group (13.4 ± 5.1) g was significantly lower than that in the ZA group (18.2 ± 2.4) g (P < 0.01). Serum zinc level in the ZD group (733 ± 231) µg/L was significantly lower than that in the ZA (1553 ± 159) µg/L and PF groups (1457 ± 216) µg/L (P < 0.01). The height ratio of jejunal mucosa villus and crypt in the ZA, ZD, and PF groups was 2.98 ± 0.5, 2.77 ± 0.5, and 2.81 ± 0.7, respectively, and lactase activity was (26.1 ± 15.0) U/mg, (27.4 ± 12.8) U/mg, and (40.8 ± 18.5) U/mg, respectively, without significant intergroup differences. The GGT activity in the jejunal mucosa in the ZD group (12.7 ± 6.5) U/g was significantly lower than that in the ZA (19.1 ± 10.4) U/g and PF groups (18.5 ± 7.7) U/g, but the difference was not significant. The activity of APN in the jejunal mucosa in the ZD group (25.5 ± 7.5) U/g was significantly lower than that in the ZA (48.7 ± 16.8) U/g and PF groups (43.9 ± 14.5) U/g (P < 0.01).

CONCLUSIONZinc deficiency can cause loss of appetite, weight loss, and decreased activity of peptidase in the jejunal mucosal brush border. Zinc deficiency has little effect on the height ratio of the villus and crypt and lactase activity, thereby indicating that zinc deficiency may first affect protein digestion and absorption.

Animals ; Intestinal Mucosa ; enzymology ; metabolism ; pathology ; Jejunum ; metabolism ; pathology ; Lactase ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Zinc ; deficiency

Hemoglobin and zinc protoporphyrin (ZPP) tests are commonly used to screen for iron deficiency, but little research has been done to systematically evaluate the sensitivity and specificity of these two tests. The goal of this study was to evaluate the effectiveness of zinc protoporphyrin/heme (ZPP/H) ratio as a point-of-service screening test for iron deficiency among preschool-aged children by comparing the sensitivity and specificity of hemoglobin, ZPP/H ratio, and serum ferritin (SF). Also completed were assessments for the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) with indicators of ferritin models. This study was carried out with 95 children ages 3 to 6 y. Anthropometric measurements were assessed, and blood samples were analyzed for hemoglobin, SF, transferrin saturation (TS), and ZPP. Anemia was common and the prevalences of anemia, ID, and IDA were 14.7%, 12.6%, and 5.2%, respectively. The ZPP/H ratio was strongly and significantly correlated with hemoglobin. And ZPP/H ratio was a more sensitive test for ID than hemoglobin or SF measurement, correctly identifying more than twice as many iron-deficient children (sensitivity of 91.7%, compared to 41.7% for hemoglobin and SF). However, ZPP/H ratio had lower specificity (60.2%, compared to 89.1% for hemoglobin or 96.4% for SF) and resulted in the false identification of more subjects who actually were not iron deficient than did hemoglobin or SF. Low hemoglobin concentration is a late-stage indicator of ID, but ZPP/H ratio can detect ID at early stages and can be performed easily at a relatively low cost. Therefore, ZPP/H ratio can serve as a potential screening test for pre-anemic iron deficiency in community pediatric practices.
Anemia ; Anemia, Iron-Deficiency ; Child ; Child, Preschool ; Ferritins ; Hemoglobins ; Humans ; Iron ; Mass Screening ; Prevalence ; Protoporphyrins ; Sensitivity and Specificity ; Transferrin ; Zinc