Changes of serum trace elements in early stage trauma and its correlation with injury severity score

Chen, Kaihong; Lv, Jidong; Wang, Guanghuan; Yu, Xiaojun; Xu, Xiaoling; Zhu, Guanbao; Shao, Zhuying; Wang, Dian; Chang, Tang; Cai, Shanqing

doi:10.1097/md.0000000000010077

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…33,34 Beyond increases in general metabolic rate and energy expenditure, fracture induces changes in micronutrient metabolism that appear to be driven by an increased demand to facilitate callus formation and mineralization. This reactive response to fracture leads to decreased serum copper, 35,36 cobalt, 35,36 iron, 35,36 vitamin D, 37,38 and zinc, 35,36,[39][40][41] with the latter two accumulating in fracture tissue. Calcium metabolism is also perturbed, where it is mobilized from the intact skeleton through the concerted actions of the parathyroid hormone and the systemic inflammatory response to fracture.…”

Section: Metabolic Response To Fracturementioning

confidence: 99%

Advances and Promises of Nutritional Influences on Natural Bone Repair

Roberts

Drissi

2019

Journal Orthopaedic Research

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Impaired fracture healing continues to be a significant public health issue. This is more frequently observed in aging populations and patients with co‐morbidities that can directly influence bone repair. Tremendous progress has been made in the development of biologics to enhance and accelerate the healing process; however, side‐effects persist that can cause significant discomfort and tissue damage. This has been the impetus for the development of safe and natural strategies to hasten natural bone healing. Of the many possible approaches, nutrition represents a safe, affordable, and non‐invasive strategy to positively influence each phase of fracture repair. However, our understanding of how healing can be hindered by malnutrition or enhanced with nutritional supplementation has lagged behind the advancements in both surgical management and the knowledge of molecular and cellular drivers of skeletal fracture repair. This review serves to bridge this knowledge gap as well as define the importance of nutrition during fracture healing. The extant literature clearly indicates that pre‐existing nutritional deficiencies should be corrected, and nutritional status should be carefully monitored to prevent the development of malnutrition for the best possible healing outcome. It remains unclear, however, whether the provision of nutrients beyond sufficiency has any benefit on fracture repair and patient outcomes. The combined body of pre‐clinical studies using a variety of animal models suggests a promising role of nutrition as an adjuvant therapy to facilitate fracture repair, but extensive research is needed, specifically at the clinical level, to clarify the utility of nutritional interventions in orthopedics. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:695‐707, 2020

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Section: Metabolic Response To Fracturementioning

confidence: 99%

Advances and Promises of Nutritional Influences on Natural Bone Repair

Roberts

Drissi

2019

Journal Orthopaedic Research

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“…Our result has a similar trend compared to other studies reporting that circulating TEs such as Cu, Se, and Fe are dramatically decreased in response to trauma in the early stage. [ 17 ]…”

Section: Discussionmentioning

confidence: 99%

“…Our result has a similar trend compared to other studies reporting that circulating TEs such as Cu, Se, and Fe are dramatically decreased in response to trauma in the early stage. [17] The bone is the main storage site for Ca and Mg ions in the mammalian body. Bone fractures, especially when treated surgically, are associated with changes in the homeostasis of TEs.…”

Section: Discussionmentioning

confidence: 99%

Effect of calcium and magnesium on inflammatory cytokines in accidentally multiple fracture adults

Song

Jin

et al. 2022

Medicine

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Calcium (Ca) and magnesium (Mg), which play an important role in several cellular processes, is essential for normal development of the skeleton and maintenance of tissue homeostasis. Deficiency of these elements might delay bone fracture recovery or accelerates bone loss. We aimed to examine whether supplementation of trace element (TE) promotes fracture healing in accidentally fracturing adults by involvement of inflammatory mechanism. A short-term follow-up in clinic was performed. Totally, 117 subjects diagnosed with multiple fractures by traffic accidents were recruited in this study. Serum Ca and Mg levels were measured by inductively coupled plasma atomic emission spectrophotometry. Short-term changes such as serum C-reactive protein, interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha in normal treatment and TE supplement groups were detected by enzyme-linked immunosorbent assay. Student t test and the Spearman correlation were performed to analyze the data. Significantly negative correlations between Ca ( r = 0.7032; P < .001) and Mg ( r = 0.2719; P < .05) and injury severity score were observed. Serum Ca and Mg were significantly increased at Day 5, 7, and 9 following TE supplements. After treatment, serum C-reactive protein, IL-1β, IL-6, and tumor necrosis factor alpha were significantly reduced whereas cytokine levels of the TE supplement group were found to be lower than that of the normal treatment group after Day 3. These findings suggest that Ca and Mg levels are associated with the injury severity of multiple fractures, and the supplement could reduce the inflammation, which may be beneficial for the bone recovery and disease process.

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“…Early negative Zn balance has been frequently observed in patients with trauma. [6][7][8][9] The increased loss could be related to hemorrhage, body fluid loss, excessive urine secretion, catabolism, decreased plasma carrier proteins, or medications. 10,11 Zn depletion alters the clearance of free radicals and results in cell damage.…”

Section: Introductionmentioning

confidence: 99%

Effect of zinc supplement on patients with trauma: A systematic review and meta‐analysis

Huang

Chan

et al. 2023

J Parenter Enteral Nutr

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Aims: This study aimed to assess the effect of zinc supplementation, with or without other antioxidants and trace elements, on clinical outcomes in patients with trauma.Methods: A systematic review was conducted for adult patients with acute trauma who had been admitted to the hospital. Those who sustained burn injuries were excluded. Studies in PubMed, Web of Science, and Embase from 1990 to 2022 regarding the additional nutrition supplementation of zinc to patients, either in a single-agent or combined regimen, were included. Comparisons were made between the zinc supplement group and those who received a placebo or regular treatment. Results:The primary outcomes of the study were mortality rate, length of hospital stay, and incidence of pneumonia. Seven studies qualified for the meta-analysis. Of the 594 patients eligible for analysis, 290 and 304 were in the zinc supplementation and control groups, respectively. The meta-analysis revealed that zinc supplementation was associated with a lower risk of pneumonia in patients with acute trauma than in the control group (odds ratio [OR], 0.506; 95% CI = 0.292-0.877; P = 0.015; heterogeneity, I 2 = 12.7%). Zinc supplementation did not influence the mortality rate (OR, 0.755; 95% CI = 0.492-1.16; P = 0.612; heterogeneity, I 2 = 0%) or the length of hospital stay (standard difference in means, −0.24; 95% CI = −0.544 to 0.063; P = 0.121; heterogeneity, I 2 = 45.0%). Conclusion:Zinc supplementation, with or without other antioxidants and trace elements, in patients with trauma was associated with a lower incidence of pneumonia.

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Changes of serum trace elements in early stage trauma and its correlation with injury severity score

Cited by 5 publications

References 24 publications

Advances and Promises of Nutritional Influences on Natural Bone Repair

Advances and Promises of Nutritional Influences on Natural Bone Repair

Effect of calcium and magnesium on inflammatory cytokines in accidentally multiple fracture adults

Effect of zinc supplement on patients with trauma: A systematic review and meta‐analysis

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