Serial Iron, Zinc and Copper Status in Adults with Pulmonary Tuberculosis in the Country of Georgia

Abstract

ObjectiveTo determine serial dietary intake and serum concentrations of immune‐related micronutrients in patients with TB disease.Methods: Estimated mean daily intake of iron (Fe), zinc (Zn), and copper (Cu) was determined in 192 adults with pulmonary TB within 7 days of diagnosis and at 16 weeks using a validated instrument and NDS‐R. Serum levels of Fe, Zn and Cu were determined by inductively coupled argon plasma spectrometry at baseline and week 16.Results: Mean subject age was 34 y and 64% were male. Serum Fe levels were below normal in 25% at baseline (24±20 umol/L), and rose significantly by week 16 [to 26±15 umol/L (P< 0.01)]. Mean dietary Fe intake at baseline and week 16 was adequate. Serum Zn levels were below normal in 35% at baseline (11.6±2.8 umol/L) and 26% at week 16 (12.2±3.2 umol/L). Mean dietary Zn intake at baseline was 11.7±5.0 mg/day (121% of RDA)] and decreased at wk 16 (to 10±3.5 mg/day;P=0.03). Serum Cu levels were normal at baseline (26.5±0.6 umol/L) and fell significantly by week 16 to 20.5±0.5 umol/L (P<0.01). Mean dietary Cu intake at baseline and week 16 was adequate.ConclusionA significant proportion of adults with newly diagnosed TB exhibited low Fe and Zn levels, while Cu levels decreased over time. Changes during treatment may reflect diet intake, decreased inflammation and endogenous anti‐microbial processes.