The Effect of Zinc Supplements in Cystic Fibrosis Patients

Biervliet, Stéphanie Van; Velde, Saskia Vande; Biervliet, J.P. Van; Robberecht, Eddy

doi:10.1159/000129650

Cited by 36 publications

(42 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Growth faltering observed in older children with cystic fibrosis (CF) is undoubtedly multifactorial, including malnutrition, but in one report, older children's total zinc intake and zinc status were adequate and unrelated to growth status [50]. In contrast, in another retrospective chart review, high-dose (5 mg zinc/kg/day) supplementation was associated with beneficial effects on growth and pulmonary function [51]. However, no controlled trials are available that replicate these effects.…”

Section: Acquired Zinc Deficiencymentioning

confidence: 99%

Update on Zinc Deficiency and Excess in Clinical Pediatric Practice

Krebs¹

2013

Ann Nutr Metab

View full text Add to dashboard Cite

The critical importance of adequate zinc status to human health, including normal growth and development, is indisputable. The high prevalence of zinc deficiency on a global basis and its importance to public health have been well documented through large-scale randomized controlled zinc supplementation trials. Similar evidence in the clinical setting, however, is much less widely available due to the nonspecific features of zinc deficiency and to the lack of sensitive biomarkers to detect zinc deficiency, especially that of a mild degree of severity. The current understanding of zinc homeostasis indicates that the primary determinants of zinc absorption are the amount of zinc ingested and dietary phytate, the latter having a major effect on zinc bioavailability. In normal as well as in many pathologic conditions, the gastrointestinal tract is the major site of zinc losses resulting from secretion of endogenous zinc into the lumen and subsequent excretion in the feces. The amount excreted is dependent on host status, the amount reabsorbed, and sometimes the presence of pathophysiologic conditions, including diarrhea and steatorrhea. Assessment in the clinical setting dictates that the clinician obtain a careful medical and diet history, recognize clinical presentations in which zinc adequacy may be compromised, and link this risk with nonspecific but plausible manifestations of deficiency. Examples discussed in this article include primary zinc deficiency due to dietary inadequacy (older breastfed infants or toddlers without zinc-rich complementary foods); genetically based deficiency (acrodermatitis enteropathica, acquired zinc deficiency of lactogenic origin), and acquired secondary deficiency in low birth weight and prematurity, gastrointestinal and hepatic disease, and cystic fibrosis. Evidence for efficacy of zinc therapy with pharmacologic doses for two conditions, Wilson's disease and viral upper respiratory infections, is also discussed.

show abstract

Section: Acquired Zinc Deficiencymentioning

confidence: 99%

Update on Zinc Deficiency and Excess in Clinical Pediatric Practice

Krebs¹

2013

Ann Nutr Metab

View full text Add to dashboard Cite

show abstract

“…Reduced levels of plasma interleukin-6 and interleukin-8 were also documented. 7 In a retrospective review of 21 subjects, Van Biervliet et al 6 reported a decrease in pulmonary exacerbations, from 3 to 2 (P Ͻ .02), as well as an increase in the FEV 1 from 72.0 to 76.5% (P Ͻ .02). They also observed an improvement in weight for height, from 90 to 94% (P ϭ .043).…”

Section: Discussionmentioning

confidence: 98%

“…18,19 Data on zinc supplementation among children with cystic fibrosis are limited to 4 studies. [6][7][8][9] Safai-Kutti et al, 9 in their placebo-controlled double-blind crossover study in children with cystic fibrosis (N ϭ 13, age 2 y, 3 months to 19 y, 1 month), gave zinc supplementation and placebo to the subjects for 6 months. They observed that all subjects had low plasma zinc levels at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…The median age of the study subjects was 8.9 y, and they received zinc sulfate in doses of 5 mg/kg (maximum 150 mg). 6 Ataee et al 8 studied 30 children with cystic fibrosis (mean age: 8.65 Ϯ 3.01 y), who were administered zinc at a dosage of 2 mg/kg/d for 6 months, along with standard therapy. They measured the subjects' clinical parameters before and after the administration of zinc.…”

Section: Discussionmentioning

confidence: 99%

“…However, data on zinc supplementation among children with cystic fibrosis, although limited, suggest that the results of supplementation are variable in terms of improvement in pulmonary function test or reduction in the need for antibiotics. [6][7][8][9] Almost a quarter of adults with cystic fibrosis who had a good nutritional status had a low plasma zinc concentration, and those with a low plasma zinc concentration had a poor clinical outcome. 10 Zinc deficiency is widespread among Indian children.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Zinc Supplementation for One Year Among Children with Cystic Fibrosis Does Not Decrease Pulmonary Infection

Sharma¹,

Lodha²,

Shastri³

et al. 2015

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Children with cystic fibrosis may have a deficiency of micronutrients, including zinc, which may affect their susceptibility to infections. There is a paucity of data on zinc supplementation among children with cystic fibrosis. We hypothesized that a pharmacologic dose of zinc administered daily for 12 months would reduce the need for antibiotics by 50%. METHODS: This double-blind randomized placebo-controlled trial was conducted among children with cystic fibrosis to assess the effect of zinc supplementation on the need for antibiotics and pulmonary function tests. The children, age 5-15 y, of either sex, received either 30-mg zinc tablets or similar looking placebo tablets daily in addition to standard care. They were followed up every month for a period of 12 months and whenever they had pulmonary exacerbations. Their serum zinc was estimated at baseline and at 12 months of enrollment. During each visit, the children underwent a pulmonary function test and sputum culture. RESULTS: Of a total of 43 children screened, 40 were enrolled, and of them, 37 completed the study. The median (interquartile range) number of days of the administration of antibiotics over 12 months of follow-up among the children receiving zinc was 42 (14 -97) d. In the placebo group, it was 38 (15-70) d (P ‫؍‬ .79). There were no significant differences in the percent-of-predicted FEV 1 or change in FEV 1 values at 12 months (P ‫؍‬ .44). The number of children in whose respiratory specimens Pseudomonas was isolated was similar for the 2 groups at different time intervals. The adverse events reported were similar in the 2 groups. CONCLUSION: We did not find any significant difference in the need for antibiotics, pulmonary function tests, hospitalization, colonization with Pseudomonas, or the need for antibiotics for children with cystic fibrosis receiving zinc supplementation of 30 mg/d.

show abstract