Zinc Nutritional Status in Patients with Cystic Fibrosis

Abstract

Background: Zinc is an essential nutrient for all forms of life and its deficiency affects the normal growth and development of human beings. Objective: The main aim was to investigate zinc nutritional status by serum zinc concentration (SZC) and dietary zinc intake and their association in cystic fibrosis (CF) patients. Methods: A cross-sectional study was conducted in CF patients. Anthropometric measurements and respiratory and pancreatic tests were conducted. Hypozincemia was determined by SZC while using atomic absorption spectrophotometry and dietary zinc deficiency by prospective 72-h dietary surveys. Results: Mean SZC (87.2 ± 16.7 μg/dL) and dietary zinc intake (97 ± 26.9% Dietary Reference Intake) were normal. Three of 17 patients with CF (17.6%) had hypozincemia and four (23.5%) had a dietary zinc deficiency. No patient with dietary zinc deficiency had hypozincemia. A positive and significant association was observed between SZC and Z-score of BMI-for-age (p = 0.048) and weight-for-height (p = 0.012) and between dietary zinc intake and energy intake (EI, p = 0.036) and Z-score of weight-for-high (p = 0.029). Conclusion: SZC was associated with the nutritional status, expressed as BMI (Body Mass Index) and weight-for-height Z score, and dietary zinc intake with EI and weight-for-height Z-score. No patient with hypozincemia had dietary zinc deficiency. This situation should alert us to a marginal zinc deficiency and it may explain why there were no overlapping cases between the two groups. We suggest that probably 41% of the cases in this study would be at elevated risk of zinc deficiency and a zinc supplementation may be considered.

Copper and Copper/Zinc Ratio in a Series of Cystic Fibrosis Patients

“…Detailed study methods regarding assessing zinc nutritional status in this series are reported elsewhere. Briefly, this nutritional study included an assessment of phenotypic characteristics, a blood test, a dietary survey, and a specific assessment of respiratory and pancreatic functions [30]. Figure 1 shows the flowchart of this cross-sectional study.…”

“…Figure 1 shows the flowchart of this cross-sectional study. In this series, the genotype of the participants, as well as the Norman-Crispin score (>5), the forced vital capacity (FVC% < 80%) and the forced expired volume in 1 s (FEV1 < 80%) to estimate respiratory sufficiency (SR) and insufficiency (IR), and the fat absorption coefficient (CFA > 94%) to evaluate pancreatic sufficiency (PS) and insufficiency (PI) were studied and published [30]. An abdominal ultrasound was taken to assess the digestive tract status.…”

“…In addition to the evaluation of weight (W) and height (H), BMI, BMI-height-age, and their corresponding indicators, Z-score, and growth rate were measured [30][31][32]. The circumference of the wrist, hip, waist, mid-arm, triceps, biceps, and subscapular and suprailiac folds (Holtain skinfold gauge, pressure 10 g/mm 3 ) were measured to obtain the waist-hip ratio, waist-height index, muscular area of the middle of the arm (MAMA), fat-free mass (FFM), and fat mass (FM).…”

“…Therefore, the main objective of this study was to investigate the serum copper levels, the copper/zinc ratio, and its relationship with nutritional indicators in a group of patients with cystic fibrosis. The nutritional status of zinc in this group has already been published [30].…”

Zinc status in infants and children with cholestatic liver diseases and its effect on growth

“…Zinc deficiency in infants and children has been known to cause malabsorption and loss of appetite (Monge et al, 2019). In addition, it leads to dry skin, , 2004).…”