Zinc status and growth in infants and young children with cystic fibrosis

Abstract

Background: Zinc deficiency is associated with poor growth in children without cystic fibrosis (CF), but its impact on growth in children with CF is unknown.Objective: To determine the prevalence of low serum Zn (sZn) and its relationship with growth in the first 3 years of life in children with CF.Methods: We utilized data from infants with CF who were enrolled in a longitudinal study of nutrition and lung health and had sZn measured as part of clinical care.Cross-sectional correlations between sZn levels and growth z scores were assessed by Pearson's correlation coefficient. To identify factors associated with sZn status and its association to longitudinal growth patterns, multiple regression analysis with repeated measures were performed using generalized estimating equations.Results: A total of 106 sZn measurements from 53 infants were identified. Seventeen infants (32%) had intermittent Zn insufficiency, defined as at least one sZn <70 mcg/dl in their first 3 years of life. There were no significant cross-sectional associations between sZn and growth z scores. However, analysis of longitudinal growth patterns revealed that weight-and length-for-age z scores in children with intermittent Zn insufficiency were lower during early infancy and their weight-forlength z scores at age 3 years were also lower compared to those who were always Zn sufficient. Conclusion:Low sZn occurs in one-third of children with CF in the first 3 years of life. Cross-sectional and longitudinal analyses revealed discrepant associations between sZn and growth. Therefore, prospective studies are needed to understand the role of Zn in growth in CF.

Zinc Iodide Dimethyl Sulfoxide Reduces Collagen Deposition by Increased Matrix Metalloproteinase-2 Expression and Activity in Lung Fibroblasts

“…A similar correlation was observed in adult asthma patients [ 26 ]. In lung fibrotic diseases, low serum zinc levels were related to increased infection rate and reduced overall growth, but not to tissue remodeling [ 16 , 17 ]. The problem of linking zinc deficiency to tissue remodeling in chronic airway diseases lies in the fact that zinc is essential for the enzymatic function of many proteins [ 27 , 28 ].…”

“…Zinc is essential to the enzymatic activity of MMPs [ 11 ], and thus it is not surprising that zinc deficiency has been linked to fibrotic events in different organs including the lungs [ 12 , 13 , 14 , 15 ]. However, regarding fibrotic diseases of the lung, studies on the role of zinc deficiency or supplementation have been focused on its effect with regard to infection in cystic fibrosis [ 15 , 16 , 17 ]. Under experimental conditions, zinc deficiency increased inflammation and tissue remodeling in the lung [ 18 ].…”

The Role of Zinc in the Pathogenesis of Lung Disease

“…Several studies have shown a dysregulation of zinc levels (lower in blood and higher in sputum) in adults and children with CF [ 25 , 58 , 86 , 87 , 88 , 89 ]. In the first three years of life, low serum zinc contents were detected in one-third of children with CF [ 86 ].…”

“…Several studies have shown a dysregulation of zinc levels (lower in blood and higher in sputum) in adults and children with CF [ 25 , 58 , 86 , 87 , 88 , 89 ]. In the first three years of life, low serum zinc contents were detected in one-third of children with CF [ 86 ]. This study also found a discrepant link between growth and serum zinc in cross-sectional and longitudinal analyses; further study to better understand the role of zinc in growth in children with CF is warranted.…”

The Role of Zinc in Developed Countries in Pediatric Patients: A 360-Degree View

“…Assessing zinc status in patients with cystic fibrosis is essential because, as underlined by Damphousee et al almost 25% of adults affected by cystic fibrosis, despite having a satisfactory nutritional status, have low levels of zinc in plasma correlated with worse clinical outcomes [ 119 ]. Similarly, Bauer et al identified low serum zinc levels in one-third of children with cystic fibrosis in the first 3 years of life [ 120 ]. Another interesting topic concerns zinc supplementation in extremely low-birth-weight (ELBW) infants (<1000 g) with chronic lung disease (CLD).…”