Zinc Pharmacotherapy for Elderly Osteoporotic Patients with Zinc Deficiency in a Clinical Setting

Although there have been reported associations between zinc and bone mineral density (BMD), no reports exist on the effect of zinc treatment in osteoporotic patients. Therefore, we investigated the efficacy and safety of zinc pharmacotherapy in Japanese elderly patients. The present investigation included 122 osteoporotic patients with zinc deficiency, aged ≥65 years, who completed 12 months of follow-up. In addition to standard therapy for osteoporosis in a clinical setting, the subjects received oral administration of 25 mg zinc (NOBELZIN®, an only approved drug for zinc deficiency in Japan) twice a day. BMD and laboratory data including bone turnover markers were collected at 0 (baseline), 6, and 12 months of zinc treatment. Neither serious adverse effects nor incident fractures were seen during the observation period. Serum zinc levels were successfully elevated by zinc administration. BMD increased significantly from baseline at 6 and 12 months of zinc treatment. Percentage changes of serum zinc showed significantly positive associations with those of BMD. Bone formation markers rose markedly from the baseline values, whereas bone resorption markers displayed moderate or no characteristic changes. Additive zinc supplementation may contribute to BMD augmentation ensuing the prevention of fracture occurrence in elderly osteoporotic patients with zinc deficiency.

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Dysgeusia Due to Zinc Deficiency After Pancreaticoduodenectomy Requiring Continuous Intravenous Zinc Supplementation: a Case Report and Literature Review

10.21203/rs.3.rs-957498/v1 ◽

2021 ◽

Author(s):

Hironobu Hata ◽

Yojiro Ota ◽

Katsuhiko Uesaka ◽

Yutaka Yamazaki ◽

Tsubasa Murata ◽

...

Keyword(s):

Zinc Deficiency ◽

Oral Surgery ◽

Oral Care ◽

Serum Zinc ◽

Zinc Level ◽

Normal Serum ◽

Acrodermatitis Enteropathica ◽

Proximal Jejunum ◽

Zinc Levels ◽

Serum Zinc Levels

Abstract Background: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies regarding the development of zinc deficiency after PD and presented the case of a patient with zinc deficiency after PD, who required home intravenous zinc replacement.Case presentation: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously under readmission. Her serum zinc levels recovered, and the lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.Conclusion: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of dysgeusia associated with zinc deficiency after cancer surgery, as well as that induced by chemotherapy or head and neck radiation therapy.

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Zinc Intake, Zinc Serum Levels, and Intelligence in School Children in Rural Areas

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5869 ◽

2021 ◽

Vol 9 (E) ◽

pp. 394-397

Author(s):

Rostika Flora ◽

Nur Alam Fajar ◽

Fatmalina Febri ◽

Indah Yuliana ◽

Yuliarti Yuliarti ◽

...

Keyword(s):

Zinc Deficiency ◽

School Children ◽

Significant Relationship ◽

Rural Areas ◽

Serum Zinc ◽

Zinc Intake ◽

Serum Zn ◽

Zinc Levels ◽

Serum Zinc Levels ◽

Low Serum

BACKGROUND: Children in rural areas are susceptible to zinc deficiency. Zinc deficiency in children can affect cognitive function in children. Zinc plays a role in cellular function and critical brain growth processes, including cell replication, DNA and RNA synthesis, and the release of neurotransmitters. AIM: This study aimed to analyze the condition of zinc deficiency and its relationship with the level of intelligence in children in rural areas. METHODS: The study design was cross-sectional, with a sample of 44 elementary school children aged 9–12 years taken randomly. Blood was drawn to measure serum Zn-levels, and serum Zn-levels were measured using Colorimetric Assay Kit (E-BC-K137). Zinc intake data were obtained from the food recall form, which was carried out 3 × 24 h. The level of intelligence is measured by the Culture Fair Intelligence Test method. The sample characteristics data obtained through a questionnaire. Furthermore, the data were analyzed using the Chi-square test. RESULTS: About 84.2% of children with insufficient zinc intake had low serum Zn-levels. There was a significant relationship between zinc intake and serum zinc levels (p = 0.026; PR = 4.293). Children with low serum zinc levels of 96.5% have intelligence levels below average. There was a significant relationship between serum zinc levels and intelligence level as well (p = 0.001; PR = 24,500). CONCLUSION: Zinc deficiency in children is characterized by low serum Zn-levels. Low serum Zn-level is caused by low zinc intake, thus children with low serum Zn-levels are at risk of having intelligence level below average. Therefore, health education about the importance of zinc intake in children should be given to parents, so that the incidence of zinc deficiency in children can be reduced.

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Zinc deficiency in Japanese children with idiopathic short stature

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0129 ◽

2019 ◽

Vol 32 (10) ◽

pp. 1083-1087 ◽

Cited By ~ 2

Author(s):

Kei Yoshida ◽

Tatsuhiko Urakami ◽

Remi Kuwabara ◽

Ichiro Morioka

Keyword(s):

Short Stature ◽

Zinc Deficiency ◽

Serum Insulin ◽

Serum Zinc ◽

Zinc Level ◽

Idiopathic Short Stature ◽

Japanese Children ◽

The Mean ◽

Zinc Levels ◽

Serum Zinc Levels

Abstract Background and methods We investigated the frequency of zinc deficiency in Japanese children with idiopathic short stature, and evaluated whether serum zinc levels correlated with background factors, including age and standard deviation scores (SDSs) for height and serum insulin-like growth factor (IGF)-1 levels. The study subjects consisted of 89 Japanese children. Results The mean serum zinc level was 79 ± 12 (49–108) μg/dL. Of all the children, 48.3% had a low zinc level, in the 60–80 μg/dL range, and 6.7% had zinc deficiency with a zinc level below 60 μg/dL. The majority with a low zinc level and zinc deficiency were asymptomatic other than for short stature. We found no significant correlations of serum zinc with age, or the SDSs for height and serum IGF-1 levels, in either the entire subject population or those with a zinc level below 80 μg/dL. Conclusions We found a low zinc level to be common in Japanese children with idiopathic short stature, whereas actual zinc deficiency was rare. However, other as yet unknown mechanisms not associated with the growth hormone (GH)-IGF-1 axis could be involved in growth retardation in idiopathic short stature.

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CARBONIC ANHYDRASE ACTIVITY AND ZINC DEFICIENCY

International Journal of PIXE ◽

10.1142/s0129083597000072 ◽

1997 ◽

Vol 07 (01n02) ◽

pp. 49-52

Author(s):

TOSHIRO KUMAKAWA ◽

TAKAHITO KONDO

Keyword(s):

Zinc Deficiency ◽

Specific Activity ◽

Laboratory Data ◽

Serum Zinc ◽

Carbonic Anhydrase Activity ◽

Zinc Level ◽

Sweat Glands ◽

Acrodermatitis Enteropathica ◽

Normal Range ◽

Serum Zinc Level

A 60-year-old female was hospitalized because of anemia, edema, and diarrhea. She was diagnosed as having short bowel syndrome. The patient developed acrodermatitis enteropathica and taste impairment. Laboratory data showed that the serum zinc level was 21 μ g/dl and erythrocyte CAI specific activity was 0 units/mg isozyme (normal range 0.37 ± 0.08 units/mg isozyme) and CAII specific activity was 2.99 units/mg isozyme (normal range 3.02 ± 0.05 units/mg isozyme). The patient was diagnosed as being in a zinc deficient status. Zinc supplementation resulted in the disappearance of these complications. The serum zinc level reached 50 μ g/dl and erythrocyte CAI specific activity was recovered to 0.26 units/mg isozyme and CAII specific activity was 1.60 units/mg isozyme. CAI is found in gastrointestinal epithelial cells, in vascular epithelium, corneal, lens, ciliary body epithelium, and in sweat glands. CAII is found in virtually all tissues and is especially abundant in secretory and absorbing epithelia. The tissue distribution of CAI corresponds to clinical and physiologic indicators of zinc deficiency. Thus, the erythrocyte CAI specific activity may reflect the actual tissue zinc deficiency status.

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Correlation between Serum Zinc Levels and Levodopa in Parkinson’s Disease

Nutrients ◽

10.3390/nu13114114 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4114

Author(s):

Hirofumi Matsuyama ◽

Keita Matsuura ◽

Hidehiro Ishikawa ◽

Yoshinori Hirata ◽

Natsuko Kato ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Zinc Deficiency ◽

Clinical Symptoms ◽

Psychiatric Symptoms ◽

Serum Zinc ◽

Dosing Frequency ◽

The Mean ◽

Zinc Levels ◽

Serum Zinc Levels

Long-term intake of potential zinc-chelating drugs may cause zinc deficiency. We postulated that zinc deficiency in Parkinson’s disease (PD) patients was related to the intake of drugs such as levodopa. We investigated the relationship between zinc levels and levodopa administration period, dosage, and symptoms of zinc deficiency in PD patients. We measured serum zinc levels and analyzed correlations between serum zinc levels, the levodopa oral administration period, dosage, dosing frequency, and zinc deficiency symptoms including taste disorders. Data analyses were performed using Spearman’s rank correlation coefficient. The mean serum zinc level was 60.5 ± 11.6 μg/dL. The mean administration period for levodopa was 8.0 ± 5.5 years, mean administration frequency 3.4 ± 0.9 times/d, and mean administration dose 420.6 ± 237.1 mg/d. Negative correlations between zinc levels and levodopa dosage and dosing frequency were found. Multiple regression analysis showed a significant correlation with the frequency of levodopa (β = −0.360, p = 0.007). No significant change in clinical symptoms was observed after zinc administration, but anxiety tended to improve. Our results indicated that frequent levodopa administration strongly influenced serum zinc levels which may have alleviating effects on psychiatric symptoms; therefore, preventing zinc deficiency can be important during PD treatment.

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Comparison of maternal serum and neonatal cord blood levels of zinc in relation to birth weight and period of gestation

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212880 ◽

2021 ◽

Vol 8 (8) ◽

pp. 1349

Author(s):

Shabbeer Ahmed ◽

Avula Kanthi Sagar

Keyword(s):

Birth Weight ◽

Cord Blood ◽

Zinc Deficiency ◽

Serum Zinc ◽

Maternal Serum ◽

Blood Levels ◽

P Value ◽

Zinc Levels ◽

Blood Zinc ◽

Serum Zinc Levels

Background: Women are at increased risk of zinc deficiency during pregnancy because of high fetal requirements for zinc. Severe maternal zinc deficiency has been associated with poor fetal growth, spontaneous abortion and congenital malformations (i.e., anencephaly), whereas milder forms of zinc deficiency have been associated with low birth weight (LBW), intrauterine growth retardation, and preterm delivery. However, the research relating maternal zinc status and birth weight has not produced consistent results. This study has been undertaken to confirm the association between maternal serum zinc concentration and birth weight and period of gestation in setting like India.Methods: A total of 100 new-borns were included and divided into two groups, the ‘study group’ had babies with birth weight <2.5 kg and control group’ with babies >2.5 kg birth weight. Cord blood from the new-borns and serum samples of mothers were collected and the zinc levels were measured.Results: The correlation of cord blood and the maternal serum zinc levels were assessed in relation to birth weight and the gestational age. The results were compared between the two groups. The difference in values between the two groups was statistically significant, maternal serum zinc levels and birth weight (84.78±21.62 vs 66.04±18.66) (‘P’ value 0.04), cord blood zinc levels and birth weight (98.44±22.59 vs 79.78±19.54) (‘P’ value <0.001). The maternal serum and cord blood zinc was compared between the preterm and term; the results were statistically significant.Conclusions: The maternal and cord blood levels of zinc are correlated well with the birth weight and the gestational age at delivery. Supplementation of zinc during gestation might help reduce the incidence of IUGR and the risk of prematurity.

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Serum zinc levels and efficacy of zinc treatment in acne vulgaris: A systematic review and meta‐analysis

Dermatologic Therapy ◽

10.1111/dth.14252 ◽

2020 ◽

Vol 33 (6) ◽

Author(s):

Brittany E. Yee ◽

Phillip Richards ◽

Jennifer Y. Sui ◽

Amanda Fleming Marsch

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Acne Vulgaris ◽

Serum Zinc ◽

Zinc Treatment ◽

Zinc Levels ◽

Serum Zinc Levels

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Prevalence of Zinc Deficiency in Japanese Patients on Peritoneal Dialysis: Comparative Study in Patients on Hemodialysis

Nutrients ◽

10.3390/nu12030764 ◽

2020 ◽

Vol 12 (3) ◽

pp. 764 ◽

Cited By ~ 1

Author(s):

Satoshi Shimizu ◽

Ritsukou Tei ◽

Masahiro Okamura ◽

Nobuteru Takao ◽

Yoshihiro Nakamura ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Zinc Deficiency ◽

Serum Albumin Level ◽

Serum Zinc ◽

Japanese Patients ◽

Zinc Level ◽

Albumin Level ◽

Zinc Levels ◽

Inadequate Dietary Intake ◽

Serum Zinc Levels

Background: It is known that patients on hemodialysis (HD) are prone to developing zinc deficiency due to removal of zinc by HD, inadequate dietary intake, and reduced gastrointestinal zinc absorption. However, the prevalence of zinc deficiency in patients on peritoneal dialysis (PD) has not been well established. Methods: Serum zinc levels were compared between 47 patients on PD and 47 patients on HD matched for age, sex, and duration of dialysis. A serum zinc level < 60 μg/dL was defined as clinical zinc deficiency and a level of 60–80 μg/dL as subclinical zinc deficiency. The prevalence of zinc deficiency and associated clinical factors were determined in both groups. Results: Clinical zinc deficiency was found in 59.6% of the PD group and 70.2% of the HD group (p = 0.391). Subclinical zinc deficiency was found in 40.4% of the PD group and 29.8% of the HD group. Age, body mass index, and serum albumin level were identified as independent predictors of zinc deficiency in the PD group by multivariate analysis. Conclusions: A higher prevalence of clinical and subclinical zinc deficiency was found in patients on PD. The rates were comparable between patients on PD and those on HD after adjustment for confounding factors.

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Biochemical Bone Turnover Markers and Osteoporosis in Older Men: Where Are We?

Journal of Osteoporosis ◽

10.4061/2011/704015 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 11

Author(s):

Pawel Szulc

Keyword(s):

Bone Resorption ◽

Bone Formation ◽

Bone Turnover ◽

Bone Turnover Markers ◽

Fragility Fractures ◽

Older Men ◽

Testosterone Replacement Therapy ◽

Mineral Density ◽

Bone Formation Markers ◽

Turnover Markers

In men aged less than 60, the association of serum and urinary levels of biochemical bone turnover markers (BTMs) and bone mineral density (BMD) is weak or not significant. After this age, higher BTM levels are correlated weakly, but significantly, with lower BMD and faster bone loss. Limited data from the cohort studies suggest that BTM measurement does not improve the prediction of fragility fractures in older men in comparison with age, BMD, history of falls and fragility fractures. Testosterone replacement therapy (TRT) decreases bone resorption. During TRT, bone formation markers slightly increase (direct effect on osteoblasts), then decrease (slowdown of bone turnover). Bisphosphonates (alendronate, risedronate, ibandronate, zoledronate) induce a rapid decrease in bone resorption followed by a milder decrease in bone formation. In men receiving antiresorptive therapy for prostate cancer, zoledronate, denosumab and toremifene decrease significantly levels of bone resorption and bone formation markers. Teriparatide induced a rapid increase in serum concentrations of bone formation markers followed by an increase in bone resorption. We need more studies on the utility of BTM measurement for the improvement of the persistence and adherence to the anti-osteoporotic treatment in men.

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Transient symptomatic zinc deficiency in an exclusively breastfed infant

BMJ Case Reports ◽

10.1136/bcr-2021-241754 ◽

2021 ◽

Vol 14 (6) ◽

pp. e241754

Author(s):

Mafalda Crisóstomo ◽

Mafalda Casinhas Santos ◽

Ermelindo Tavares ◽

Florbela Cunha

Keyword(s):

Zinc Deficiency ◽

Serum Zinc ◽

Failure To Thrive ◽

Skin Lesions ◽

Normal Range ◽

The Face ◽

History Of ◽

Zinc Levels ◽

Nasolabial Folds ◽

Family Contact

A 3-month-old, full term female infant, adequate for gestational age, and exclusively breastfed, was admitted with a 10 day history of generalised scaling erythematous dermatitis, affecting the face (perinasal, nasolabial folds and periauricular), acral and intertriginous areas, with irritability and failure to thrive. Her mother had been treated with isoniazid since the third trimester because of family contact with tuberculosis. Based on a diagnosis of suspected impetiginised eczema, the infant was treated with flucloxacillin and prednisolone, and maternal isoniazid was suspended, with no improvement. Investigations found low serum zinc levels in the infant (33 μg/dL; normal range (NR) >60 μg/dL), normal plasma zinc levels in the mother (111.3 μg/dL; NR 68–120 μg/dL) and lower than the normal range of zinc levels in breast milk (270μg/L; NR 1000–2500 μg/L), suggesting acrodermatitis caused by zinc deficiency. Oral zinc supplementation (3 mg/kg/day) was started with a marked improvement in skin lesions, as well as good weight gain. At the age of 6 months, after food diversification, supplementation was suspended, without any recurrence of symptoms.

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