Administration of zinc to preterm infants with hypozincemia does not reduce serum copper concentrations in most cases: a single-center retrospective observational study

Background Zinc is an essential trace element involved in various physiological functions. In Japan, zinc acetate dihydrate is administered to neonates and infants with hypozincemia. Since serum copper concentrations are reduced by the administration of zinc, we retrospectively investigated changes in serum zinc and copper concentrations in preterm infants with hypozincemia receiving zinc acetate dihydrate. Methods Sixty-three preterm infants were included in the present study. Serum zinc and copper concentrations, doses, and other clinical characteristics were retrieved from electronic medical records. Results The medians and interquartile ranges of the dosage and duration of zinc acetate dihydrate were 2.1 (1.8–2.5) mg/kg/day and 12.0 (10.0–13.0) days, respectively. Its administration increased serum zinc concentrations in 39 patients (61.9%) and to more than 70 μg/dL in 16 patients (25.4%). The group with a serum zinc concentration of 70 μg/dL or higher after administration had a significantly higher zinc dose of 2.5 mg/kg/day than the group with a serum zinc concentration of less than 70 μg/dL. Serum copper concentrations did not decrease in 44 patients (69.8%). In the group with a decreased serum copper concentration, postmenstrual age and body weight were significantly lower, while serum zinc concentrations were significantly higher at the start of administration. Conclusion The present results showed that when zinc acetate dihydrate was administered to preterm infants with hypozincemia, it was possible to increase serum zinc concentrations without decreasing serum copper concentrations in many cases. However, caution may be required when administering zinc to preterm infants with a lower postmenstrual age or milder hypozincemia because serum copper concentrations may decrease.

Serum zinc status in thalassemic adolescents attending Yangon Children Hospital, Myanmar

Background: Thalassemia constitutes a major public health problem causing a significant burden on children and their families. Zinc deficiency plays an important role in many thalassemia-related complications like growth retardation, hypogonadism and delayed puberty which are frequently noted in adolescent age. Although zinc is supplemented to thalassemic patients visiting Day Care Center, Yangon Children Hospital (YCH), Myanmar, a report concerning serum zinc level of these patients is still lacking. This study, therefore, aimed to assess serum zinc status in thalassemic adolescents attending Day Care Center, YCH. Materials and Methods: This hospital-based cross-sectional study was conducted on 99 thalassemic adolescents. Mean age of diagnosis was 5.1±2.1 years. Non-fasting serum zinc concentration was determined by atomic absorption spectrophotometry. According to National Health and Nutrition Examination Survey data, zinc deficiency was defined as serum zinc concentration < 66 μg/dL (female) and < 70 μg/dL (male). Results: Serum zinc concentration (μg/dL) was 57.35 (47.30-80.14) (median, interquartile range) with maximum, 195.05 and minimum, 28.83. Zinc deficiency was observed in 69.7% (69 out of 99; 35 males and 34 females) of the patients. The associations of zinc deficiency with gender, phenotype and the use of chelator were non-significant (P>0.05). Conclusion: In spite of zinc supplementation, nearly 70% of the thalassemic adolescents showed zinc deficiency. Zinc deficiency in these adolescents might not be related to gender, phenotypes or the use of chelator. Poor compliance to take zinc supplementation and/or irregular blood transfusion could partly be attributable to zinc deficiency in these adolescents. Providing health education on the importance of regular intake of adequate zinc is advisable and periodic evaluation of zinc levels is recommended for thalassemic adolescents.