A study of serum zinc levels in children admitted with pneumonia in a tertiary care hospital in India

Background: Worldwide, pneumonia is a leading cause of morbidity and mortality in children under 5 years of age; especially, in developing countries. Objectives: The objective of the study is to investigate whether zinc deficiency and other nutritional factors are related to pneumonia in children between 6 months and 5 years old. Methodology: In this casecontrol study, a valid written consent was obtained from mothers of enrolled children. The cases included 75 children fulfilling the World Health Organization criteria for pneumonia, between the age group of 6 months and 5 years. They were interrogated for potential nutritional risk factors as per a predesigned proforma followed by a measurement of serum zinc levels. In the control group, 75 children of the same age group who were siblings of admitted children were included along with other children of the same age group admitted for non-respiratory complaints. A detailed case history was obtained and physical examination was done according to a predesigned proforma to elicit various potential risk factors. A semi-auto analyzer was used to measure the serum zinc levels through colorimetric methods using 5-bromo-PAS. Results: Significant nutritional risk factors identified were low serum zinc level, malnutrition, and anemia. Conclusion: The present study has identified various nutritional risk factors for pneumonia which can be tackled through effective education of the community and appropriate initiatives.

HGCSG1902 Multicenter, Prospective, Observational Study of Chemotherapy-induced Dysgeusia in Gastrointestinal Cancer

PurposeDysgeusia is an adverse event caused by chemotherapy. Although retrospective studies have shown zinc administration improves dysgeusia, there have been no prospective studies. The present study examined effects of zinc therapy on dysgeusia in patients with gastrointestinal cancer.MethodsThis multicenter, prospective, observational study enrolled patients with dysgeusia during chemotherapy treatment. Patients received treatment of no intervention (control), polaprezinc p.o., or zinc acetate hydrate p.o. and serum zinc levels were measured at 0 (baseline), 6, and 12 weeks. Dysgeusia was assessed using CTCAE v5.0 and Subjective Total Taste Acuity (STTA) criteria using questionnaires at baseline and 12 weeks.ResultsFrom February 2020 to June 2021, 180 patients were enrolled from 17 institutes. There were no differences in mean serum zinc levels in each group at baseline (67.3, 66.6, and 67.5 μg/dL in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. P = 0.846) and the mean changes in serum zinc level in the three groups from baseline to after 12 weeks were −3.8, +14.3, and +46.6 μg/dl, respectively. The efficiency rates of dysgeusia were 33.3%, 36.8%, and 34.6% using CTCAE and 33.3%, 52.6%, 32.7% using STTA in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. The polaprezinc group showed a significantly improved STTA score compared with the no intervention group (P = 0.045).ConclusionThere was no significant correlation between the degree of serum zinc elevation and improvement in dysgeusia, suggesting that polaprezinc, but not zinc acetate hydrate, is effective in improving chemotherapy-induced dysgeusia.Trial registration number UMIN000039653. Date of registration, March 2, 2020.

Serum zinc levels and in vivo beta-amyloid deposition in the human brain

Background Despite the known associations between zinc levels and Alzheimer’s disease (AD) dementia and related cognitive impairment, the underlying neuropathological links remain poorly understood. We tested the hypothesis that serum zinc level is associated with cerebral beta-amyloid protein (Aβ) deposition. Additionally, we explored associations between serum zinc levels and other AD pathologies [i.e., tau deposition and AD-signature cerebral glucose metabolism (AD-CM)] and white matter hyperintensities (WMHs), which are measures of cerebrovascular injury. Methods A total of 241 cognitively normal older adults between 55 and 90 years of age were enrolled. All the participants underwent comprehensive clinical assessments, serum zinc level measurement, and multimodal brain imaging, including Pittsburgh compound B-positron emission tomography (PET), AV-1451 PET, fluorodeoxyglucose (FDG)-PET, and magnetic resonance imaging. Zinc levels were stratified into three categories: < 80 μg/dL (low), 80 to 90 μg/dL (medium), and > 90 μg/dL (high). Results A low serum zinc level was significantly associated with increased Aβ retention. In addition, apolipoprotein E ε4 allele (APOE4) status moderated the association: the relationship between low zinc level and Aβ retention was significant only in APOE4 carriers. Although a low zinc level appeared to reduce AD-CM, the relationship became insignificant on sensitivity analysis including only individuals with no nutritional deficiency. The serum zinc level was associated with neither tau deposition nor the WMH volume. Conclusions Our findings suggest that decreased serum zinc levels are associated with elevation of brain amyloid deposition. In terms of AD prevention, more attention needs to be paid to the role of zinc.

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

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.

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

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.

Serum Zinc Levels and Incidence of Ischemic Stroke: The Reasons for Geographic and Racial Differences in Stroke Study

Background and Purpose: Despite zinc’s role as an antioxidant and anti-inflammatory agent, prospective studies relating zinc levels to ischemic stroke risk are lacking. To examine the association between serum zinc levels and incidence of ischemic stroke in a US population. Methods: Using a case–cohort study nested within the Reasons for Geographic and Racial Differences in Stroke cohort, participants were randomly selected from the Reasons for Geographic and Racial Differences in Stroke cohort to generate a sub-cohort (n=2346). All incident ischemic stroke cases as of September 2012 (n=660) were included, with 62 incident cases overlapping in the sub-cohort. Serum zinc levels were measured at baseline. Barlow-weighted Cox’s proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios and the corresponding 95% CI of ischemic stroke by serum zinc levels. Results: The median zinc level for the sub-cohort was 121.19 µg/dL (interquartile range, 104.86–140.39 µg/dL). Serum zinc levels were inversely associated with incidence of ischemic stroke after adjustment for potential confounders (quartile 4 versus quartile 1: hazard ratio, 0.78 [95% CI, 0.61–0.98], P =0.03 for trend). When stratified by prespecified factors (sex, race, region), only sex showed a significant modification ( P =0.03 for interaction). The inverse association was more pronounced among females (quartile 4 versus quartile 1: hazard ratio, 0.58 [95% CI, 0.41–0.84], P <0.01 for trend) than males (quartile 4 versus quartile 1: hazard ratio, 1.08 [95% CI, 0.78–1.51], P =0.92 for trend). Conclusions: Serum zinc concentration was inversely associated with incidence of ischemic stroke, especially among women, indicating that low zinc levels may be a risk factor for ischemic stroke.

Comparison of Serum Zinc Levels Between Children With Febrile Urinary Tract Infection and Healthy Children

Background: Urinary tract infection is one of the most common bacterial infections in children. Zinc is the second most abundant mineral in the body involved in the growth, cell division, and regulation of immune system activity. In studies, zinc administration has been effective in improving pneumonia and gastroenteritis in children, and today, zinc is used to treat acute gastroenteritis in children. Due to the increasing use of various supplements in children and the importance of urinary tract infection and its complications in children. Objectives: This study was performed to compare serum zinc levels between children with febrile urinary tract infection and healthy children. Methods: In this case-control study, serum zinc was measured in 60 healthy children and 60 children with febrile urinary tract infection, without any underlying disease, by an Auto analyzer. Data were analyzed by SPSS version 22 software. Results: The difference in serum zinc levels between the two groups was not statistically significant. There was no statistically significant difference in zinc deficiency between the groups. Serum zinc levels were not associated with sex, age, frequency of urinary tract infection, the severity of leukocytosis, the severity of ESR increase, CRP, and length of hospitalization. In the age group of 24 - 72 months, a significant linear relationship was observed between serum zinc levels and weight. The incidence of urinary tract infections was higher in girls, and this difference was statistically significant in all groups, except in age groups 6 - 12 months and above 72 months. Conclusions: This study showed that low serum zinc levels did not increase the risk of febrile urinary tract infection in children. Therefore, prescribing zinc supplements to treat or prevent urinary tract infections requires further studies.