Zinc and vitamin A deficiency in a cohort of children with autism spectrum disorder.

BACKGROUND AND OBJECTIVES: Studies suggest that trace element and vitamin deficiencies are common in children with autism spectrum disorder (ASD). Data describing the rates of vitamin and trace element deficiencies in the ASD population of the northwest of Ireland is lacking. We wished to determine the prevalence of zinc and vitamin A deficiency in the ASD population compared with controls within this geographical area. METHODS: Parents of children aged 2-18 years with ASD were invited to participate in the study. The control group consisted of well children attending the paediatric department for routine blood sampling. Children on vitamin supplements were excluded from both ASD and control groups. Informed written consent was obtained prior to recruitment. Samples were analysed for zinc and vitamin A levels according to standardized laboratory procedures. RESULTS: Seventy-four of the 150 children with ASD who were invited and 72 controls underwent blood sampling. Mean zinc and vitamin A levels were normal in both groups. There were significantly more males in the ASD group (88% versus 56%, p value < 0.001). The mean (SD) zinc level was not different between the groups (ASD 11.7 [1.7] versus control 11.6 [2.1] µmol/L, p value = 0.86). The mean (standard deviation) vitamin A level was higher in the ASD group (ASD 350.6 [82.6] versus 319.2 [82.8] µg/L, p value = 0.03), but this was likely confounded by age. CONCLUSION: Children with ASD in the northwest of Ireland have mean zinc and vitamin A levels within the normal range. It is important that these findings are relayed to health professionals and to parents of children with ASD so that informed decisions on vitamin supplementation can be made.

Foliar Selenate and Zinc Oxide Separately Applied to Two Pea Varieties: Effects on Growth Parameters and Accumulation of Minerals and Macronutrients in Seeds under Field Conditions.

Though selenium (Se) and zinc (Zn) constitute essential nutrients for human health, their deficiencies affect up to 15% and 17% of the global population, respectively. Agronomic biofortification of staple crops with Se/Zn may alleviate these challenges. Pea (Pisum sativum L.) is a nutritious legume crop that has great potential for Se/Zn biofortification. Herein, two varieties of pea (Ambassador, Premium) were biofortified via foliar application of sodium selenate (0/50/100 g of Se/ha) or zinc oxide (0/375/750 g of Zn/ha) during the flowering stage under field conditions. While no significant differences were found in Se accumulation between seed varieties upon Se treatments, selenate enhanced the accumulation of Se in the two seed varieties in a dose dependent manner. Selenium concentration was most elevated in seeds of Ambassador exposed to 100 g of Se/ha (3.93 mg/kg DW compared to the control (0.08 mg/kg DW), p < 0.001). 375 g of Zn/ha (35.7 mg/kg DW) and 750 g of Zn/ha (35.5 mg/kg DW) significantly and similarly enhanced Zn concentrations compared to the control (31.3 mg/kg DW) in Premium seeds, p < 0.001. Zinc oxide also improved accumulations of Fe, Cu, Mn, and Mg in Premium seeds. Se/Zn treatments did not significantly affect growth parameters and accumulations of soluble solids and protein in seeds. Positive and significant (p < 0.01) correlations were observed between Zn and Fe, Cu, Mn and Mg levels in Premium seeds, among others. Consuming 33 g/day of pea biofortified with Se at 50 g/ha and 266 g/day of pea biofortified with 375 g of Zn/ha could provide 100% of the RDA (55 µg) for Se and RDA (9.5 mg) for Zn in adults, respectively. These results are relevant for enhancing Se/Zn status in peas by foliar biofortification.

Micronutrient Deficiencies in Patients with Decompensated Liver Cirrhosis.

Patients with cirrhosis often develop malnutrition and micronutrient deficiencies, leading to a worse prognosis and increased mortality. Our main goal was to assess the prevalence of micronutrient deficiencies in patients with decompensated cirrhosis. This was a prospective single-center study including 125 consecutive patients hospitalized for acute decompensation of cirrhosis (mostly of alcoholic etiology). A blood test including trace elements and vitamins was performed on admission. The main micronutrient deficiencies observed were vitamin D (in 94.5%), vitamin A (93.5%), vitamin B6 (60.8%) and zinc (85.6%). Patients in Child-Pugh class C had lower levels of vitamin A (p < 0.0001), vitamin E (p = 0.01) and zinc (p < 0.001), and higher levels of ferritin (p = 0.002) and vitamin B12 (p < 0.001) than those in Child-Pugh class A and B. Patients with a higher model of end-stage liver disease (MELD) score had lower levels of vitamin A (p < 0.0001), vitamin E (p < 0.001), magnesium (p = 0.01) and zinc (p = 0.001), and higher levels of ferritin (p = 0.002) and vitamin B12 (p < 0.0001). Severe hepatic insufficiency correlated with lower levels of zinc, vitamin E and vitamin A, and higher levels of vitamin B12 and ferritin.

Cardiomyopathy Associated with Zinc Deficiency after Bariatric Surgery.

Noncompliance with vitamin and mineral supplement protocol after bariatric surgery may lead to true-elements deficiency. Among them, zinc and selenium deficiencies were closely related to cardiac complications, such as myocardial fibrosis, heart failure, and arrhythmias. We describe a 30-year-old female, 6 weeks after delivery and 5 years after bariatric surgery, who was admitted to the cardiology department because of dyspnea and clinical evidence of heart failure, as well as an echocardiogram that demonstrated reduced systolic left ventricular function. Standard antifailure regimen shows mild benefit. Zinc supplements added to treatment lead to significant clinical and echocardiographic improvement.

Patients at risk for trace element deficiencies: bariatric surgery.

Obesity is a worldwide epidemic associated with diseases such as diabetes mellitus and cardiovascular disease. Current methods for weight loss are not very effective, particularly for those with morbid obesity. Surgical therapy may be recommended for those with a BMI≥40kg/m(2), or BMI≥35kg/m(2) with co-morbidities. This therapy can produce significant weight loss and improve/resolve co-morbidities including hypertension and hyperlipidemia. Yet successes may be tempered by adverse effects on trace element absorption and status. A PubMed literature search identified studies from January 1980 to February 2013 for inclusion in a meta-analysis. Publications that contained keywords 'bariatric surgery or gastric bypass,' 'trace element or mineral or zinc or iron or copper or iodine or manganese', and 'absorption or status or rate or level' were identified. Inclusion criteria were human markers that reflect changes in trace element status before and after bariatric surgery. The meta-analysis found a decrease in blood copper, zinc, hemoglobin, as well as an increase in iron, regardless of the type of surgery. The pooled effect sizes and 95% confidence intervals were 0.17 and -0.09 to 0.43 for plasma/serum iron (p=0.20); -0.49 and -0.67 to -0.31 for blood hemoglobin (p=0.00); -0.47 and -0.90 to -0.05 for plasma/serum copper (p=0.03); -0.77 and -1.20 to -0.35 for plasma/serum zinc (p=0.00). Differences in levels of these minerals pre- and post-surgery may have been influenced by the time period after surgery, a pre-existing deficiency, type and dose of vitamin-mineral supplements, and malabsorption due to elimination of parts of the gastrointestinal tract.