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1.
Redox Biol ; 38: 101764, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33126054

RESUMO

SARS-CoV-2 infections cause the current coronavirus disease (COVID-19) pandemic and challenge the immune system with ongoing inflammation. Several redox-relevant micronutrients are known to contribute to an adequate immune response, including the essential trace elements zinc (Zn) and selenium (Se). In this study, we tested the hypothesis that COVID-19 patients are characterised by Zn deficiency and that Zn status provides prognostic information. Serum Zn was determined in serum samples (n = 171) collected consecutively from patients surviving COVID-19 (n = 29) or non-survivors (n = 6). Data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study were used for comparison. Zn concentrations in patient samples were low as compared to healthy subjects (mean ± SD; 717.4 ± 246.2 vs 975.7 ± 294.0 µg/L, P < 0.0001). The majority of serum samples collected at different time points from the non-survivors (25/34, i.e., 73.5%) and almost half of the samples collected from the survivors (56/137, i.e., 40.9%) were below the threshold for Zn deficiency, i.e., below 638.7 µg/L (the 2.5th percentile in the EPIC cohort). In view that the Se status biomarker and Se transporter selenoprotein P (SELENOP) is also particularly low in COVID-19, we tested the prevalence of a combined deficit, i.e., serum Zn below 638.7 µg/L and serum SELENOP below 2.56 mg/L. This combined deficit was observed in 0.15% of samples in the EPIC cohort of healthy subjects, in 19.7% of the samples collected from the surviving COVID-19 patients and in 50.0% of samples from the non-survivors. Accordingly, the composite biomarker (SELENOP and Zn with age) proved as a reliable indicator of survival in COVID-19 by receiver operating characteristic (ROC) curve analysis, yielding an area under the curve (AUC) of 94.42%. We conclude that Zn and SELENOP status within the reference ranges indicate high survival odds in COVID-19, and assume that correcting a diagnostically proven deficit in Se and/or Zn by a personalised supplementation may support convalescence.


Assuntos
/sangue , Selectina-P/sangue , Zinco/sangue , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Taxa de Sobrevida
2.
BMC Infect Dis ; 20(1): 867, 2020 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-33213392

RESUMO

BACKGROUND: Micronutrients are minerals and vitamins and they are essential for normal physiological activities. The objectives of the study were to describe the progress and determinants of micronutrient levels and to assess the effects of micronutrients in the treatment outcome of kalazar. METHODS: A prospective cohort study design was used. The data were collected using patient interviews, measuring anthropometric indicators, and collecting laboratory samples. The blood samples were collected at five different periods during the leishmaniasis treatments: before starting anti-leishmaniasis treatments, in the first week, in the second week, in the third week, and in the 4th week of anti-leishmaniasis treatments. Descriptive statistics were used to describe the profile of patients and to compare the treatment success rate. The generalized estimating equation was used to identify the determinants of serum micronutrients. RESULTS: The mean age of the patients were 32.88 years [SD (standard deviation) ±15.95]. Male constitute 62.3% of the patients and problematic alcohol use was present in 11.5% of the patients. The serum zinc level of visceral leishmaniasis patients was affected by alcohol (B - 2.7 [95% CI: - 4.01 - -1.5]), DDS (B 9.75 [95% CI: 7.71-11.79]), family size (B -1.63 [95% CI: - 2.68 - -0.58]), HIV (B -2.95 [95% CI: - 4.97 - -0.92]), and sex (B - 1.28 [95% CI: - 2.5 - -0.07]). The serum iron level of visceral leishmaniasis patients was affected by alcohol (B 7.6 [95% CI: 5.86-9.35]), family size (B -5.14 [95% CI: - 7.01 - -3.28]), malaria (B -12.69 [95% CI: - 14.53 - -10.87]), Hookworm (- 4.48 [- 6.82 - -2.14]), chronic diseases (B -7.44 [95% CI: - 9.75 - -5.13]), and HIV (B -5.51 [95% CI: - 8.23 - -2.78]). The serum selenium level of visceral leishmaniasis patient was affected by HIV (B -18.1 [95% CI: - 20.63 - -15.58]) and family size (B -11.36 [95% CI: - 13.02 - -9.7]). The iodine level of visceral leishmaniasis patient was affected by HIV (B -38.02 [95% CI: - 41.98 - -34.06]), DDS (B 25 .84 [95% CI: 22.57-29.1]), smoking (B -12.34 [95% CI: - 15.98 - -8.7]), chronic illness (B -5.14 [95% CI: - 7.82 - -2.46]), and regular physical exercise (B 5.82 [95% CI: 0.39-11.26]). The serum vitamin D level of visceral leishmaniasis patient was affected by HIV (B -9.43 [95% CI: - 10.92 - -7.94]), DDS (B 16.24 [95% CI: 14.89-17.58]), malaria (B -0.61 [95% CI: - 3.37 - -3.37]), and family size (B -1.15 [95% CI: - 2.03 - -0.28]). The serum vitamin A level of visceral leishmaniasis patient was affected by residence (B 0.81 [95% CI: 0.08-1.54]), BMI (B 1.52 [95% CI: 0.42-2.6]), DDS (B 1.62 [95% CI: 0.36-2.88]), family size (B -5.03 [95% CI: - 5.83 - -4.22]), HIV (B -2.89 [95% CI: - 4.44 - -1.34]),MUAC (B 0.86 [95% CI: 0.52-1.21]), and age (B 0.09 [95% CI: 0.07-0.12]). CONCLUSION: The micronutrient levels of visceral leishmaniasis patients were significantly lower. The anti-leishmaniasis treatment did not increase the serum micronutrient level of the patients.


Assuntos
Antiprotozoários/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Micronutrientes/sangue , Adulto , Consumo de Bebidas Alcoólicas , Feminino , Infecções por HIV/complicações , Infecções por HIV/patologia , Humanos , Entrevistas como Assunto , Leishmaniose Visceral/complicações , Leishmaniose Visceral/patologia , Malária/complicações , Malária/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Selênio/sangue , Zinco/sangue
3.
Niger J Clin Pract ; 23(11): 1555-1560, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33221781

RESUMO

Background: Alopecia areata (AA) involves oxidative reactions in the hair follicle. Its treatment is difficult due to both the unknown etiology and the adverse drug effects. Aims: This study aimed to evaluate the effects of orally administered ginger powder on the oxidative stress markers of the plasma and blood cells in Iraqi patients with AA. Subjects and Methods: Twenty patients (9 females and 11 males), with a mean age of 26.0 ± 8.0 years, with different lesions of stable alopecia areata localized on the scalp, were enrolled in this pilot study. Exclusion criteria include the use of any medication that may influence the course of the disease. All patients were treated with 500 mg of ginger powder once daily for 60zz days. Blood samples were obtained at zero time, day-30 and day-60 and utilized for the evaluation of the erythrocytes and lymphocytes contents of reduced glutathione (GSH), malondialdehyde (MDA) and total antioxidant status (TAS), in addition to the assessment of serum zinc (Zn) and copper (Cu) levels. The results are compared with those of 20 healthy subjects served as a control group. Results: Treatment of the AA patients with ginger significantly improves the antioxidant/oxidant balance of the erythrocytes and lymphocytes, which is known to be impaired in the patient group as compared with healthy subjects. The ginger powder also elevates the serum concentration of zinc up to that reported in controls and associated with normalizing serum copper levels at the end of the treatment period. Conclusion: Consumption of ginger as a supplement by the patients with AA could improve the oxidant/antioxidant balance of the erythrocytes and lymphocytes and restoring the normal level of serum zinc.


Assuntos
Alopecia em Áreas/metabolismo , Antioxidantes/análise , Antioxidantes/metabolismo , Biomarcadores/sangue , Gengibre/química , Gengibre/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/química , Oligoelementos/sangue , Adolescente , Adulto , Alopecia em Áreas/sangue , Cobre/sangue , Suplementos Nutricionais , Feminino , Humanos , Masculino , Malondialdeído/sangue , Malondialdeído/metabolismo , Projetos Piloto , Raízes de Plantas/química , Pós/química , Adulto Jovem , Zinco/sangue
4.
PLoS One ; 15(10): e0240195, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33095789

RESUMO

This study aimed to investigate the relationship between serum zinc level and hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). A cross-sectional study was conducted using nationally representative samples from the Korea National Health and Nutrition Examination Survey 2010. Significant hepatic fibrosis was defined as Fibrosis-4 (FIB-4) index>1.3. Zinc level was measured using inductively coupled plasma mass spectrometry. Univariable and multivariable logistic regression analyses were performed to assess risk factors for significant hepatic fibrosis in patients with NAFLD. A total of 300 patients with NAFLD were analyzed in this study. The mean serum zinc level was 139.8±29.9 µg/dL. FIB-4 index was significantly increased as the serum zinc level decreased (Adjusted correlation coefficient = -0.177, p = 0.003). Significant liver fibrosis was observed in 62 patients (21%). The multivariable analysis showed that significant liver fibrosis in NAFLD was associated with diabetes mellitus (odds ratio [OR], 3.25; 95% confidence interval [CI], 1.71-6.19; p<0.001), male (OR, 2.59; 95% CI, 1.31-5.12; p = 0.006), and zinc level <140 µg/dL (OR, 2.14; 95% CI, 1.16-3.94; p = 0.015). There was an inverse relationship between serum zinc level and FIB-4 index in NAFLD. Low levels of serum zinc were an independent risk factor for significant hepatic fibrosis in NAFLD.


Assuntos
Cirrose Hepática/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Zinco/sangue , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Cirrose Hepática/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/patologia
5.
Rhinology ; 58(5): 417, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32902518

RESUMO

The October 2020 issue of Rhinology is a very interesting edition as it illustrates how world-wide colleagues pave the way for a better future of patients affected by nose and sinus diseases. After the successful launch of EPOS2020 in Spring 2020, the editorial team of Rhinology is proud to present to you the latest and most exciting data in Rhinology research. Getting insight into the complexity and relevance of proteomics in CRS, epithelial-mesenchymal contribution to CRS, zinc levels in nasal and systemic compartment of CRS, nasal biomarkers of CRSwNP that predict recurrence of disease after sinus surgery, and the odor identification test for children, called "U-Sniff", and FID scores (Frequency, Intensity and Duration) scores for epistaxis are all in the 2020 October issue and highly relevant for Rhinology practice. These studies build further on the solid grounds of previous Rhinology research meeting the unmets needs in the field.


Assuntos
Rinite , Sinusite , Criança , Doença Crônica , Infecções por Coronavirus , Humanos , Pólipos Nasais , Pandemias , Publicações Periódicas como Assunto , Pneumonia Viral , Zinco/sangue
6.
Int J Infect Dis ; 100: 343-349, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32920234

RESUMO

BACKGROUND: Zinc is a trace element with potent immunoregulatory and antiviral properties, and is utilized in the treatment of coronavirus disease 2019 (COVID-19). However, we do not know the clinical significance of serum Zinc levels in COVID-19 patients. The aim of this study was to determine the clinical significance of serum zinc in COVID-19 patients and to establish a correlation with disease severity. METHODS: This was a prospective study of fasting zinc levels in COVID-19 patients at the time of hospitalization. An initial comparative analysis was conducted between COVID-19 patients and healthy controls. COVID-19 patients with zinc deficiency were compared to those with normal zinc levels. RESULTS: COVID-19 patients (n = 47) showed significantly lower zinc levels when compared to healthy controls (n = 45): median 74.5 (interquartile range 53.4-94.6) µg/dl vs 105.8 (interquartile range 95.65-120.90) µg/dl (p < 0.001). Amongst the COVID-19 patients, 27 (57.4%) were found to be zinc deficient. These patients were found to have higher rates of complications (p = 0.009), acute respiratory distress syndrome (18.5% vs 0%, p = 0.06), corticosteroid therapy (p = 0.02), prolonged hospital stay (p = 0.05), and increased mortality (18.5% vs 0%, p = 0.06). The odds ratio (OR) of developing complications was 5.54 for zinc deficient COVID-19 patients. CONCLUSIONS: The study data clearly show that a significant number of COVID-19 patients were zinc deficient. These zinc deficient patients developed more complications, and the deficiency was associated with a prolonged hospital stay and increased mortality.


Assuntos
/complicações , Zinco/deficiência , Adolescente , Adulto , Idoso , Antivirais/uso terapêutico , /terapia , Feminino , Hospitalização , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem , Zinco/sangue
7.
N Engl J Med ; 383(13): 1231-1241, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32966722

RESUMO

BACKGROUND: The World Health Organization recommends 20 mg of zinc per day for 10 to 14 days for children with acute diarrhea; in previous trials, this dosage decreased diarrhea but increased vomiting. METHODS: We randomly assigned 4500 children in India and Tanzania who were 6 to 59 months of age and had acute diarrhea to receive 5 mg, 10 mg, or 20 mg of zinc sulfate for 14 days. The three primary outcomes were a diarrhea duration of more than 5 days and the number of stools (assessed in a noninferiority analysis) and the occurrence of vomiting (assessed in a superiority analysis) within 30 minutes after zinc administration. RESULTS: The percentage of children with diarrhea for more than 5 days was 6.5% in the 20-mg group, 7.7% in the 10-mg group, and 7.2% in the 5-mg group. The difference between the 20-mg and 10-mg groups was 1.2 percentage points (upper boundary of the 98.75% confidence interval [CI], 3.3), and that between the 20-mg and 5-mg groups was 0.7 percentage points (upper boundary of the 98.75% CI, 2.8), both of which were below the noninferiority margin of 4 percentage points. The mean number of diarrheal stools was 10.7 in the 20-mg group, 10.9 in the 10-mg group, and 10.8 in 5-mg group. The difference between the 20-mg and 10-mg groups was 0.3 stools (upper boundary of the 98.75% CI, 1.0), and that between the 20-mg and 5-mg groups was 0.1 stools (upper boundary of the 98.75% CI, 0.8), both of which were below the noninferiority margin (2 stools). Vomiting within 30 minutes after administration occurred in 19.3%, 15.6%, and 13.7% of the patients in the 20-mg, 10-mg, and 5-mg groups, respectively; the risk was significantly lower in the 10-mg group than in the 20-mg group (relative risk, 0.81; 97.5% CI, 0.67 to 0.96) and in the 5-mg group than in the 20-mg group (relative risk, 0.71; 97.5% CI, 0.59 to 0.86). Lower doses were also associated with less vomiting beyond 30 minutes after administration. CONCLUSIONS: Lower doses of zinc had noninferior efficacy for the treatment of diarrhea in children and were associated with less vomiting than the standard 20-mg dose. (Funded by the Bill and Melinda Gates Foundation; ZTDT ClinicalTrials.gov number, NCT03078842.).


Assuntos
Antidiarreicos/administração & dosagem , Diarreia/tratamento farmacológico , Zinco/administração & dosagem , Antidiarreicos/efeitos adversos , Antidiarreicos/sangue , Pré-Escolar , Diarreia Infantil/tratamento farmacológico , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Lactente , Masculino , Adesão à Medicação , Vômito/induzido quimicamente , Vômito/epidemiologia , Zinco/efeitos adversos , Zinco/sangue
8.
Int J Infect Dis ; 100: 230-236, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32911042

RESUMO

OBJECTIVES: Because most severely ill patients with COVID-19 in our hospital showed zinc deficiency, we aimed to examine the relationship between the patient's serum zinc level and severe cases of COVID-19. METHODS: Serum zinc <70 µg/dL was defined as the criterion for hypozincemia, and patients continuously with serum zinc <70 µg/dL were classified in the hypozincemia cohort. To evaluate whether hypozincemia could be a predictive factor for a critical illness of COVID-19, we performed a multivariate analysis by employing logistic regression analysis. RESULTS: Prolonged hypozincemia was found to be a risk factor for a severe case of COVID-19. In evaluating the relationship between the serum zinc level and severity of patients with COVID-19 by multivariate logistic regression analysis, critical illness can be predicted through the sensitivity and false specificity of a ROC curve with an error rate of 10.3% and AUC of 94.2% by only two factors: serum zinc value (P = 0.020) and LDH value (P = 0.026). CONCLUSIONS: Proper management of the prediction results in this study can contribute to establishing and maintaining a safe medical system, taking the arrival of the second wave, and the spread of COVID-19 in the future into consideration.


Assuntos
/sangue , Estado Terminal/epidemiologia , Zinco/sangue , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Gravidade do Paciente , Valor Preditivo dos Testes , Curva ROC , Fatores de Risco
9.
PLoS One ; 15(8): e0237370, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857769

RESUMO

BACKGROUND: Copper (Cu) and zinc (Zn) are essential nutrients and cofactors of enzymatic reactions with their binding partner. Metallothionein (MT) plays an important role in protecting against heavy metals and oxidative injury, however it may also portend drug resistance and a worse prognosis for hepatocellular carcinoma (HCC) patients. The aim of this study was to determine the amount of Cu, Zn, Cu/Zn and MT in evaluating a group of patients with HCC, including those treated with lenvatinib. METHODS: We enrolled 175 patients with HCC (139 men, 36 women; mean age 71.1 years; hepatitis C virus n = 85, hepatitis B virus n = 19, hepatitis C virus and hepatitis B virus n = 2, non-alcoholic steatohepatitis n = 39, alcohol n = 25, others n = 5; Child-Pugh A n = 141, Child-Pugh B n = 30, Child-Pugh C n = 4; Barcelona clinic liver cancer (BCLC) stage 0 n = 38, stage A n = 56, stage B n = 39, stage C n = 38, stage D n = 4). We evaluated the associations between Cu, Zn and MT. The study outcome was liver cancer-specific survival. Moreover, we treated 12 HCC patients with lenvatinib and investigated the changes in MT during lenvatinib therapy. RESULTS: The serum level of Cu was positively correlated with alanine aminotransferase and the BCLC stage. The serum level of Zn decreased concordant with liver disease progression. Patients with a Cu/Zn ratio≥0.999 had significantly improved rates of survival when compared to patients with a Cu/Zn ratio<0.999 (45.3 vs. 30.1 months, p<0.001). MT was significantly correlated with the Cu/Zn ratio and increased after the administration of lenvatinib. Using multivariate Cox regression analyses, it was determined that the Cu/Zn ratio (hazard ratio [HR]: 1.442, p = 0.008), alpha-fetoprotein (HR: 1.000, p<0.001) and BCLC stage (HR: 2.087, p<0.001) were independent predictors of survival. CONCLUSIONS: The Cu/Zn ratio could serve as a useful predictive marker for survival in cases of HCC. MT levels increased in HCC patients receiving lenvatinib therapy, and maybe a predictor of reduced survival.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Hepatocelular/sangue , Cobre/sangue , Neoplasias Hepáticas/sangue , Metalotioneína/sangue , Zinco/sangue , Idoso , Carcinoma Hepatocelular/tratamento farmacológico , Feminino , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Masculino , Compostos de Fenilureia/uso terapêutico , Quinolinas/uso terapêutico
10.
Int J Infect Dis ; 100: 390-393, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32795605

RESUMO

The relationship between immunity and nutrition is well known and its role in coronavirus disease 2019 (COVID-19) is also being paid great attention. However, the nutritional status of COVID-19 patients is unknown. Vitamin B1, B6, B12, vitamin D (25-hydroxyvitamin D), folate, selenium, and zinc levels were measured in 50 hospitalized patients with COVID-19. Overall, 76% of the patients were vitamin D deficient and 42% were selenium deficient. No significant increase in the incidence of deficiency was found for vitamins B1, B6, and B12, folate, and zinc in patients with COVID-19. The COVID-19 group showed significantly lower vitamin D values than the healthy control group (150 people, matched by age/sex). Severe vitamin D deficiency (based on a cut-off of ≤10 ng/dl) was found in 24.0% of the patients in the COVID-19 group and 7.3% in the control group. Among 12 patients with respiratory distress, 11 (91.7%) were deficient in at least one nutrient. However, patients without respiratory distress showed a deficiency in 30/38 cases (78.9%; p = 0.425). These results suggest that a deficiency of vitamin D or selenium may decrease the immune defenses against COVID-19 and cause progression to severe disease. However, more precise and large-scale studies are needed.


Assuntos
Betacoronavirus , Infecções por Coronavirus/metabolismo , Estado Nutricional , Pneumonia Viral/metabolismo , Adulto , Idoso , Infecções por Coronavirus/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Selênio/deficiência , Deficiência de Vitamina D/epidemiologia , Vitaminas/sangue , Zinco/sangue
11.
Chemosphere ; 261: 127547, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32717506

RESUMO

Snack foods are common and highly advertised to children and serve their natural predispositions for sweet and salty tastes. However, the risk issues of low-cost snacks eaten by 0-6 aged children are lack of more concern. To better understand the issue of low-cost snacks this study considered potentially toxic metals (PTMs) impact on children's health risk, measured PTMs in a collection of 570 collected low-cost snacks contributed by 1342 voluntary participants children aged 0-6 years involved in Xi'an city are conducted. Nine priority PTMs and amounts ranked as Mn > Zn > Cu > Cr > Sb > Pb > Ni > Cd > Co. The Estimated Weekly Intake of PTMs in snacks for children accounted for a proportion of the Provisional Tolerance Weekly Intake. Children's daily snack ingestion of Cr, Cd and Pb were especially concerning. It was noted that all PTMs in flour products contribute to the total Target Hazard Quotient (THQ>1) were observed having a non-carcinogenic risk compared to the single metals Cr, Co and Cd with carcinogenic risk. The correlations between Cu, Pb, Zn in low-cost snacks and children's bloods reflected PTMs especially for Pb that transfers into children's bodies mostly through low-cost foodstuffs ingestion. Also, the elevated blood lead levels (BLLs) depended on readily available, low-quality snacks accessible for children. Therefore, multi-initiatives aimed at improving the quality, increasing awareness, and a PTM monitoring program for low-cost snack food market to young children should be undertaken.


Assuntos
Exposição Dietética/estatística & dados numéricos , Contaminação de Alimentos , Metais Pesados/sangue , Lanches , Carcinógenos/análise , Criança , Pré-Escolar , Cidades , Cobre/sangue , Ingestão de Alimentos , Monitoramento Ambiental , Feminino , Humanos , Lactente , Recém-Nascido , Chumbo , Metais Pesados/análise , Medição de Risco , Zinco/sangue
12.
J Int Soc Sports Nutr ; 17(1): 35, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32646441

RESUMO

BACKGROUND: The aim of the present study was to determine changes occurring in the erythrocyte concentrations of chromium (Cr), copper (Cu), manganese (Mn), molybdenum (Mo), selenium (Se) and zinc (Zn) in male subjects with different training levels living in the same region (Spain). METHODS: Thirty sedentary subjects (24.34 ± 3.02 years) formed the control group (CG); 24 moderately trained (4-7 h/week) subjects (23.53 ± 1.85 years) formed the group with a moderate degree of training (MTG) and 22 professional cyclists (23.29 ± 2.73 years), who performed more than 20 h/week of training, formed the high-level training group (HTG). Erythrocyte samples were collected from all subjects in fasting conditions, washed and frozen at - 80 °C until analysis. Erythrocyte analysis of trace elements was performed by inductively coupled plasma mass spectrometry (ICP-MS). RESULTS: The results showed that there was a statistically significant lower erythrocyte concentration of Cu, Mn, Mo and Zn in the MTG and HTG than CG. Se was only significantly lower in HTG than CG. The correlation analysis indicates that this change was correlated with training in the case of Cu, Mn, Se and Zn. All results are expressed in µg/g Hb. CONCLUSIONS: We can conclude that physical training produces a decrease in erythrocyte concentrations of Cu, Mn, Se and Zn, which can cause a decrement in athletes' performance given the importance of these elements. For this reason, erythrocyte monitoring during the season would seem to be advisable to avoid negative effects on performance.


Assuntos
Eritrócitos/química , Aptidão Física , Oligoelementos/sangue , Cromo/sangue , Cobre/sangue , Humanos , Masculino , Manganês/sangue , Molibdênio/sangue , Selênio/sangue , Espanha , Adulto Jovem , Zinco/sangue
13.
JAMA Netw Open ; 3(6): e205123, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32515795

RESUMO

Importance: Few studies have described the longitudinal trajectories of serum levels of micronutrients whose deficiencies are associated with serious sequelae following bariatric procedures, such as anemia, osteoporotic fractures, and neuropathies. Furthermore, previous studies comparing laparoscopic sleeve gastrectomy (LSG) vs Roux-en-Y gastric bypass (LRYGB) or one-anastomosis gastric bypass (OAGB) procedures may have been limited by selection and confounding biases. Objective: To appraise the spectrum and temporal course of micronutrient deficiencies associated with bone metabolism and erythropoiesis after LSG vs OAGB or LRYGB procedures, using the propensity score as a balancing score. Design, Setting, and Participants: This prospective, longitudinal comparative effectiveness study was conducted at a high-volume bariatric unit in Singapore from September 1, 2008, to November 30, 2017, with a cutoff date for analysis of September 2018. Patients who underwent adjustable gastric banding, biliopancreatic diversion procedures, and intragastric balloon procedures were excluded. All other patients who underwent bariatric procedures were included. Data were analyzed from September 23 to 30, 2018. Main Outcomes and Measures: Serial assessment of 13 biochemical parameters at 12 time points for up to 5 years after bariatric procedure. Inverse probability-of-treatment weights were used to obtain estimates of the mean associations of variables assessed with the bariatric surgical interventions. Longitudinal trajectories were analyzed using mixed-effects generalized linear models to apportion the temporal variation of serum micronutrients into fixed-effects and random-effects components. Results: A total of 688 patients were included in this study, of whom 499 underwent LSG (mean [SD] age, 41.5 [11.3] years; 318 [63.7%] women) and 189 underwent OAGB or LRYGB (mean [SD] age, 48.6 [9.4] years; 112 [59.3%] women). There were no differences during follow-up among patients who underwent LSG vs those who underwent OAGB or LRYGB in intact parathyroid hormone levels (mean difference, 7.05 [95% CI, -28.67 to 42.77] pg/mL; P = .70), serum 25-hydroxyvitamin D levels (mean difference, -0.72 [95% CI, -1.56 to 0.12] ng/mL; P = .09), or phosphate levels (mean difference, 0.006 [95% CI, -0.052 to 0.064] mg/dL; P = .83). Hemoglobin levels were a mean 0.63 (95% CI, 0.41 to 0.85) g/dL higher among patients who underwent LSG compared with those who underwent OAGB or LRYGB (P < .001), despite no differences in iron concentration levels (mean difference, 1.50 [95% CI, -1.39 to 4.39] µg/dL; P = .31), total iron-binding capacity (mean difference, 4.36 [95% CI, -5.25 to 13.98] µg/dL; P = .37), or ferritin levels (mean difference, 3.0 [95% CI, -13.0 to 18.9] ng/mL; P = .71). Compared with patients who underwent LSG procedures, patients who underwent OAGB or LRYGB had higher folate levels (mean difference, 2.376 [95% CI, 1.716 to 3.036] ng/mL; P < .001) but lower serum magnesium levels (mean difference, -0.25 [95% CI, -0.35 to -0.16] mg/dL; P < .001) and zinc levels (mean difference, -7.58 [95% CI, -9.92 to -5.24] µg/dL; P < .001). Conclusions and Relevance: These findings suggest that LSG vs OAGB or LRYGB procedures have differential associations with various micronutrient and metabolic parameters. These differences should be recognized in guidelines for postbariatric nutritional surveillance and prevention.


Assuntos
Gastrectomia , Derivação Gástrica , Micronutrientes/sangue , Adulto , Anemia/etiologia , Osso e Ossos/metabolismo , Pesquisa Comparativa da Efetividade , Eritropoese , Feminino , Ferritinas/sangue , Ácido Fólico/sangue , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Hemoglobinas/metabolismo , Humanos , Ferro/sangue , Estudos Longitudinais , Magnésio/sangue , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Pontuação de Propensão , Estudos Prospectivos , Albumina Sérica/metabolismo , Fatores Sexuais , Vitamina D/análogos & derivados , Vitamina D/sangue , Zinco/sangue
14.
J Pregnancy ; 2020: 9435972, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32411468

RESUMO

Preterm birth is delivery before 37 completed weeks. A study was conducted to evaluate the association of maternal serum concentrations of selenium, copper, and zinc and preterm birth. There were 181 women in this nested case-control study, 90/181 (49.7%) term and 91/181 (50.3%) preterm pregnant women. The overall mean serum concentration of selenium was 77.0, SD 19.4 µg/L; of copper was 2.50, SD 0.52 mg/L; and of zinc was 0.77, SD 0.20 mg/L with reference values of 47-142 µg/L, 0.76-1.59 mg/L, and 0.59-1.11 mg/L, respectively. For preterm birth, mean serum concentration for selenium was 79.7, SD 21.6 µg/L; for copper was 2.61, SD 0.57 mg/L; and for zinc was 0.81, SD 0.20 mg/L compared to that for term births: selenium (74.2; SD 16.5 µg/L; p = 0.058), copper (2.39; SD 0.43 mg/L; p = 0.004), and zinc (0.73; SD 0.19 mg/L; p = 0.006), respectively. In an adjusted analysis, every unit increase in maternal selenium concentrations gave increased odds of being a case OR 1.01 (95% CI: 0.99; 1.03), p = 0.234; copper OR 1.62 (95% CI: 0.80; 3.32), p = 0.184; zinc OR 6.88 (95% CI: 1.25; 43.67), p = 0.032. Results show that there was no deficiency of selenium and zinc and there were high serum concentrations of copper in pregnancy. Preterm birth was associated with higher maternal serum concentrations of copper and zinc.


Assuntos
Cobre/sangue , Gravidez/sangue , Nascimento Prematuro/etiologia , Selênio/sangue , Zinco/sangue , Estudos de Casos e Controles , Feminino , Humanos , Malaui , Risco
15.
PLoS One ; 15(5): e0233357, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433650

RESUMO

Trace elements and minerals are compounds that are essential for the support of a variety of biological functions and play an important role in the formation of and the defense against oxidative stress. Here we describe a technique, allowing sequential detection of the trace elements (K, Zn, Se, Cu, Mn, Fe, Mg) in serum and whole blood by an ICP-MS method using single work-up, which is a simple, quick and robust method for the sequential measurement and quantification of the trace elements Sodium (Na), Potassium (K), Calcium (Ca), Zinc (Zn), Selenium (Se), Copper (Cu), Iron (Fe), Manganese (Mn) and Magnesium (Mg) in whole blood as well as Copper (Cu), Selenium (Se), Zinc (Zn), Iron (Fe), Magnesium (Mg), Manganese (Mn), Chromium (Cr), Nickel (Ni), Gold (Au) and Lithium (Li) in human serum. For analysis, only 100 µl of serum or whole blood is sufficient, which make this method suitable for detecting trace element deficiency or excess in newborns and infants. All samples were processed and analyzed by ICP-MS (Agilent Technologies). The accuracy, precision, linearity and the limit of quantification (LOQ), Limit of Blank (LOB) and the limit of detection (LOD) of the method were assessed. Recovery rates were between 80-130% for most of the analyzed elements; repeatabilities (Cv %) calculated were below 15% for most of the measured elements. The validity of the proposed methodology was assessed by analyzing a certified human serum and whole blood material with known concentrations for all elements; the method described is ready for routine use in biomonitoring studies.


Assuntos
Espectrofotometria Atômica/métodos , Espectrometria de Massas em Tandem/métodos , Oligoelementos/sangue , Cálcio/sangue , Cromo/sangue , Cobre/sangue , Ouro/sangue , Humanos , Ferro/sangue , Limite de Detecção , Lítio/sangue , Magnésio/sangue , Manganês/sangue , Níquel/sangue , Potássio/sangue , Selênio/sangue , Sódio/sangue , Zinco/sangue
16.
PLoS One ; 15(5): e0233108, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32413070

RESUMO

BACKGROUND: Stunting is an indicator of poor linear growth in children and is an important public health problem in many countries. Both nutritional deficits and toxic exposures can contribute to lower height-for-age Z-score (HAZ) and stunting (HAZ < -2). OBJECTIVES: In a community-based cross-sectional sample of 97 healthy children ages 6-59 months in Kampala, Uganda, we examined whether exposure to Pb, As, Cd, Se, or Zn were associated with HAZ individually or as a mixture. METHODS: Blood samples were analyzed for a mixture of metals, which represent both toxins and essential nutrients. The association between HAZ and metal exposure was tested using multivariable linear regression and Weighted Quantile Sum (WQS) regression, which uses mixtures of correlated exposures as a predictor. RESULTS: There were 22 stunted children in the sample, mean HAZ was -0.74 (SD = 1.84). Linear regression showed that Pb (ß = -0.80, p = 0.021) and Se (ß = 1.92, p = 0.005) were significantly associated with HAZ. The WQS models separated toxic elements with a presumed negative effect on HAZ (Pb, As, Cd) from essential nutrients with presumed positive effect on HAZ (Se and Zn). The toxic mixture was significantly associated with lower HAZ (ß = -0.47, p = 0.03), with 62% of the effect from Pb. The nutrient WQS index did not reach statistical significance (ß = -0.47, p = 0.16). DISCUSSION: Higher blood lead and lower blood selenium level were both associated with lower HAZ. The significant associations by linear regression were reinforced by the WQS models, although not all associations reached statistical significance. These findings suggest that healthy children in this neighborhood of Kampala, Uganda, who have a high burden of toxic exposures, may experience detrimental health effects associated with these exposures in an environment where exposure sources are not well characterized.


Assuntos
Transtornos do Crescimento/etiologia , Metais/toxicidade , Estatura , Peso Corporal , Cádmio/sangue , Cádmio/toxicidade , Pré-Escolar , Estudos Transversais , Exposição Ambiental , Feminino , Transtornos do Crescimento/sangue , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Chumbo/sangue , Chumbo/toxicidade , Modelos Lineares , Masculino , Metais/sangue , Estado Nutricional , Selênio/sangue , Uganda , Zinco/sangue , Zinco/toxicidade
17.
Eur J Epidemiol ; 35(12): 1149-1156, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32405672

RESUMO

Infections are one of the main causes of mortality in elderly due to the decrease of immune response, for which copper (Cu) and zinc (Zn) are claimed to be crucial. High serum copper-to-zinc-ratio (Cu/Zn-ratio) has been reported with infections, but little is known whether it could also predict the incidence of infections. The study cohort consisted of 1975 men aged 42-60 years and free of severe infectious disease at baseline in 1984-1989 from the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. The main outcome was an incident infection leading to hospitalization. Cox proportional hazards regression models were used for statistical analysis. During the average follow-up of 19.2 years, 636 incident first cases of infections were diagnosed. The hazard ratio (HR) of developing an incident infectious disease in the highest compared to the lowest Cu/Zn-ratio quartile after adjustment for age and baseline examination year was 1.35 [95% confidence interval (CI) = 1.07-1.69, P-trend across quartiles = 0.005]. The association was slightly attenuated after additional adjustment for potential confounders (HR = 1.21, 95% CI = 0.96-1.53, P-trend = 0.054). Furthermore, higher serum Cu concentration was associated with higher risk of an incident infection. The multivariable-adjusted HR was 1.39 (95% CI = 1.10-1.75, P-trend = 0.005) in the highest versus the lowest serum Cu quartile. Serum Zn concentration was not associated with the risk (multivariable-adjusted extreme-quartile HR = 0.83, 95% CI = 0.67-1.04, P-trend = 0.218). In conclusion, our data suggest that an increased Cu/Zn-ratio and especially serum Cu concentration are associated with increased risk of incident infections in middle-aged and older men in Eastern Finland.


Assuntos
Cobre/sangue , Infecções/sangue , Infecções/epidemiologia , Zinco/sangue , Adulto , Biomarcadores/sangue , Finlândia/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
18.
Acta Neurochir (Wien) ; 162(6): 1417-1424, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32246202

RESUMO

BACKGROUND: Hypozincaemia may develop in critically ill patients, including those with acute brain injury in the early phase after hospital admission. The aim of this study was to investigate the prevalence of hypozincaemia after aneurysmal subarachnoid haemorrhage (aSAH) and its association with delayed cerebral ischemia and functional outcome. METHODS: We retrospectively analysed a cohort of 384 patients with SAH admitted to the Neurointensive Care Unit at Rigshospitalet, Copenhagen, Denmark, in whom at least one measurement of plasma zinc concentration was done during the hospital stay. Hypozincaemia was defined as at least one measurement of plasma zinc below 10 µmol/L. Potential associations between hypozincaemia, demographic variables and functional outcome after aSAH were analysed in multivariable logistic regression models. RESULTS: Hypozincaemia was observed in 67% (n = 257) of all patients and occurred within 7 days in more than 95% of all hypozincaemic patients. In a multivariable model, severe SAH (WFNS 3-5; OR 4.2, CI 2.21-8.32, p < 0.001) and Sequential Organ Failure Assessment (SOFA) score on the day of admission (OR 1.24, CI 1.11-1.40, p < 0.001) were independently associated with hypozincaemia. In another multivariable model, hypozincaemia was independently associated with an unfavourable outcome (defined as a modified Rankin Scale score from 3 to 6) (OR 1.97, CI 1.06-3.68, p = 0.032), as was age (OR 1.03, CI 1.01-1.05, p = 0.015), SOFA score on the day of admission (OR 1.14, CI 1.02-1.29, p = 0.02), a diagnosis of delayed cerebral ischaemia (OR 4.06, CI 2.29-7.31, p < 0.001) and a clinical state precluding assessment for delayed cerebral ischaemia (OR 15.13, CI 6.59-38.03, p < 0.001). CONCLUSION: Hypozincaemia occurs frequently after aSAH, is associated with a higher disease severity and independently contributes to an unfavourable outcome.


Assuntos
Isquemia Encefálica/sangue , Hemorragia Subaracnóidea/sangue , Zinco/sangue , Adulto , Idoso , Isquemia Encefálica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/patologia
19.
Am J Clin Nutr ; 111(4): 927-937, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32266402

RESUMO

BACKGROUND: The accurate estimation of zinc deficiency at the population level is important, as it guides the design, targeting, and evaluation of nutrition interventions. Plasma or serum zinc concentration (PZC) is recommended to estimate zinc nutritional status; however, concentrations may decrease in the presence of inflammation. OBJECTIVES: We aimed to assess the relation between PZC and inflammation in preschool children (PSC; 6-59 mo) and nonpregnant women of reproductive age (WRA; 15-49 y), and to compare different inflammation adjustment approaches, if adjustment is warranted. METHODS: Cross-sectional data from 13 nationally representative surveys (18,859 PSC, 22,695 WRA) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project were analyzed. Correlation and decile analyses were conducted, and the following 3 adjustment methods were compared if a consistent negative association between PZC and C-reactive protein (CRP) or α-1-acid glycoprotein (AGP) was observed: 1) exclude individuals with CRP > 5 mg/L or AGP > 1 g/L; 2) apply arithmetic correction factors; and 3) use the BRINDA regression correction (RC) approach. RESULTS: In 6 of 12 PSC surveys, the estimated prevalence of zinc deficiency increased with increasing CRP deciles, and to a lesser extent, with increasing AGP deciles. In WRA, the association of PZC with CRP and AGP was weak and inconsistent. In the 6 PSC surveys in which adjustment methods were compared, application of RC reduced the estimated prevalence of zinc deficiency by a median of 11 (range: 4-18) percentage points, compared with the unadjusted prevalence. CONCLUSIONS: Relations between PZC and inflammatory markers were inconsistent, suggesting that correlation and decile analyses should be conducted before applying any inflammation adjustments. In populations of PSC that exhibit a significant negative association between PZC and CRP or AGP, application of the RC approach is supported. At this time, there is insufficient evidence to warrant inflammation adjustment in WRA.


Assuntos
Anemia/sangue , Zinco/sangue , Adolescente , Adulto , Anemia/imunologia , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Orosomucoide/metabolismo , Adulto Jovem
20.
Chemosphere ; 254: 126809, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32334258

RESUMO

Associations between plasma elements and chronic kidney disease (CKD) among the elderly are poorly understood. In this cross-sectional study, we explored the associations between exposure to four plasma elements and CKD in elderly people aged ≥90 years in longevity areas in China. We measured plasma selenium, manganese, iron, and zinc levels and used logistic regression models to investigate associations between CKD and these four plasma elements after adjusting for confounding factors among 461 participants aged ≥90 years in the fifth wave of the Chinese Longitudinal Healthy Longevity Study (CLHLS) conducted in 2009. The median plasma selenium, manganese, iron, and zinc levels were 120.51 µg/L, 26.64 µg/L, 2880.52 µg/L, and 1882.42 µg/L in the CKD group and 108.76 µg/L, 31.55 µg/L, 4512.00 µg/L, and 2294.24 µg/L in the non-CKD group, respectively. Single- and multiple-element multivariable models showed that plasma manganese, iron, and zinc were negatively associated with CKD. In the multiple-element multivariable models, the adjusted odds ratios for CKD were 0.48 (95% confidence interval [CI]: 0.27-0.86) for the second highest quartile of manganese, 0.37 (95% CI: 0.21-0.68) and 0.36 (95% CI: 0.19-0.65) for the third highest and highest quartiles of iron, respectively, and 0.53 (95% CI: 0.29-0.94) for the highest quartile of zinc, compared with the lowest quartiles of these three elements. Plasma manganese, iron, and zinc levels protect against CKD in elderly people aged ≥90 years in longevity areas.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/sangue , Insuficiência Renal Crônica/epidemiologia , Oligoelementos/sangue , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Ferro , Modelos Logísticos , Manganês/sangue , Pessoa de Meia-Idade , Razão de Chances , Plasma , Zinco/sangue
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