Estimation of Serum Zinc and Copper in Children with Acute Diarrhea

Abstract

Diarrhea is, in reality, as much a nutritional disease as one of fluid and electrolyte loss. Children who die from diarrhea, despite good management of dehydration, are usually malnourished and often severely so. In this study, we determined the serum levels of zinc and copper before and after standard oral rehydration solution (ORS) therapy in children with acute diarrhea and correlated it with diarrheal duration and severity. One hundred ten children suffering from acute diarrhea were included. Serum zinc and copper levels of these children were estimated at the time of enrollment and after treatment with standard ORS therapy. This study shows that children suffering from acute diarrhea show a statistically significant decrease of 13.1% and 12.8% in serum zinc and copper concentrations, respectively, compared to normal. These levels further decrease by 22.6% and 22.4%, respectively, after treatment with standard ORS therapy. Our study shows that children with the lower plasma zinc and copper levels suffered with more severe and longer duration of diarrhea. Zinc and copper supplementation could be added to standard ORS therapy for the reduction in morbidity and mortality associated with acute diarrhea in children.

Mechanisms of action of zinc on rat intestinal epithelial electrogenic ion secretion: insights into its antidiarrhoeal actions

“…Human oral bioavailability of dietary zinc under nondiarrhoeal conditions ranges from 36–71% [29] . It is likely that facilitated oral absorption of zinc in secretory diarrhoea compensates for the 13% lower serum levels of serum zinc seen in afflicted children [30] . The inverse relationship between dose and bioavailability suggests that zinc permeation of enterocytes is not simply due to passive paracellular flux.…”

“…[29] It is likely that facilitated oral absorption of zinc in secretory diarrhoea compensates for the 13% lower serum levels of serum zinc seen in afflicted children. [30] The inverse relationship between dose and bioavailability suggests that zinc permeation of enterocytes is not simply due to passive paracellular flux. In diarrhoea, upregulated Zn 2+ transporters compensate as Zn 2+ enters small intestinal epithelia via the Zip4 transporter on the apical membrane, and then exits via ZnT1 and/or Zip5 on the basolateral membrane.…”

Zinc and copper supplementation in acute diarrhea in children: a double-blind randomized controlled trial

“…Diarrhea causes an estimated 2.5 million child deaths in developing countries each year, 35% of which are due to acute diarrhea [ 1 ]. The importance of zinc and copper in the pathophysiology of acute diarrhea is highlighted by the significantly higher daily fecal losses of these elements during acute diarrheal episodes than the fecal losses in unaffected children [ 2 ]. Conversely, zinc supplementation exhibits therapeutic action by facilitating the transport of water and electrolytes across the intestinal mucosa, preventing villous atrophy and improving overall immunity [ 3 ].…”

Dysentery - a risk factor for zinc deficiency

“…4,7 The current study shows that zinc deficiency is more prevalent among children with dysentery, compared with those who have acute non-bloody diarrhoea. The lower serum zinc levels observed among children with dysenteric stools may be related to the loss of significant amounts of zinc through the red blood cells that are passed in the stools in dysentery.…”