Evaluation of micronutrient profile of North Indian children with cystic fibrosis: a case–control study

Abstract

Background: Data on the micronutrient levels in children with cystic fibrosis (CF) are not available from developing countries, wherein the nutritional profile of children is quite different from that of Western countries. Methods: Levels of fat-soluble vitamins (A, D, and E) and trace metals (iron, copper, and zinc) were measured in 27 CF cases and 27 controls. results: CF cases had significantly low levels of all studied micronutrients compared with controls, and the levels were even lower in cases with exacerbation than in stable CF cases. Prevalence of deficiency of vitamin D, vitamin E, iron, copper, and zinc was significantly higher in cases than in controls, whereas vitamin A deficiency was almost equal in both the groups. conclusion: The prevalence of deficiency of vitamins A, D, and E and iron, copper, and zinc was high in CF cases, and their levels were significantly lower in cases than controls. CF cases should be regularly monitored for these micronutrients, and appropriate supplementation should be considered.

Minerals and Trace Elements in Cystic Fibrosis

“…Decreased levels 40 1-46 In plasma of 10% of CF patients (Akanli, et al, 2003) 15 Mean 1.8 months In plasma of 30% of CF patients (Krebs, et al, 2000) 27 3 months-12 years In 96% of North Indian CF children (Yadav, et al, 2014) 304 18-66 In plasma of 22% of patients with moderate lung disease (Damphousse, et al, 2014) 13 2-19 In plasma (Safai-Kutti, et al, 1991) 20 7-19 In plasma of patients with moderate-severe growth retardation and severe pulmonary disease (Neve, et al, 1983b) 14 2-19 In serum (Richard, et al, 1990) 51 1-46 In RBC of 31% of CF patients (Akanli, et al, 2003) Elevated levels 20 7-19 In RBC (Neve, et al, 1983a) 20 7-19 In RBC (Neve, et al, 1983b) No difference 18 6-17 In plasma, decreases with age (Jacob, et al, 1978) 20 7-19 In plasma of relatively healthy CF patients (Neve, et al, 1983b) 15…”

“…In serum (van Caillie-Bertrand, et al, 1982) 101 Mean 16 In serum (Van Biervliet, et al, 2007) 117 − In serum (Kelleher, et al, 1986) Zn levels in other analytes 18 6-17 Decreased Zn levels in hair (Jacob, et al, 1978) 9 − Decreased Zn levels in hair (Varkonyi, et al, 1992) 30 − Decreased Zn levels in hair and nails (Kopito, Shwachman, 1964) − − Elevated Zn levels in nails (Escobar, et al, 1980) 23 − Elevated Zn levels in sputum (Gray, et al, 2010) 52 Children Elevated Zn levels in sputum (Sirotkin, 1999) 35 4-21 No difference in Zn levels in submandibular saliva (Blomfield, et al, 1973) 52 Children Elevated Zn levels in urine of CF patients with pulmonary heart disease (Sirotkin, 1999) 20 7-30 Elevated Zn levels in the exhaled air condensate (Griese, et al, 2003) 7 11-17 Elevated (16 times higher) Zn levels in cerumen (Brand-Auraban, et al, 1972) Copper (Cu) Decreased levels 27 3 months-12 years In 44% of North Indian CF children (Yadav, et al, 2014) Elevated levels 20 7-19 In RBC (Neve, et al, 1983a) 20 7-19 In RBC (Neve, et al, 1983b) 7 19-32 In plasma (Percival, et al,, 1999) 18 6-18 In plasma (Solomons, et al,, 1981) No difference 13 10-22 − (Percival, et al, 1995) 20 7-19 In plasma (Neve, et al, 1983b) 117 − In serum (Kelleher, et al, 1986) 13 6-15 In serum (van Caillie-Bertrand, et al, 1982) Cu levels in other analytes 9 − No difference in Cu levels in hair (Varkonyi, et al, 1992) − − Elevated Cu levels in nails (Escobar, et al, 1980) 36 Children Elevated Cu levels in nails (van Stekelenburg, et al, 1975) 23 − Elevated Cu levels in sputum (Gray, et al, 2010) 35…”

“…No difference in Cu levels in submandibular saliva (Blomfield, et al, 1973) 13 6-15 Elevated Cu levels in urine (van Caillie-Bertrand, et al, 1982) 16 0-20 Decreased Cu levels in pancreas (Kopito, Shwachman, 1976) Iron (Fe) Decreased levels 27 3 months-12 years In 48% of North Indian CF children (Yadav, et al, 2014) 14 2-19 − (Richard, et al, 1990) 18 6-18 In plasma (Solomons, et al, 1981) 15…”

“…Although pancreatic enzyme replacement therapy is common in CF affected, fat malabsorption still continues at a certain degree (Siwamogsatham, et al, 2014). This results in the development of severe deficiency of fat-soluble vitamins (A, D, E, and K) (Carr, McBratney, 2000) and trace elements (Yadav, et al, 2014). It has been established that the nutrition status of CF patients correlates with their lung function and survival rate (Liou, et al, 2001;Gozdzik, et al, 2008).…”

Zinc Supplementation for One Year Among Children with Cystic Fibrosis Does Not Decrease Pulmonary Infection

“…2 They are more prone to illnesses caused by zinc deficiencies, such as acrodermatitis, which improve with supplementation. [3][4][5] Deficiency of micronutrients, including zinc, is associated with an increased risk of infection.…”