Increased iron deficiency and iron deficiency anemia in children with zinc deficiency

Abstract

Objective: The aim of the present study is to determine the presence of iron (Fe) deficiency and Fe deficiency anemia in children with zinc (Zn) deficiency. Materials and Methods: This retrospective study comprised 560 patients aged 6 months to 16 years in whom Zn levels in hair samples were measured concurrently with serum levels of ferritin, Fe, Fe-binding capacity, and blood count analysis. For all patients, we retrospectively assessed serum ferritin, serum Fe, Febinding capacity, transferrin saturation index, red blood cell count, hemoglobin levels, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width (RDW). Patients were divided into two groups according to the level of the hair Zn level as Zn deficiency (hair Zn level <100 µg/g) and without Zn deficiency (hair Zn level >100 µg/g). Data were analyzed to determine whether there was a significant difference between any of these parameters and the presence of Fe deficiency and Fe deficiency anemia between patients with and without Zn deficiency. Results: A total of 238 patients had Zn levels <100 µg/g, and 322 patients had Zn levels >100 µg/g. The median ferritin level was 16.2 (9.8-24.9) ng/mL in the Zn-deficient group and 18.7 (12-29.3) ng/mL in those without Zn deficiency group. The presence of Fe deficiency was higher in the Zn deficiency group (60.1%) than in the without Zn deficiency group (50%; p<0.05). The presence of Fe deficiency anemia was significantly higher in the Zn deficiency group (20.2%) than in the without Zn deficiency group (12.7%; p<0.05). There were very weak negative significant correlation between hair Zn and RDW level (r=−0.24; p<0.001) and weak positive correlation between hair Zn and MCV (r=0.31; p<0.001). Conclusion: Fe deficiency and Fe deficiency anemia increased in patients with zinc deficiency.

Sex differences and associations between zinc deficiency and anemia among hospitalized adolescents and young adults with eating disorders

“…Zinc is necessary for iron metabolism, including intestinal absorption and tissue mobilization. The relationship between zinc and hemoglobin reported in human studies [ 23 – 27 ] supports the use of plasma zinc as a marker for iron deficiency anemia [ 8 ]. However, this relationship has not been developed in patients with eating disorders.…”

“…In females, iron stores can be depleted among patients who are menstruating [ 21 ]. Animal studies have demonstrated that zinc is required for iron metabolism [ 22 ] and numerous human studies have established the correlation between low zinc and low hemoglobin [ 23 – 27 ]. Zinc could, therefore, plausibly be used as a marker of iron deficiency anemia.…”

Zinc Deficiency-induced Hypogeusia in a Patient with Refractory Iron-deficiency Anemia: A Case Report

“…It functions as a cofactor or structural stabilizer for more than 300 enzymes throughout the body and directs a wide array of biochemical and cellular processes, including signal transduction, ribonucleic acid (RNA) transcription, and cellular growth, division, and differentiation [5][6]. Interestingly, patients with IDA have been shown to have significantly reduced serum levels of zinc while IDA is significantly more prevalent in patients known to have zinc deficiency [7][8][9]. More specifically, zinc deficiency has been speculated to contribute to the development of IDA through the inhibition of the intestinal absorption of iron as well as its mobilization from tissue stores [10].…”

Iron-Induced Hepatocarcinogenesis—Preventive Effects of Nutrients

“…The zinc-deficient diet increased plasma hepcidin level, consistent with reduced intestinal iron absorption ( 109 ). There might be a physiological crosstalk between iron and zinc in erythropoiesis because clinical studies revealed that patients with iron deficiency anemia were significantly associated with zinc deficiency ( 110 , 111 ). Moreover, zinc supplementation stimulates erythropoiesis while zinc plus iron more efficiently ameliorated anemia than iron alone ( 112 , 113 ).…”