Renal Zinc Clearance/Glomerular Filtration Rate Ratio as an Indicator of Marginal Zinc Deficiency Associated with Iron Deficiency in Childhood

Tural, Ersin; Meral, Cihan; Süleymanoğlu, Selami; Karademır, Ferhan; Aydınöz, Seçil; Özkaya, Halit; Gültepe, Mustafa; İpçioğlu, Osman Metin; Göçmen, İsmail

doi:10.1080/07315724.2010.10719823

“…In the study by Bains et al [5], Zn deficiency was detected in 17.9% of children aged 6 months-5 years, and rates of low Fe and ferritin level were 84.6% and 71.8% among children with Zn deficiency, respectively. In the studies of Tural et al [8] and Kelkitli et al [9] from Turkey, Zn deficiency has been frequently detected in patients with Fe deficiency. In the study by Erdoğan et al [10], serum Zn level was markedly lower in patients with Fe deficiency anemia than in controls.…”

Section: Discussionmentioning

confidence: 98%

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

Ergül

¹

,

Turanoglu

²

,

Karakükçü

³

et al. 2017

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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.

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“…Motadi et al [7] revealed the rate of association of Fe and Zn deficiencies as 2% among preschool-age children. Tural et al [8] noted that there was a strict relationship between Fe and Zn, attributing this relationship to the fact that Zn is a cofactor for several enzymes involved in Fe metabolism. Kelkitli et al [9] found markedly low serum Zn level in patients with Fe deficiency anemia when compared with controls, suggesting that Zn levels should be assessed in patients with Fe deficiency anemia.…”

Section: Discussionmentioning

confidence: 99%

Increased Iron Deficiency and Iron Deficiency Anemia in Children with Zinc Deficiency

Ergül¹,

Turanoglu²,

et al. 2018

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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.

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“…A total of 26 studies measured urinary zinc in infants and children aged 0 to 9 years. [48][49][50][51]54,57,60,[62][63][64][67][68][69][70][71]74,[76][77][78][79][82][83][84][85][86][87] Of these, 14 provided data from children aged 0 to 3 years [48][49][50]54,57,60,67,71,73,74,77,84,86,87 and 13 provided data from children aged 4.5 to 9 years. 48,51,[62][63][64][68][69][70]76,79,82,…”

Section: Data Synthesismentioning

confidence: 99%

“…Tables S1 and S3 in the Supporting Information provide descriptions of these studies, with Table S1 detailing studies excluded from the metaanalyses and Table S3 detailing studies included in the meta-analyses. Urinary zinc was measured by atomic absorption spectrometry, 48,49,51,54,60,[62][63][64]68,69,71,74,[76][77][78][79]82,84,86,87 a colorimetric method, 50,67 inductively coupled plasma-atomic emission spectrophotometry, 85 inductively coupled plasma mass spectrometry, 70 and liquid chromatography. 83 Three studies assessed zinc excretion from spot urine samples.…”

Section: Data Synthesismentioning

confidence: 99%

Toward revising dietary zinc recommendations for children aged 0 to 3 years: a systematic review and meta-analysis of zinc absorption, excretion, and requirements for growth

Ceballos-Rasgado

¹

,

Lowe

²

,

Morán

³

et al. 2022

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Context The Food and Agriculture Organization of the United Nations and the World Health Organization are updating their dietary zinc recommendations for children aged 0 to 3 years. Objective The aim of this review was to retrieve and synthesize evidence regarding zinc needs for growth as well as zinc losses, absorption, and bioavailability from the diet. Data Sources MEDLINE, Embase, and Cochrane Library databases were searched electronically from inception to August 2020. Studies assessing the above factors in healthy children aged 0 to 9 years were included, with no limits on study design or language. Data Extraction Ninety-four studies reporting on zinc content in tissue (n = 27); zinc absorption (n = 47); factors affecting zinc bioavailability (n = 30); and endogenous zinc losses via urine, feces, or integument (n = 40) met the inclusion criteria. Four reviewers extracted data and two reviewers checked for accuracy. Data Analyses Studies were synthesized narratively, and meta-analyses of zinc losses and gains as well the subgroups of age, type of feeding, country’s income, and molar ratio of phytate to zinc were conducted. Meta-analysis revealed an overall mean (95%CI) urinary and endogenous fecal zinc excretion of 17.48 µg/kg/d (11.80–23.15; I2 = 94%) and 0.07 mg/kg/d (0.06–0.08; I2 = 82%), respectively, with a mean fractional zinc absorption of 26.75% (23.69–29.81; I2 = 99%). Subgrouping by age revealed differences in mean values associated with the transition from milk-based diets to solid food during the first 3 years of life. Conclusion This review synthesizes data that may be used to formulate zinc requirements in young children. Results should be interpreted with caution because of considerable heterogeneity in the evidence. Systematic Review Registration PROSPERO registration number CRD42020215236.

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Renal Zinc Clearance/Glomerular Filtration Rate Ratio as an Indicator of Marginal Zinc Deficiency Associated with Iron Deficiency in Childhood

Cited by 4 publications

References 19 publications

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

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

Increased Iron Deficiency and Iron Deficiency Anemia in Children with Zinc Deficiency

Toward revising dietary zinc recommendations for children aged 0 to 3 years: a systematic review and meta-analysis of zinc absorption, excretion, and requirements for growth

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