Serum zinc levels in patients with iron deficiency anemia and its association with symptoms of iron deficiency anemia

Abstract

Iron deficiency anemia (IDA) is a major public health problem especially in underdeveloped and developing countries. Zinc is the co-factor of several enzymes and plays a role in iron metabolism, so zinc deficiency is associated with IDA. In this study, it was aimed to investigate the relationship of symptoms of IDA and zinc deficiency in adult IDA patients. The study included 43 IDA patients and 43 healthy control subjects. All patients were asked to provide a detailed history and were subjected to a physical examination. The hematological parameters evaluated included hemoglobin (Hb); hematocrit (Ht); red blood cell (erythrocyte) count (RBC); and red cell indices mean corpuscular volume (MCV), mean corpuscular hemoglobin (МСН), mean corpuscular hemoglobin concentration (МСНС), and red cell distribution width (RDW). Anemia was defined according to the criteria defined by the World Health Organization (WHO). Serum zinc levels were measured in the flame unit of atomic absorption spectrophotometer. Symptoms attributed to iron deficiency or depletion, defined as fatigue, cardiopulmonary symptoms, mental manifestations, epithelial manifestations, and neuromuscular symptoms, were also recorded and categorized. Serum zinc levels were lower in anemic patients (103.51 ± 34.64 μ/dL) than in the control subjects (256.92 ± 88.54 μ/dL; <0.001). Patients with zinc level <99 μ/dL had significantly more frequent mental manifestations (p < 0.001), cardiopulmonary symptoms (p = 0.004), restless leg syndrome (p = 0.016), and epithelial manifestations (p < 0.001) than patients with zinc level > 100 μ/dL. When the serum zinc level was compared with pica, no statistically significant correlation was found (p = 0.742). Zinc is a trace element that functions in several processes in the body, and zinc deficiency aggravates IDA symptoms. Measurement of zinc levels and supplementation if necessary should be considered for IDA patients.

Zinc deficiency and its predictive capacity for anemia: Unique model in school children

“…Kelkitli et al suggested a mediator role for zinc in iron metabolism in anemia pathogenesis. 26 The aforementioned studies and the present results indicate that the etiopathogenesis of anemia in zinc deficiency is still unclear. The proportions of the contribution of these minerals to the development of anemia are also unclear.…”

The Relationship of Vitamin B12 Deficiency and Red Cell Distribution Width-Platelet Ratio

“…RDW indicates heterogeneity and equivalent of anisocytosis of red blood cell. It was documented that high levels of RDW predicts elevated red blood cell destruction in iron, folate, and vitamin B12 deficiency [19][20][21]. Eventually, different-sized erythrocytes may be expressed and elevated RDW may result in increased RPR.…”

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

“…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.…”