Zinc absorption in inflammatory bowel disease

Abstract

Zinc absorption was measured in 29 patients with inflammatory bowel disease and a wide spectrum of disease activity to determine its relationship to disease activity, general nutritional state, and zinc status. Patients with severe disease requiring either supplementary oral or parenteral nutrition were excluded. The mean 65ZnCl2 absorption, in the patients, determined using a 65Zn and 51Cr stool-counting test, 45 +/- 17% (SD), was significantly lower than the values, 54 +/- 16%, in 30 healthy controls, P less than 0.05. Low 65ZnCl2 absorption was related to undernutrition, but not to disease activity in the absence of undernutrition or to zinc status estimated by leukocyte zinc measurements. Mean plasma zinc or leukocyte zinc concentrations in patients did not differ significantly from controls, and only two patients with moderate disease had leukocyte zinc values below the 5th percentile of normal. In another group of nine patients with inflammatory bowel disease of mild-to-moderate severity and minimal nutritional impairment, 65Zn absorption from an extrinsically labeled turkey test meal was 31 +/- 10% compared to 33 +/- 7% in 17 healthy controls, P greater than 0.1. Thus, impairment in 65ZnCl2 absorption in the patients selected for this study was only evident in undernourished persons with moderate or severe disease activity, but biochemical evidence of zinc deficiency was uncommon, and clinical features of zinc depletion were not encountered.

Zinc regulates the function and expression of the iron transporters DMT1 and IREG1 in human intestinal Caco‐2 cells

“…It is well recognised that there are interactions between these metals in the intestinal lumen, affecting their dietary bioavailability. For example, high concentrations of iron can inhibit zinc absorption [1–6] and likewise high zinc content can reduce iron absorption [7]. However, relatively little is known regarding the effects of prolonged high dietary metal intake on the transport machinery required for the absorption of these essential micronutrients.…”

Zinc deficiency manifested by dermatitis and visual dysfunction in a patient with Crohn's disease

“…1 Impaired absorption has been considered to be the most important factor in the development of zinc deficiency in Crohn's disease. 8,9 Zinc absorption is decreased even in the histologically normal intestinal mucosa in patients with Crohn's disease. 9 The patient presented here had a history of longstanding Crohn's disease and simultaneously manifested dermatitis and decreased visual acuity after the institution of total parenteral nutrition.…”

Nutrition and Gastrointestinal Illness

“…Folic acid ' s use in chemoprevention for colon cancer is controversial (Levine and Burakoff, 2007 ). Zinc defi ciency may be observed in upwards of 40% of patients with Crohn ' s disease because of fecal loss of zinc in diarrhea (Valberg et al , 1986 ). Defi ciency can be diffi cult to determine based on measurement of serum zinc concentration because zinc is bound to albumin, other proteins, and amino acids, concentrations of which may be depressed in active Crohn ' s disease because of the presence of a protein -losing enteropathy.…”