Estado nutricional de zinc en una serie de pacientes con enfermedades crónicas

Estado Nutricional de Zinc en una Serie de Pacientes con Enfermedades Crónicas. Valladolid - España. 2001 – 2003. Introducción: El zinc es un micronutriente esencial para todas las formas de vida y su deficiencia afecta el normal crecimiento y desarrollo del ser humano. Objetivo: El principal objetivo fue investigar el estado nutricional de zinc en una serie de pacientes infanto-juveniles con enfermedades crónica de diferente etiología. Material y métodos: Se realizó un estudio transversal en cien pacientes entre 1 a 31 años de edad, con enfermedades crónicas de diferente etiología; remitidos consecutivamente para su valoración nutricional a la Unidad de Nutrición Pediátrica del Hospital Clínico Universitario de Valladolid. Los pacientes fueron clasificados de acuerdo al sexo, grupos de edad por Tanner, diagnóstico de patología de base y estado de nutrición por índice de masa corporal (IMC). Se realizó una valoración antropométrica, determinándose la prevalencia de retraso del crecimiento (RC) por la talla para la edad (T/E) en los niños menores de 5 años. Se evaluó el perfil lipídico y la concentración sérica de zinc (CSZ:μg/dL). Se comparó la exactitud y precisión del método Colorimétrico respecto al método de espectrofotometría de absorción atómica de llama (EAA). Se estableció la ingesta dietética de zinc (mg/día) y el consumo de energía (kilocalorías/día) en porcentaje de la ingesta dietética de referencia (%IDR); empleando una encuesta dietética prospectiva de 72 horas (incluyendo uno de los días de fin de semana). Se valoró el estado nutricional y el estado marginal de zinc, empleando los tres indicadores recomendados por WHO/UNICEF/IAEA/IZiNCG: Prevalencia >20% de RC en los niños menores de 5 años, > 25% de deficiencia dietética de zinc (DDZ), y >20% de deficiencia sérica de zinc o hipozincemia. Resultados: La media de la T/E ((-1.28 ± 1.03 cm), de la ingesta dietética de zinc (73.4 ± 35%IDR) y de la CSZ (86.5 ± 13 μg/dL), fueron normales. Se observó una asociación positiva y significativa entre la ingesta de zinc y el consumo de energía. La CSZ se asoció positiva y significativamente con el coeficiente LDL/HDL, y negativamente con el HDL-Colesterol. El 22.2% de los niños menores de cinco años presento RC, el 62% DDZ y el 8% hipozincemia. El 5.1% de los pacientes presento DDZ e hipozincemia simultáneamente, el 3.1% hipozincemia con adecuada ingesta dietética de zinc, y el 57.1% DDZ sin hipozincemia. El 16% de los pacientes con hiperlipidemia y fibrosis quística y el 14% con enfermedad renal, se hallaban cerca de la zona de riesgo de deficiencia de zinc (>20%). Conclusiones: Soló cinco pacientes de nuestra serie presentaron DDZ e hipozincemia. Esta situación debería alertarnos de un estado de deficiencia marginal de zinc, el cual podría explicar porque no hay más casos superpuestos entre estos dos grupos. Sugerimos que probablemente el 65% de los casos en este estudio estarían en elevado riesgo de deficiencia de zinc y debería considerarse su suplementación.Departamento de Pediatría e Inmunología, Obstetricia y Ginecología, Nutrición y Bromatología, Psiquiatría e Historia de la CienciaDoctorado en Investigación en Ciencias de la Salu

Efectos de la administración de sulfato de zinc sobre el estado nutricional en niños con insuficiencia renal crónico terminal: Lima-Perú, 1996-1997

Objetivos: Evaluar el efecto de la administración de sulfato de zinc sobre el estado nutricional en niños con insuficiencia renal crónica. Material y métodos: Este estudio fue llevado a cabo en 48 niños con insuficiencia renal crónica. El estudio fue controlado, concurrente, aleatorizado y abierto (no enmascarado), realizándose en dos fases: Fase I: Diagnóstico del estado nutricional basal. Dos meses de duración: valoración antropométrico mensual (10 indicadores) y un análisis bioquímico (3 indicadores). Fase II: Doce meses. Por aleatorización restrictiva fueron asignados a un grupo A (30 mg de sulfato de Zn/día) o B (15 mg de Zn/día). El grupo B se consideró como grupo control y la dosis de 15 mg como el requerimiento mínimo necesario diario de zinc. Se hizo un seguimiento antropométrico mensual y un análisis bioquímico en el último mes. Se obtuvieron los niveles séricos de la proteína C reactiva (marcador de infección), de la albúmina (reserva proteica visceral) y del zinc. Las valoraciones antropométricas de peso (P), talla (T), perímetro braquial (PB) y pliegue cutáneo tricipital (PCT) sirvieron para elaborar los siguientes indicadores: peso para la edad (P/E), talla para la edad (T/E), peso para la talla (P/T), índice nutricional (IN), índice de masa corporal (IMC), masa magra (MM), masa grasa (MG) y la velocidad de crecimiento (VC). La prueba estadística empleada fue la no paramétrica de los rangos con signo de Wilcoxon. Resultados: De los 13 indicadores nutricionales, se obtuvo una media de 0,78% de obesos, un 36,45% de eutróficos y un 59,64% de desnutridos en la primera evaluación. Posterior a la administración oral de zinc se mantuvo una media de 1,04% de obesidad, un 27,06% de eutrofia y un 43,49% de desnutrición. Hubo un 25% y un 20,84% de hipozincemia en la primera y segunda evaluación bioquímica, respectivamente. Con 30 mg/día de sulfato de zinc, se consiguió un cambio significativo en la masa corporal, patente a través del índice nutricional (p=0,025), del índice de masa corporal (p=0,009), y del perímetro braquial (p=0,041). Este incremento en la masa corporal fue significativo en el grupo de menores de 14 años, con dosis de 30 mg/día, evidenciado a través del índice de masa corporal (p=026) y del perímetro braquial (p=0,039).Objectives: Evaluate the effect of administration of zinc sulfate on nutritional status in children with chronic renal failure. Material and methods: This study was conducted in 48 children with chronic renal failure. The study was controlled, concurrent, randomized and open (not masked), conducted in two phases: Phase I: Baseline nutritional status diagnosis.Two months: monthly anthropometric assessment (10 indicators) and biochemical analysis (3 indicators). Phase II: Twelve months. For restrictive randomization were assigned to group A (sulfate 30 mg Zn/day) or B (15 mg Zn/day). Group B was a control group and the dose of 15 mg Zn/day as the minimum daily requirement of zinc. Were followed monthly anthropometric and biochemical analysis in the last month. We obtained serum levels of C-reactive protein (marker of infection), albumin (visceral protein reserve) and zinc. Anthropometric assessments of weight (W), height (H), mid-arm circumference (MAC) and triceps skinfold thickness (TSF) were used to develop the indicators: weight for age (W/A), height for age (H/A), weight for height (W/H), nutritional index (IN), body mass index (BMI), mid-arm muscle area (MAMA) or lean mass (LM), fat mass (FM) and growth rate (GR). The statistics test used was the nonparametric test of Wilcoxon signed ranks. Results: Of the 13 indicators of nutrition, we obtained an average of 0.78% of obese, a 36.45% of normal and an 59.64% of malnourished children in the first evaluation. After oral administration of zinc remained half of 1.04% of obesity, eutrophication of a 27.06% of normal and 43.49% of malnutrition. There were 25% and 20.84% of hypozincemia in the first and second biochemical evaluation, respectively. With 30 mg/day of zinc sulfate, there was a significant change in the nutritional index (p=0.025), the body mass index (p=0.009) and in arm circumference (p=0.041). This increase in body mass was significant in the age group under 14 years, with doses of 30 mg/day, evidenced through the body mass index (p=0.26) and the arm circumference (p=0.039).Tesi

Zinc nutritional status in a series of Children with chronic diseases: A cross-sectional study

Producción CientíficaZinc is an essential trace element for the normal growth and development of human beings. The main objective was to evaluate the nutritional status of zinc and its association with nutritional indicators in a series of children with chronic diseases. Methods: The prevalence of patients with dietary zinc deficiency or deficit zinc intake (<80% DRI: dietary reference intake) was analyzed through prospective 72 h dietary surveys, and serum zinc deficiency or hypozincemia (≤70 µg/dL in children under 10 years of age in both sexes and in females older than 10 years and <74 µg/dL in males older than 10 years) was measured through atomic absorption spectrophotometry. The participants were classified according to their nutritional status by body mass index (BMI). Results: Mean serum zinc level in obese (87 µg/dL), undernourished (85 µg/dL), and eutrophic children (88 µg/dL) were normal, but in the undernutrition (60% DRI) and eutrophic (67% DRI) groups the mean dietary zinc intake was low compared to that in the obesity group (81% DRI). There were different associations between nutritional parameters, dietary zinc intake, and serum zinc. All patients with hypozincemia had dietary zinc deficiency. Conclusions: In the whole series, 69%of participants showed a zinc intake lower than recommended and might be at high risk of zinc deficiency

Copper and Copper/Zn Ratio in a Series of Children with Chronic Diseases: A Cross-Sectional Study

Copper is an essential micronutrient for humans. A cross-sectional and comparative study was done to assess serum Cu levels and serum copper/zinc (Cu/Zn) ratio and its association with nutritional indicators in a series of children and adolescents with chronic diseases. Anthropomet-ric, biochemical, dietary, body composition, and bone densitometry assessments were carried out. Serum Cu and Zn were measured by atomic absorption spectrophotometry. Seventy-eight patients (55% women) participated. The mean serum Cu in the entire series and by nutritional status through body mass index (BMI) was normal. Serum Cu decreased significantly with age and was meaning-fully higher in children than in adolescents. The risk of finding altered Cu levels in children and men was higher than in adolescents and women, respectively. Twenty-two per cent of patients had abnormal serum copper levels, 13 had hypercupremia, and four had hypocupremia. The Cu/Zn ratio was greater than 1.00 for 87% of the patients, which is an indicator of an inflammatory state. All patients with hypozincemia and hypocupremia had deficient Zn intake, but only 65% of the patients with hypercupremia had dietary Zn deficiency. Consequently, the Cu/Zn ratio could indicate an inflammatory state and a high risk of zinc deficiency in this specific child population

Comparison study between colorimetric method and flame atomic absorption spectrophotometry in serum zinc status

Introduction: Zinc is an essential trace element for human life and its deficiency affects human growth and development. Serum zinc concentration (SZnC) provides useful information in the clinical categorization of deficiency and toxicity states. Objectives: This paper presents a comparison study of Flame Atomic Absorption Spectrometry (FASS) and the Colorimetric method in the analysis of SZnC and hypozincemia. Methods: The serum concentrations of zinc of 93 patients (1 to 31 years old) with chronic diseases were used for analysis. Statistical analytical: for SZnC, Pearson correlation coefficient, simple linear regression analysis, Bland & Altman method (B&A), and concordance correlation coefficient (CCC) were valued; and for hypozincemia, the differences were studied and Cohen’s Kappa index was used. Results: The main results indicate the means of the SZnC by both methods presented neither significant difference (p=0.328) nor linear relation (R=0.18, p=0.077). Furthermore, the percentage of cases of hypozincemia by the Colorimetric method was almost double (13%) than by the FASS (8%). There was only one coincident case in both methods at <70 μg/dl. Discussion: The Colorimetric method in hypozincemia ranges predicted lower values with the FASS. This concordance poor between both methods was corroborated with a concordance correlation coefficient (CCC) lowly of 0.17. Moreover, the Cohen’s Kappa index (-0.013) shown a concordance poor between both methods, too. In other studies, the variability of SZnC by Colorimetric method is more than FASS. Conclusion: In summary, despite that, the mean of serum concentrations of zinc by both methods is similar; the diagnosis of cass with hypozincemia is not. The degree of agreement between methods is poor, with a poor strength of concordance to diagnosis hypozincemia. Therefore, we recommended the use of FASS to evaluated zinc status and diagnosis of hypozincemia, instead of the Colorimetric method

Land Vulnerability, Risk Zoning, and Ecological Protection in the Protection Forest of Pagaibamba (Peru)

The protection of natural areas is considered an essential strategy for environment conservation. The objective of this work was to determine the level of vulnerability, considering the characterization and identification of the risk zones and ecological protection of the Pagaibamba Protection Forest (PPF, Peru). To determine the vulnerable areas, Landsat ETM satellite images, topographic, geological, ecological, and vegetation cover maps were used. Geological, physiographic, edaphological, vegetation cover, and land use potential characteristics, were analyzed. Three Ecological Protection and Risk Zones were identified, with the largest extension of the PPF corresponding to lands of very high and high vulnerability and high ecological risk, which include >85% of Protected Natural Areas (PNA) and 54% of the Buffer Zone (BZ). Moderate risk areas represent 30% of the Buffer Zone (BZ) and 13% of the PNA, and the low-risk areas (represent 15% of the BZ and 2% of the PNA). Biogeographically, the PPF was related to the Cloudy Montane Forests Ecoregion of the Andes Mountains, standing out the Tropical Montane Cloud Forest (TMCF) and the Tropical Lower Montane Cloud Forest (TLMCF). These forests are a global conservation priority due to their great biodiversity, high level of endemicity of flora and fauna, and the crucial hydrological function they fulfill

Estado nutricional de zinc en una serie de pacientes con enfermedades crónicas

Dado que el zinc es un elemento esencial para todas las formas de vida, se realizó un estudio transversal con el objetivo de investigar el estado nutricional de zinc en una serie de pacientes infanto-juveniles con enfermedades crónica de diferente etiología. Se evaluó el porcentaje de niños menores de cinco años con retraso de crecimiento (RC), la prevalencia de casos con hipozincemia y con deficiente ingesta de zinc. El 22% de niños menores de 5 años tuvo RC, el 62% deficiencia dietética de zinc y el 8% hipozincemia. Por lo tanto, el 65% de la serie presenta alto riesgo de deficiencia de zinc

Copper and Copper/Zinc Ratio in a Series of Cystic Fibrosis Patients

t: Cystic fibrosis (CF) patients require a stable and sufficient supply of micronutrients. Since copper is an essential micronutrient for human development, a cross-sectional study was carried out to investigate the serum copper levels, serum copper/zinc (Cu/Zn) ratios, and their relationship with nutritional indicators in a group of CF patients. Anthropometric, biochemical, and dietary measurements, an abdominal ultrasound, and respiratory and pancreatic tests were conducted. Seventeen CF patients were studied (10 females, 59%), 76.5% of whom were ∆F580. Their mean serum copper (113 ± 23 µg/dL) was normal, and there was only one teenager with hypocupremia (6%) and two children with hypercupremia (18%). A significant association between serum copper and zinc levels was discovered. The Cu/Zn ratio was higher than 1.00 for 94% of patients, which is an indicator of an inflammation status. There was no significant correlation between the serum copper concentrations and respiratory and pancreatic function, respiratory colonization, and the results of the abdominal ultrasound. Linear regression analysis showed that serum copper had a positive association with both the Z-score body mass index (BMI) and mean bone conduction speed (BCS). Therefore, since 94% of CF patients had a Cu/Zn ratio > 1.00, this factor must alert us to consider the risk of zinc deficiency and high inflammatory response. The measurement of serum zinc alone does not show one’s zinc status. However, the Cu/Zn ratio may be an indicator of zinc deficiency and the inflammatory status of CF patients

Effects of Zinc Supplementation on Nutritional Status in Children with Chronic Kidney Disease: A Randomized Trial

Zinc is an essential micronutrient for human beings and its deficiency a ects their normal growth and development. Objective: The main aim was to evaluate the e ect of two doses of zinc supplementation (ZS) on the nutritional status in chronic kidney disease (CKD) children. Methods: A randomized-trial multicentric study was conducted in 48 CKD (23 females) patients under 18-years-old, for a year. At random, participants took 30 or 15 mg/day of ZS, respectively. Anthropometric measurements and biochemical analysis were performed. Hypozincemia was determined by serum zinc concentration (SZC) using atomic absorption spectrophotometry. The positive or negative change in patients’ body mass index (BMI) Z-score, serum albumin, zinc and C-reactive protein (CRP) levels were used to evaluate the e ect of ZS. Results: Mean SZC was normal before and after ZS. Despite ZS, there were no significant changes in serum albumin, zinc and CRP levels. A positive and significant association was observed between SZC and serum albumin before (p = 0.000) and after (p = 0.007) ZS. In both groups of ZS, there was a small but positive and significant change in body mass and normalization in BMI Z-score, hypoalbuminemia, hypozincemia and high CRP, especially with 30 mg/day of ZS. Conclusions: Zinc supplementation may be beneficial for nutritional status in children and adolescents with CKDCONCYTEC in Lima, Per