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Published on: May 16, 2019
Predictors of plasma zinc concentrations in children with acute diarrhea
Tor A Strand1, Ramesh K Adhikari, Ram K Chandyo
1Centre for International Health, University of Bergen, Norway.
Insights
Factors like fever, inflammation, and hemolysis impact plasma zinc levels in children with diarrhea. Dehydration and albumin levels also influence zinc status, requiring consideration for accurate assessment.
Area of Science:
- Pediatric Nutrition
- Clinical Biochemistry
- Infectious Diseases
Background:
- Plasma and serum zinc concentrations are key indicators of zinc status.
- Accurate assessment of zinc status is crucial for child health.
Purpose of the Study:
- To identify factors influencing plasma zinc concentrations in children experiencing acute diarrhea.
- To understand the relationship between various clinical and biochemical markers and zinc status during diarrheal episodes.
Main Methods:
- Cross-sectional study involving 1757 Nepalese children (6-35 months) with acute diarrhea.
- Linear regression analyses were used to assess associations between plasma zinc and clinical, anthropometric, socioeconomic, and biochemical variables.
Main Results:
- Increased axillary temperature, dysentery, and elevated C-reactive protein were associated with lower plasma zinc.
- Dehydration correlated with higher plasma zinc, while decreased albumin was linked to lower plasma zinc.
- Hemolysis was positively associated with plasma zinc concentration.
Conclusions:
- Plasma zinc assessment in diarrheal illness requires accounting for dehydration, inflammation indicators (e.g., C-reactive protein), hemolysis, and plasma albumin levels.
- These factors are critical for accurate interpretation of zinc status during childhood diarrhea.
Background:
Plasma and serum zinc concentrations are the most widely used markers of zinc status in individual persons and populations.
Objective:
The objective was to identify factors that influence plasma zinc concentrations during acute childhood diarrhea.
Design:
This was a cross-sectional study of 1757 cases of acute diarrhea in 6-35-mo-old Nepalese children. The association between plasma zinc concentration and several clinical, anthropometric, socioeconomic, and biochemical variables was estimated in simple and multiple linear regression analyses.
Results:
We observed a reduction in the mean plasma zinc concentration of 0.59 (95% CI: 0.44, 0.74) micro mol/L per degree ( degrees C) increase in axillary temperature. Having dysentery and an elevated plasma C-reactive protein concentration was also independently associated with lower plasma zinc. Children with clinical features of dehydration had higher plasma zinc concentrations than did those who were not dehydrated. Furthermore, a decrease in plasma albumin of 1 g/L was associated with a decrease in plasma zinc of 0.25 (95% CI: 0.21, 0.29) micro mol/L. The plasma albumin concentration confounded the associations between some clinical variables and plasma zinc, but the association between axillary temperature and dehydration on one hand and plasma zinc on the other was not substantially influenced by the albumin concentration. Moreover, the plasma zinc concentration increased with an increase in observed hemolysis.
Conclusions:
Dehydration, clinical and biochemical indicators of inflammation and hemolysis, and, when possible, plasma albumin concentrations should be taken into account when the plasma zinc concentration is used to estimate zinc status during episodes of diarrhea in childhood.
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