Assessment of zinc nutritional status of pellagra patients

The objective of the present study was to assess zinc nutritional status in alcoholic patients with pellagra using plasma, hair, urine and nail zinc levels, as well as the zinc tolerance test. The study was conducted on 81 patients, 73 males and eight females. Zinc parameters were compared with those of 84 individuals with no apparent disease aged 23-45 years. Plasma zinc levels were lower in patients with pellagra than in the controls (P < 0.01). The results of the zinc tolerance test showed that: (1) basal zinc levels were 69.7 +/- 16.8 micrograms/100 ml in pellagrins and 82.3 +/- 34.0 micrograms/100 ml in the controls (P < 0.01); (2) after 1 h the increase in plasma levels was similar in the pellagrin and control groups; (3) during the second hour the increase was more marked in the controls (P < 0.01), and the same was observed during the third and fourth hours (P < 0.05). Urinary zinc excretion (mg/24 h) was higher in pellagrins (P < 0.01). Zinc concentration in hair and toenails did not differ between pellagrins and controls. We conclude that pellagrins present zinc deficiency as demonstrated by plasma and urine zinc levels and by their abnormal response to the zinc tolerance test. We suggest that hair and nail zinc levels should not be used to assess zinc nutritional status in patients with pellagra.