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Plasma zinc status in Indian childhood tuberculosis: impact of antituberculosis therapy
1Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Children with tuberculosis have significantly lower plasma zinc levels. Treatment with antituberculosis therapy led to a significant increase in plasma zinc, indicating its potential as a marker for disease severity and treatment response.
Area of Science:
- Pediatrics
- Biochemistry
- Infectious Diseases
Background:
- Tuberculosis (TB) is a significant global health concern, particularly in children.
- Nutritional status, including micronutrient levels like zinc, can impact TB progression and treatment outcomes.
- Plasma zinc levels have not been extensively studied as a marker in pediatric TB.
Purpose of the Study:
- To evaluate plasma zinc status in children diagnosed with various forms of tuberculosis.
- To investigate the correlation between plasma zinc levels, nutritional status, disease activity, and severity in pediatric TB patients.
- To assess the impact of antituberculosis therapy on plasma zinc levels over a six-month period.
Main Methods:
- A comparative study involving 50 children with different forms of tuberculosis and control groups of 10 healthy and 10 malnourished children without TB.
- Plasma zinc concentrations were measured at baseline (0 months) and at 1, 2, 3, and 6 months during antituberculosis therapy.
- Statistical analysis was performed to compare zinc levels between groups and over time.
Main Results:
- Children with tuberculosis exhibited significantly lower mean plasma zinc concentrations (ranging from 59.0 to 68.65 microg/dl) compared to healthy (129.10 microg/dl) and malnourished (108.40 microg/dl) children without TB (P < 0.001).
- Plasma zinc levels were lowest in disseminated TB (59.0 microg/dl) and highest in pulmonary TB (68.65 microg/dl) at the start of therapy.
- A significant increase in plasma zinc levels was observed by the end of six months of antituberculosis therapy (P < 0.001).
Conclusions:
- Children with tuberculosis demonstrate significantly depleted plasma zinc levels, irrespective of their overall nutritional status.
- Plasma zinc levels show a significant improvement following antituberculosis therapy.
- Plasma zinc status emerges as a potential objective biomarker for monitoring disease severity and therapeutic response in pediatric tuberculosis.
Setting:
Department of Paediatrics and Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Objective:
To assess the plasma zinc status in children with tuberculosis and to correlate it with nutritional status, activity and severity of disease in relation to antituberculosis therapy.
Design:
The plasma zinc status of 50 children with different forms of tuberculosis was compared with 10 healthy and 10 malnourished children without tuberculosis at 0, 1, 2, 3 and 6 months of antituberculosis therapy.
Result:
The mean plasma zinc concentration in children with pulmonary tuberculosis (n = 20) was 68.65+/-2.50 microg/dl, central nervous system (CNS) tuberculosis (n = 10) was 64.20+/-3.82 microg/dl, tuberculous lymphadenitis (n = 10) was 63.2+/-3.77 microg/dl and disseminated tuberculosis (n = 10) was 59.0+/-2.75 microg/dl at 0 months. The mean plasma zinc level of healthy children was 129.10+/-3.01 microg/dl and in malnourished non-tuberculous children it was 108.40+/-3.16 microg/dl. Thus children with tuberculosis had significantly lower plasma zinc level than those without tuberculosis, irrespective of their nutritional status (P < 0.001). There was a significant rise in zinc level at the end of 6 months of antituberculosis therapy (P < 0.001).
Conclusion:
Plasma zinc status may prove to be a good objective marker for monitoring the severity of the disease and the response to therapy.