Subclinical Trace Element Deficiency in Children with Undue Susceptibility to Infections

ABSTRACT. Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron ( p < 0.05) and zinc ( p < 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.     

Subclinical trace element deficiency in children with undue susceptibility to infections

Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p less than 0.05) and zinc (p less than 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.     

Early Changes of Some Serum Proteins and Metals in Diabetic Children

ABSTRACT. Serum concentrations of prealbumin, albumin, orosomucoid, magnesium, zinc and calcium were studied in 30 children with newly diagnosed IDDM aged 3–15 years, during the first two years of the disease, and in 44 healthy control children. On admission serum prealbumin was significantly lower in IDDM children (149±48 mg/1) (M±SD) than in healthy controls (194±39 mg/1) ( p <.001). During the two years follow-up prealbumin increased significantly, but did not reach the level of healthy controls. Serum albumin was slightly increased at diagnosis ( p <0.01), but later decreased significantly ( p <0.01). Orosomucoid concentrations did not differ between diabetics and controls. Serum magnesium was initially within the reference interval but later decreased, and after 2 years of IDDM it was highly significantly reduced ( p <0.001). Serum zinc was significantly reduced in IDDM children at diagnosis ( p <0.001), but was within the reference interval after one and 2 years. Serum calcium was increased in the IDDM group at diagnosis ( p <0.01), but later normalized. It is concluded that in early IDDM there is a decrease in serum prealbumin and albumin, and serum magnesium decreases progressively, while serum zinc is only transiently reduced.     

Serum zinc,copper, and magnesium levels in obese children

Serum zinc, copper and magnesium levels were measured using atomic absorption spectrophotometry in 41 obese and 41 healthy (control) children (between 7 and 11 years of age) who were living in Malatya (Turkey). Serum zinc levels of obese children (mean value 102.40 ± 2.78 μg/dL) were found to be significantly higher than those of the control group (mean value 80.49 ± 2.98 μg/dL; P < 0.01). Serum copper concentrations were also found to be significantly higher in obese children (mean value 132.34 ± 1.79 μg/dL) than the healthy controls (mean value 107.58 ± 1.62 μg/dL; P < 0.01). On the other hand, serum magnesium levels were found to be significantly lower in obese children (mean value 1.78 ± 0.03 mg/dL) than in the healthy children (mean value 2.14 ± 0.04 mg/dL; P < 0.01).     

Interaction between anemia and blood levels of iron,zinc, copper,cadmium and lead in children

Objective Anemia is a widespread problem among infants and children in many parts of the world, and it is often associated with some trace elements (iron, zinc, copper) and heavy metals (cadmium and lead). Aim of this study was to investigate the relationship between anemia and these elements. Methods This research was performed on 256 children (mean age 6.8 ± 0.2) living in Denizli city center. We observed iron deficiency anemia (IDA) in 23 children, iron deficiency without anemia (ID) in 36 children and only anemia (ferritin level normal) (OA) in 18 children, and 179 children were found healthy and they were regarded as controls (C). Blood samples were taken from subjects and the concentrations of zinc, copper, iron, cadmium and lead in serum were measured with atomic absorption spectrophotometer. Results The levels of copper, cadmium and lead in serum were significantly higher in children with IDA than those of controls (p<0.05, p<0.05, p<0.01, respectively). The other elements in the serum of ID were not different from controls.     

孤独症谱系障碍儿童血清微量元素水平与核心症状间关系的全国多中心调查

目的 探讨孤独症谱系障碍（autism spectrum disorder,ASD）儿童的血清微量元素水平与ASD核心症状之间的关系。方法 2018年9月至2019年9月在中国13个城市三级甲等医院门诊和特殊教育机构调查了1 020例ASD儿童和1 038例年龄、性别相匹配的健康儿童,采用孤独症行为量表、社交反应量表和孤独症评定量表评估ASD儿童的核心症状,采用电感耦合等离子体质谱法测定血清微量元素镁、铁、铜、锌的水平。结果 ASD儿童的血清镁、铜和锌水平显著低于健康儿童（均P < 0.05）。重度ASD儿童的血清镁和锌水平显著低于轻-中度ASD儿童（均P < 0.05）。偏相关分析结果显示,血清镁水平与孤独症行为量表总分、交往能力得分呈负相关（分别r=-0.318、0.282,均P < 0.001）;血清锌水平与孤独症行为量表总分、交往能力得分及躯体运动得分呈负相关（分别r=-0.221、-0.270、-0.207,均P < 0.001）。结论 血清镁和锌水平与ASD儿童核心症状具有一定关联,但这种关联的意义需要进一步研究;临床上应注意监测ASD儿童的微量元素营养状况。     

Predictive inability of cord zinc, magnesium and copper levels on the development of benign hyperbilirubinemia in the newborn

Cord serum concentrations of zinc, magnesium and copper were determined in 90 healthy term infants. The infants were divided by peak bilirubin values into an icteric group (peak bilirubin > 136 mumol/l) (n = 21) and a control group (peak bilirubin < or = 136 mumol/) (n = 69). Mean cord serum zinc, magnesium and copper concentrations in the icteric group did not differ from those of the control group. Furthermore, no significant correlation was found between peak serum bilirubin concentrations and cord serum concentrations of these three elements. We conclude that cord serum concentrations of zinc, magnesium or copper are not useful in predicting which neonates will develop hyperbilirubinemia.     

Assessment of magnesium status in newly diagnosed diabetic children: measurement of erythrocyte magnesium level and magnesium tolerance testing

The aim of this study was to investigate the relationship between serum, erythrocyte and urine magnesium levels and retained magnesium percentage in newly diagnosed diabetic children. In a cross-sectional study, 34 children with insulin dependent diabetes mellitus (IDDM) and 21 healthy age- and sex-matched control subjects were screened for their serum, erythrocyte, and urine magnesium levels. Magnesium tolerance test was performed on diabetic and control subjects. Serum and erythrocyte magnesium levels in diabetic children were significantly lower than in healthy controls (plasma magnesium, p<0.05; erythrocyte magnesium, p<0.001); however, serum magnesium level was in normal range in diabetics and controls. Erythrocyte magnesium levels in diabetic children showed an inverse correlation with percentage of retained magnesium load (r=-0.44, p<0.01). Urine magnesium excretion in diabetic children (7.12 +/- 2.18 mmol/g creatinine/24-hr) was significantly higher than in healthy controls (4.0 +/- 1.35 mmol/g creatinine/24-hr) (p<0.001). There was a negative correlation between erythrocyte magnesium (2.07 +/- 0.62 mmol/L) and urine magnesium (7.12 +/- 2.18 mmol/g creatinine/24-hr) (r=-0.68 p<0.01) in diabetic children. Magnesium tolerance test showed that percentage of retained magnesium in diabetic children (66 +/- 26%) was significantly higher than in controls (16 +/- 7%) (p<0.001). This study is the first study to simultaneously investigate serum, erythrocyte and urine magnesium levels and magnesium tolerance test in newly diagnosed diabetic children. In conclusion, erythrocyte magnesium levels decrease earlier than serum magnesium in diabetic children. The follow-up parameters in diabetics may include the policy of monitoring magnesium status. Erythrocyte magnesium measurement is preferred to serum magnesium. Magnesium tolerance test is a reliable and sensitive method, which may be used as an alternative to erythrocyte magnesium measurement or in combination with it in hospitalized diabetic children.     

Zinc and Copper Status of Allergic Children

ABSTRACT. Zinc and copper status was examined in 19 healthy and 43 atopic children (22 asthmatics and 21 eczematous) 2–14 years old. Dietary intakes for energy, protein, zinc and copper and some nutritional indices (height, weight, serum protein, albumin, ceruloplasmin) were similar in the allergic and in the control group. The proton-induced X-ray fluorescence technique was used to assess zinc and copper concentrations in serum and hair. No difference was detected in serum zinc concentration between allergic and healthy children. In contrast, mean hair zinc level was lower ( p <0.05) in allergic than in healthy children (99±6 vs. 147±9 μg/g). Mean serum copper content was higher in asthmatic than in control children while mean hair copper was higher ( p <0.05) in asthmatic and eczematous children than in the control group. These findings suggest a different zinc and copper nutritional status between allergic and healthy subjects. Allergic children, in particular, seem to be a risk of zinc deficiency.     

Early changes of some serum proteins and metals in diabetic children

Serum concentrations of prealbumin, albumin, orosomucoid, magnesium, zinc and calcium were studied in 30 children with newly diagnosed IDDM aged 3-15 years, during the first two years of the disease, and in 44 healthy control children. On admission serum prealbumin was significantly lower in IDDM children (149 +/- 48 mg/l) (M +/- SD) than in healthy controls (194 +/- 39 mg/l) (p less than 0.001). During the two years follow-up prealbumin increased significantly, but did not reach the level of healthy controls. Serum albumin was slightly increased at diagnosis (p less than 0.01), but later decreased significantly (p less than 0.01). Orosomucoid concentrations did not differ between diabetics and controls. Serum magnesium was initially within the reference interval but later decreased, and after 2 years of IDDM it was highly significantly reduced (p less than 0.001). Serum zinc was significantly reduced in IDDM children at diagnosis (p less than 0.001), but was within the reference interval after one and 2 years. Serum calcium was increased in the IDDM group at diagnosis (p less than 0.01), but later normalized. It is concluded that in early IDDM there is a decrease in serum prealbumin and albumin, and serum magnesium decreases progressively, while serum zinc is only transiently reduced.     

Serum soluble endothelial-cell specific adhesion molecules in children with insulin-dependent diabetes mellitus

Endothelial-cell specific adhesion molecules are reported to be elevated in patients with diabetes mellitus and related to diabetic vascular complications. We studied serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), endothelial-leukocyte adhesion molecule (sE-selectin) in 30 healthy children and 35 children with type 1 diabetes without symptomatic vascular complications. sE-selectin levels were higher in diabetics than in controls (p < 0.001). sVCAM-1 and sICAM-1 levels were not different between the groups (p > 0.05). In seven newly diagnosed diabetics with ketoacidosis, concentrations of these molecules were not different before and after one month of insulin therapy (p > 0.05). In the combined group, only sE-selectin was correlated positively with serum glucose, HbA1c (r = 0.3, p < 0.05 for both) and negatively with C-peptide levels (r = -0.4, p < 0.05). In diabetic children without symptomatic vascular complications, sE-selectin but not sICAM and sVCAM levels was elevated; this finding might reflect ongoing endothelial-cell activation rather than endothelial damage.     

Reduced Serum Proteins in Diabetic Children on a Twice-Daily Insulin Schedule

ABSTRACT. The concentrations of selected proteins of transport and nutrition were investigated in 27 diabetic children and 13 healthy controls by an immunodiffusion technique. The diabetic children had significantly lower mean pre-albumin ( p <0.001), albumin ( p <0.01) and orosomucoid levels ( p <0.05) than the healthy controls. No correlation was observed between age or sex and the blood concentrations of the specific proteins analyzed in this series. Haptoglobin and hemopexin showed positive correlations with serum triglycerides (both p <0.01) and slight positive correlations with some of the variables of carbohydrate control. The reduced levels of prealbumin and albumin were not correlated to diabetic control as measured by HbA₁, fasting plasma glucose or urinary glucose excretion. The non-physiological distribution site and the abnormal temporal pattern of insulin offered to diabetic children might be the reason for the protein abnormalities found in this study. This is seemingly the first time reduced serum levels of proteins have been reported in diabetic children .     

Zinc and copper status of allergic children

Zinc and copper status was examined in 19 healthy and 43 atopic children (22 asthmatics and 21 eczematous) 2-14 years old. Dietary intakes for energy, protein, zinc and copper and some nutritional indices (height, weight, serum protein, albumin, ceruloplasmin) were similar in the allergic and in the control group. The proton-induced X-ray fluorescence technique was used to assess zinc and copper concentrations in serum and hair. No difference was detected in serum zinc concentration between allergic and healthy children. In contrast, mean hair zinc level was lower (p less than 0.05) in allergic than in healthy children (99 +/- 6 vs. 147 +/- 9 micrograms/g). Mean serum copper content was higher in asthmatic than in control children while mean hair copper was higher (p less than 0.05) in asthmatic and eczematous children than in the control group. These findings suggest a different zinc and copper nutritional status between allergic and healthy subjects. Allergic children, in particular, seem to be a risk of zinc deficiency.     

The Levels of Calcium and Magnesium,and of Selected Trace Elements,in Whole Blood and Scalp Hair of Children with Growth Retardation

Objective

Metals such as copper (Cu), zinc (Zn), iron (Fe) are essential for human beings. Chronic metabolic disturbances may result from an excess or deficiency of these metals. Ca and Mg are also nutrient elements and play an important role in biological systems. Thus, it is very important to check regularly trace elements concentration in the body. The purpose of this study was to measure the content of Fe, Cu, Zn, Ca and Mg in whole blood and hair of children with growth retardation compared to that of controls.

Methods

A quantitative elemental analysis of whole blood and scalp hair of children with constitutional growth retardation (n = 27) and matched controls (n = 21) was used to find out correlation and possible changes, between growth retardation and healthy controls. Atomic absorption spectrophotometric (AAS) analysis of quantitative method was used to determine iron, zinc, copper, calcium and magnesium levels of whole blood and scalp hair.

Findings

The whole blood levels of Fe and Zn were significantly lower in children with growth retardation (P<0.05), but there were no differences in Cu, Ca and Mg concentrations in whole blood between children with growth retardation and healthy controls. The hair levels of Fe, Zn, Ca and Mg were significantly lower in children with growth retardation when compared to that of controls (P<0.05). The Cu concentrations in the hair of children with growth retardation and healthy controls showed no significant differences (P>0.05).

Conclusion

The usefulness and significance of these elements in growth retardation should be discussed more detailed in the light of the most recent data.     

Nutritional status in active juvenile chronic arthritis not treated with steroids

Nutritional status and nutrient intake were assessed in 17 children with active juvenile chronic arthritis (JCA) who never received steroids and in 17 controls matched for age and sex. Five patients had systemic, seven polyarticular and five oligoarticular JCA. Values significantly below those of the controls were found in systemic patients for height ( p < 0.05), upper arm circumference ( p < 0.05) and arm muscle area ( p < 0.01), and in polyarticular subjects for arm muscle area ( p < 0.01). All patients had unremarkable anthropometric fat measurements. All anthropometric measurements were normal in oligoarticular patients. Twelve JCA patients had reduced serum iron (Fe), 6 reduced serum zinc (SZn), 14 reduced intra-erythrocytic zinc (EZn) and 2 reduced serum copper (SCu). SZn was inversely correlated with erythrocyte sedimentation rate (ESR) ( p = 0.023). EZn was inversely related to lymphocyte count ( p = 0.022). SCu was related to ESR ( p = 0.037) and to lymphocyte count ( p = 0.016). No significant difference in nutrient intake was found between patients and controls. Active JCA was associated with reduced muscular mass, Fe, SZn and EZn. These alterations did not depend on reduced nutrient intake.
Juvenile chronic arthritis, nutrient intake, nutritional status, trace elements     

Low serum TNF-alpha levels in subjects at risk for type 1 diabetes

OBJECTIVE: The aim of our study was to determine whether serum TNF-alpha levels in individuals at risk of developing type 1 diabetes, such as first-degree relatives of diabetic patients and children with incidental hyperglycemia, underwent alterations, and also to establish whether these levels might be used to identify individuals prior to insulin dependence. RESEARCH DESIGN AND METHOD: We studied 71 healthy first-degree relatives (FDR) of type 1 diabetic patients and 11 children with incidental hyperglycemia. We looked for immunogenetic (HLA class II serologic alleles and HLA-DQ alpha/beta genomic polymorphisms), immunologic (islet-cell and insulin autoantibodies) and metabolic (FPIR to IVGTT) markers of type 1 diabetic risk. Serum concentrations of TNF-alpha were quantified using IRMA. RESULTS: We found significantly lower serum TNF-alpha levels in FDR of type 1 diabetic patients (median: 54.3 pg/ml) (p=0.01) and in children with incidental hyperglycemia (median: 10.83 pg/ml) (p<0.0001) compared to controls (median: 76.56 pg/ml). No significant difference was observed between subjects with or without immunogenetic, immunologic and metabolic markers of type 1 diabetic risk. A negative correlation was found between serum TNF-alpha and HbA1c levels (r=-0.27, p=0.023). Two children with incidental hyperglycemia, whose TNF-alpha levels were very low, developed type 1 diabetes 6 and 8 months after this study. CONCLUSION: Our results are compatible with an impaired immune system in the prediabetic period and suggest that serum TNF-alpha concentrations may be considered as an immunological marker useful to identify subjects at risk of developing type 1 diabetes.     

Dietary Intake, Trace Elements and Serum Protein Status in Young Diabetics

ABSTRACT. Dietary intake of energy and nutrients and its relation to trace element and protein status, as observed in 27 diabetic children and 13 healthy controls are discussed. The diabetic children had consistently higher intakes than the healthy controls in nearly all respects, except for carbohydrate and ascorbic acid. In spite of this, the diabetic children had a significantly lower mean serum magnesium than the healthy controls. It is suggested that hypomagnesemia in diabetic children may be the result of increased urinary loss or diversion of magnesium from normal metabolic pathways in this disease. This review also revealed a significantly higher mean serum selenium level in the diabetic children than in the healthy controls. However, no significant correlation WBS observed between serum selenium concentrations and protein intake, suggesting that a factor other than protein intake underlay the elevated levels of serum selenium. The diabetic children as a group had significantly lower levels of selected serum proteins than the controls, in spite of a significantly higher intake of protein by the diabetic group. It is suggested that both reduced serum proteins and elevated levels of serum selenium in the diabetic children are an expression of altered metabolism in combination with the effects of current modes of insulin treatment in this disease.     

Magnesium and Zinc in Diabetic Pregnancy

ABSTRACT. The concentrations of zinc and magnesium in serum were investigated in 23 non-pregnant and 14 pregnant women with insulin-dependent diabetes (IDDM) and 20 with gestational diabetes, and in cord blood from newborns of the latter two groups. These groups were compared with healthy women, non-pregnant as well as parturient, and newborns of the latter. In the non-pregnant state the mean serum concentrations of zinc and magnesium were lower in IDDM patients than in healthy control women. Although a decrease in S-Zn and S-Mg was obsenwl during pregnancy in both IDDM and control subjects, the difference between carefully insulin-treated IDDM patients and controls was no longer apparent at term of pregnancy as regards S-Zn, whereas S-Mg was lower at term both in IDDM patients and in insulin-treated women with gestational diabetes. Besides the probable importance of a nearly normalized glucose metabolism in IDDM patients during pregnancy, it is postulated that the altered pattern of plasma proteins in diabetes and pregnancy, and possibly also exogenous insulin may influence the serum concentrations of zinc and magnesium seen at the end of pregnancy.     

Apolipoproteins and Lipoproteins in Children with Type I Diabetes: Relation to Glycosylated Serum Protein and HbA1

ABSTRACT. Serum levels of cholesterol (C), triglycerides (TG), lipoprotein-C and apolipoproteins (apo) A-I, A-II and B were measured in 30 children with type I diabetes mellitus (16 boys, 14 girls, aged 11–14 years) and in 26 healthy controls (15 boys, 11 girls, aged 10–13 years). For 19 diabetics controls matched for age, sex and relative body weight were selected. The diabetic patients were considered to be in fair metabolic control according to HbA₁ levels and glycosylated serum protein concentrations. Mean serum apo A-I, A-II and B, C, TG, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) did not differ significantly between diabetic and nondiabetic children. Very low density lipoprotein cholesterol (VLDL-C) was significantly higher in diabetic children than in controls. Serum C and LDL-C levels showed close univariate linear correlations with glycosylated serum protein (LDL-C: r =0.53, p <0.01, C: r =0.58, p <0.01) in diabetics. The ratio LDL/HDL-C was significantly correlated to HbA₁ levels ( r =0.47, p <0.01). By canonical and multiple linear correlation analysis significant relations of a selected set of variables concerning the control and therapy of diabetes (serum glucose, HbA₁, glycosylated serum protein, insulin dose) with a set of lipoprotein variables (C, TG, VLDL-C, HDL-C, LDL-C, apo A-I, A-II, B) could be demonstrated. From these data we conclude that significant relations between atherogenic serum lipids and lipoproteins (C, LDL-C) and the degree of metabolic control exist in diabetic children, even in the absence of marked dyslipoproteinemia. The close relation of LDL-C and total C with glycosylated serum protein in the diabetics might be due to glycosylation of LDL .     

Trace elements in the serum of mothers and their children.

The serum copper, zinc and iron levels, iron binding capacity and coeruloplasmin activity were determined in 28 maternal and cord bloods and in 50 infants and children. At the end of the gestation period the serum copper level increased, iron concentration remained unchanged while the level of zinc decreased significantly as compared to the values for healthy, non-pregnant women. Iron and zinc concentrations at birth were significantly higher in the newborn than in the mother, whereas the copper level amounted only to 20% of the maternal value. Subsequently, the copper level increased to reach the lower limit of healthy adults in the first to second year of life. The remarkably high neonatal zinc concentration fell significantly in the first 2 to 4 weeks of life and decreases to the normal adult level at one year of age. The changes in the trace element concentrations may be due to quantitative differences in the transporting proteins, variations in placental permeability and in the function of transfer proteins.