小儿哮喘与肺炎支原体肺炎血中一氧化氮和氧自由基的不同变化及意义

目的：　探讨一氧化氮(NO)、脂质过氧化物(LPO)、血栓素B2 (TXB2 )、循环内皮细胞(CEC)在小儿哮喘及肺炎支原体(MP)肺炎中的作用。方法：　分别检测36例小儿哮喘、40例MP肺炎患儿及15例健康体检儿血NO,LPO,TXB2及CEC水平。结果：　小儿哮喘及MP肺炎急性期血NO,LPO,TXB2,CEC4项指标分别为:哮喘组(162 .27±36.12) μmol/L ,(8.62± 0.87)nmol/ml,(22 9.11± 64.75) pg/ml,(6.13± 1.15)n/0.9μl;MP肺炎组(95.52±33.84)μmol/L ,(5.76± 0 .53)nmol/ml,(388.72±80 .09) pg/ml,(6.36±1.02)n/0 .9μl,分别与对照组 [(68.57±13.80 ) μmol/L ,(4.62± 1.80 )nmol/ml,(105.76±20.10)pg/ml,(4.40±1.04)n/0 .9μl]相比,均增高显著,差异有显著性意义(P<0.01)。其中哮喘组血中NO ,LPO较MP肺炎组增高显著(P<0.01);MP肺炎组TXB2 较哮喘组增高明显 (P<0.01)。恢复期两种疾病所有指标均降低,TXB2,LPO已降至正常范围,而NO ,CEC在两周后[哮喘组(82.64±20.56)μmol/L,(5.41±1.29)n/0.9μl,MP肺炎组 (86.12±21.34)μmol/L,(5.57±1.12 )n/0 .9μl]仍高于正常对照组(P<0.05或0.01)。结论：　本研究提示     

TRACE METALS IN CYSTIC FIBROSIS

ABSTRACT. Serum zinc and copper concentration, 24 hrs urinary zinc and copper excretion, plasma selenium and red blood cell glutathione peroxidase activity were measured in 13 cystic fibrosis patients aged 6 to 15 years. The mean serum zinc value ± S. D. (17.3 μmol/1 ± 4.6) did not differ from that of the control group (17.9 μmol/1 ± 3.1). Urinary zinc excretion in 12 out of 13 patients was within the normal range (1.53-13.8 μmol/24 hrs). The mean serum copper ± S. D. (23.8 μmol/1 ± 4.2) was not significantly elevated as compared to the value found in the control group (19.2 μmol/1 ± 3.5), but 4 children, including 1 with documented portal hypertension, showed an urinary copper excretion >0.94 μmol/24 hrs (normal: 0.16-0.80 μmol/24 hrs). Mean plasma selenium ± S. D. (0.84 μmol/1 ± 0.25) was significantly reduced as compared to the control group (1.0 μmol/1 ± 0.15) ( p <0.05). The correlation between selenium concentration and RBC glutathione peroxidase activity was significant ( p <0.01). A negative correlation was also found between plasma selenium and 24 hrs faecal fat excretion ( p <0.05). It is concluded that CF children with severe dysfunction of the exocrine pancreas are at increased risk to develop symptoms of subclinical or manifest zinc and/or selenium deficiency. Appropriate supplementation should therefore systematically be considered.     

Altered erythrocyte sodium-lithium counter-transport and Na+/K+-ATPase activity in cystic fibrosis

Patients with cystic fibrosis (CF) exhibit normal concentrations of sodium and chloride in spite of the disturbance of Cl^- and Na+ transport in epithelial cells. To characterize compensatory mechanisms in the regulation of sodium homeostasis, erythrocytes of 13 CF patients were analysed for sodium-lithium counter-transport (SLC), Na+/K+ -ATPase activity and intracellular sodium content. Values were compared to those of healthy controls. Patients with CF had normal serum sodium and chloride concentrations and renal excretions of these ions were within the physiological range. Intracellular sodium concentration was similar in the CF and the control group (6.8 ± 2.2 vs 5.7 ± 1.0 mmol/l RBCs). Red blood cells' SLC and Na+/ K+ -ATPase activity were elevated in CF patients (381 ± 106 μmol/h/l RBCs vs 281 ± 64; p < 0.01) and (445 ± 129 μmol ATP mg prot/h vs 322 ± 84, p < 0.01). Our study demonstrates that transmembrane cation transport systems are highly activated in CF. The increased sodium transport may be part of a compensatory mechanism of sodium homeostasis in children with CF.     

Serum neopterin levels in children with primary nephrotic syndrome

AIM: To assess the changes that occurs in serum neopterin levels in children with primary nephrotic syndrome. METHODS: Serum neopterin levels were measured by ELISA in 38 children with active primary nephrotic syndrome (group I) and 17 children with primary nephrotic syndrome in remission (group II) and 20 healthy controls. All patients had normal creatinine clearance. Among group I, 28 patients were steroid-sensitive while 10 patients were steroid-resistant. RESULTS: Serum neopterin levels were significantly elevated in group I patients (median = 30, 7.2-43.2 nmol/l) compared with group II (median = 6, 2-10 nmol/l, P<0.001) and controls (median = 3.2, range: 0.4-1.8 nmol/l, P<0.001). Group II patients had similar neopterin levels compared with controls (P=0.71). There was a significant positive correlation between serum neopterin levels and the degree of proteinuria in group I patients (r = 0.4, P=0.01). No significant differences in serum neopterin levels were noted between steroid-sensitive and steroid-resistant patients (P=0.4). CONCLUSION: Serum neopterin could be used as a marker of the activity of primary nephrotic syndrome but it could not be used to differentiate between steroid-sensitive and steroid-resistant patients.     

Eosinophil cationic protein, myeloperoxidase and tryptase in children with asthma and atopic dermatitis

Serum levels of eosinophil cationic protein (ECP), myeloperoxidase (MPO), tryptase, total IgE and differential blood cell counts were studied in atopic children with: 1) moderate to severe asthma using inhaled steroids and symptom-free for the last 3 weeks (n= 13), 2) mild asthma with sporadic symptoms, using only inhaled β₂-agonists < 3 times/week (n= 15), 3) acute asthmatic attacks admitted to hospital (n= 12), 4) mild to moderate atopic dermatitis (n= 14). Fifteen children without any history of atopy served as controls. ECP, MPO, tryptase and IgE were measured in serum by radioimmunoassays (RIA). The symptom-free children with inhaled steroids had similar median ECP and MPO values as the controls, 8.0 and 360 μg/l, vs. 9.0 and 310 μg/l, while both ECP and MPO were significantly (p < 0.001) increased in the symptom-free children without anti-inflammatory treatment, 32 and 887 μg/l and in those with acute asthma, 28 and 860 μg/l. The children with atopic dermatitis had increased ECP but normal MPO levels, 16.0 and 455 μg/l. Tryptase in serum was not measurable in any patient. All groups except the control group had significantly elevated total IgE levels. The results indicate that in atopic children serum ECP is a good marker of ongoing asthma or atopic dermatitis. The normal levels of ECP and MPO in the children with asthma using inhaled steroids seem to reflect successful anti-inflammatory treatment. The increased levels of ECP and MPO in the children with mild asthma and no anti-inflammatory treatment may indirectly reflect airway inflammation.     

Elevated Serum Selenium in Diabetic Children

ABSTRACT. Twenty-seven diabetic children, 16 girls and 11 boys, 5–18 years of age, with a duration of the disease ranging from 2–15 years, comprised the study group. Thirteen children with a similar age and sex distribution, living in the same area served as healthy controls. All 40 children had a normal growth pattern. The mean serum selenium concentration in the diabetic children, determined by neutron activation analysis, was 7.4 ± 0.8 μg/100 ml (mean ± SD) and in the healthy controls 6.5 ± 0.8 μg/100 ml. The difference between the two groups was statistically highly significant ( p < 0.01). Boys and girls in both groups had nearly identical mean serum selenium levels and no correlation was observed between the selenium concentrations and either the age, weight or height of the children or the indicators of diabetic control. The selenium status in diabetic children has not been reported previously. The possibility of elevated serum selenium in diabetic children in response to altered lipid metabolism is discussed.     

单纯性肾病患儿甲状腺功能测定的临床意义

目的：　探讨单纯性肾病血清甲状腺素水平的变化。方法：　用双抗体放免法检测肾病患儿组与健康对照组各 20例血清甲状腺素,比较两组变化的差异。结果：　对照组血清甲状腺素水平正常,肾病组血清T3 ,T4 ,TSH有不同程度的变化 ,分别为 (1.0± 0 .5)nmol/L ,(15.5±32.4)nmol/L,(20.2±13.2)mU/L,两组差异有显著性意义(P<0.01)。结论：　检测单纯性肾病患儿血清甲状腺素水平,对增进治疗效果,估计和改善预后有比较重要的意义。     

Serum inflammatory markers and effects of age and tobacco smoke exposure in young non-asthmatic children

Serum eosinophil cationic protein (ECP), but not serum myeloperoxidase (MPO), has been found to reflect disease activity of asthma and eczema, but no reference values exist for young children. Thus, we aimed to provide values of serum-ECP and serum-MPO in young children without obstructive airways disease (OAD), and determine possible influencing factors. Parental interview was performed and serum was collected from a total of 245 children (207 children aged 24-41 months and 76 children aged 0-23 months) with no history of lower respiratory disease. Repeated serum samples were obtained in 38 subjects. Ten percent of the children had active eczema at examination. All children were controls in the"Environment and Childhood Asthma"study in Oslo. Geometric means (GM ± 1.96 SD) for serum ECP were 11.8 μg/l (2.5-56.0) and 7.9 μg/l (2.0-30.4), respectively, in the 0-23 and 24-41-month-old children, with the corresponding values for serum MPO 453 μg/l (153-1349) and 347 μg/l (142–859), respectively. Age was inversely associated with serum-ECP and serum-MPO, most pronounced in the youngest children. Active eczema and maternal daily smoking adversely affected serum-ECP, but not serum-MPO. Gender and parental atopy did not influence the results. We conclude that serum-ECP in very young children is influenced by age and active eczema and is related to maternal smoking in a dose-dependent fashion. These factors should be considered when assessing inflammatory markers in very young children.     

Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test

This study evaluates the effects of glucagon 30 μg/kg (maximal 1 mg) on β-cell function in children by C-peptide determined before and 6 min after intravenous administration. From 1990 to 2005, 118 Taiwanese children with newly diagnosed diabetes mellitus (98 children with type 1 and 20 children with type 2) and 29 normal Taiwanese children were enrolled in this study. Fasting and 6-min post-glucagon C-peptide levels were analyzed. In the pre-pubertal group, the median fasting serum C-peptide levels were 0.2 and 0.8 nmol/l in type 1 diabetes and normal children, respectively. These levels rose to 0.3 and 1.9 nmol/l after glucagon stimulation. In the pubertal group, the median fasting serum C-peptide levels were 0.3, 1.0 and 0.9 nmol/l in type 1 diabetes, type 2 diabetes and normal children, respectively. They rose to 0.4, 2.5 and 2.7 nmol/l after glucagon stimulation. Both fasting and post-glucagon C-peptide levels in type 1 diabetes patients were significantly lower than those of normal children and children with type 2 diabetes. The optimal cut-off values to distinguish type 1 diabetes patients from those with type 2 as determined by the receiving operating characteristic curve were 0.7 and 1.1 nmol/l, respectively. The sensitivities of both C-peptide values were 93%. The post-glucagon C-peptide level was more powerful in distinguishing type 1 diabetes from type 2 diabetes with higher specificity (95% vs. 85%). The 6-min glucagon test is valuable in assessing β-cell function in children and can help pediatricians in the differential diagnoses of diabetes mellitus in children.     

Soluble receptors to tumour necrosis factor and interleukin-6 in urine during acute pyelonephritis

We compared the urinary concentrations of soluble TNF-I (sTNF-RI), TNF-II receptors, and soluble IL-6 receptor (sIL-6R) standardized to urinary creatinine concentrations, in children with acute pyelonephritis, in children with non-renal fever and in healthy controls. These levels were related to the acute inflammatory response in the kidneys and later renal scarring, as determined by acute and 1-y follow-up with ^99mTC-dimercaptosuccinic acid scintigraphy (DMSA). The concentrations of the soluble receptors were measured using enzyme immunoassay (EIA). The urinary levels of sTNF-RI were significantly higher in children with acute pyelonephritis (median 1320 pg/mmol) than in children with non-renal fever, children 6 weeks after acute pyelonephritis and healthy controls (873, 251 and 477 pg/μmol, respectively). Median sTNF-RII urine levels were also higher in acute pyelonephritis (4123 p/μmol) than in the three control groups (2000, 964 and 1850 pg/μmol, respectively). In contrast, the highest urinary sIL-6R concentrations were found in healthy children (median 420 pg/μmol). compared to those with acute pyelonephritis (235 pg/μmol), children with non-renal fever and children 6 weeks after pyelonephritis (137 and 50 pg/μmol, respectively). No significant difference was found in any of the urinary soluble receptor levels in children with or without DMSA uptake defects at the acute or the 1-y follow-up scintigraphy. In conclusion, although the urinary soluble TNF receptor levels were higher during acute pyelonephritis, this observation was not useful for deciding which children needed follow-up after acute pyelonephritis.     

PLASMA AND ERYTHROCYTE ZINC, COPPER AND SELENIUM IN CYSTIC FIBROSIS

ABSTRACT. Plasma and erythrocyte zinc, copper and selenium were measured in 20 cystic fibrosis children, aged 7 to 19 years. Mean plasma zinc and copper levels were not different from those in age-matched controls but very low zinc levels occurred sporadically. Plasma zinc concentrations were significantly lower in patients with moderate-to-severe growth retardation and with severe pulmonary disease as compared to patients without growth failure and with moderate pulmonary disease. Mean erythrocyte zinc (40.8 μg/g Hb ±9.2) and copper levels (3.56 μg/g Hb ±0.50) were very significantly increased (30.4 μg/g Hb ±5.2 and 2.73 μg/g Hb ±0.30 respectively, for age-matched controls). Mean plasma and erythrocyte selenium levels (63 ng/ml ±15 and 329 ng/g Hb ±86) were significantly lower than those in age-matched controls (82 ng/ml ±13 and 404 ng/g Hb ±116). The trace element concentrations in erythrocytes are discussed in relation to the activities of the copper- and zinc-containing enzyme superoxide dismutase and the seleno-enzyme glutathione peroxidase. We consider that more data on trace element metabolism in CF should be collected before specific supplementation is considered.     

Psychological Development at 7 Years of Age in Children with Congenital Hypothyroidism: Timing and Dosage of Initial Treatment

ABSTRACT. Sixty of 68 consecutive patients detected during the first two years of the Swedish screening programme for congenital hypothyroidism were Griffiths tested at the age 6.5–7.5 years. The test quotients of the patients could not be distinguished from those of reference population. Replacement therapy with 8.7 ± 2.8 μg of l -thyroxine (mean±SD)/kg/d had been started at 15.0 ± 7.1 days of life. Furthermore, normal results on Griffiths tests were also found in 13 patients with delayed normalization of serum TSH, i.e. ≥ 19 mU/l at the age of six weeks, as well as in patients with retarded skeletal maturity and/or very low neonatal serum levels of thyroxine, i.e. < 18 nmol/l and tri-iodothyronine, i.e. <0.92 nmol/l. Our findings indicate that replacement dose of 6–11 μg l -thyroxine/kg/d is adequate and allows normal psychological development if treatment is started early.     

Effect of Phosphate Supplementation to Breast Fed Very Low Birthweight Infants on Urinary Calcium Excretion, Serum Immunoreactive Parathyroid Hormon and Plasma 1.25-Dihydroxy-vitamin D Concentration

ABSTRACT. The effect of two doses of Phosphorus (P) supplementation to pooled breast milk (BM): 0.48 and 0.800 mmol/kg/24 h given during the second month of life was evaluated in 22 very low birthweight infants. The concentration of calcium and phosphorus in serum and urine, the serum concentration of immunoreactive parathyroid hormon (iPTH) and the plasma 1,25-dihydroxy-vitamin D concentration (1,25-OH-D) were compared to the values in 19 control infants. The mean ± SD concentrations in control infants and adults are 63 ±18 ulEq/ml for serum iPTH and 85±pmol/l for plasma 1,25-OH-D. With 0.48 P supplementation, urinary Ca (UCa) excretion (median and range) 0.238 mmol/kg/24 h (0.105-0.520) was lower than in the control group 0.288 (0.205-0.679) (p<0.05); the reduction of UCa was larger with 0.8 P supplementation: 0.047 (0.023-0.163) (p<0.01). P supplementation induced no change in serum Ca concentration but a slight and significant increase in serum iPTH was observed only with the 0.8 P supplementation: 55 μl Eq/ml (<25-80) (p<0.05). With 0.8 P supplementation there was no significant change of plasma 1,25-OH-D concentration: 173 μmol/l (106-271) vs. 255 (132-293) in the control group. These data show that with 0.8 P supplementation, the hypercalciuria in BM-fed infant disappears without secondary hyperparathyroidism, but without any change in plasma 1,25-OH-D concentration.     

Growth and adrenal androgen status at 7 years in very low birth weight survivors with and without bronchopulmonary dysplasia

Aims: To evaluate whether 7 year old VLBW (very low birth weight, <1500 g) survivors with and without bronchopulmonary dysplasia (BPD) evince similar growth status and higher adrenal androgen (AA) levels than term controls, and whether AA levels are higher in VLBW children born small for gestational age (SGA) than in non-SGA cases. Methods: Assessment of height standard deviation score (SDs), body mass index (BMI), and serum androstenedione and dehydroepiandrostenedione sulphate levels in 31 VLBW children with BPD, 33 without BPD (no-BPD group), and 33 term controls. Results: Lower median (range) height SDs was found in BPD (-1.0 (-3.4 to 1.4) SD) and no-BPD (-0.9 (-2.9 to 2.2) SD) children than in term controls (0.3 (-1.5 to 1.9) SD). Low BMI (below 10th centile) was more common in both the BPD (18 (58%)) and no-BPD (16 (49%)) children compared to term cases (3 (9%)). The median (range) androstenedione levels tended to be higher in the BPD (0.8 (0 to 2.8) nmol/l) and no-BPD (0.8 (0 to 2.3) nmol/l) groups than in term controls (0.6 (0 to 1.8)). Higher median (range) dehydroepiandrostenedione sulphate levels were detected in the no-BPD compared to the term group (0.9 (0 to 4.1) v 0.3 (0 to 2.3) µmol/l). VLBW children born SGA had higher AA levels compared to non-SGA cases. Conclusions: At 7 years of age, VLBW children are shorter and tend to have higher AA levels than term controls, but VLBW children with and without BPD do not differ from each other in growth or AA status. Those born SGA have higher AA levels compared to non-SGA cases. The consequences of these findings to final height and to later metabolic and vascular health remain to be determined.     

EFFECT OF INTRAVENOUS HYDROCORTISONE ADMINISTRATION ON GLUCOSE HOMEOSTASIS IN SMALL FOR GESTATIONAL AGE INFANTS

Abstract. The effects of I.V. hydrocortisone (H) (10 mg/kg) on glucose homeostasis were evaluated at 25 to 85 hours of age in 14 infants who were small for gestational age (SGA) in comparison to 17 control SGA infants. Three hours after H administration, higher levels of plasma glucose than in controls were detected (mean ±S.E.M.): 4.78±0.2 vs. 2.88±0.2 mmol/1 ( p <0.01), while lower levels were found for blood pyruvate (38±7 vs. 89±12 μmol/l— p <0.01), plasma insulin (6.4±0.5 vs. 12±0.8 μIU/ml— p <0.05) and plasma glucagon (62.25±6.6 vs. 81.6±6.6 pmol/l— p <0.05). Three hours after H administration, I.V. injection of l -alanine (150 mg/kg) produced a significant rise over baseline of plasma glucose concentration from 4.78±0.2 to 5.94±0.2 mmol/l at 50 min ( p <0.05), whereas no significant change was observed in controls. There was no significant change in plasma glucagon and insulin concentrations after l -alanine injection in either group. These results show that in SGA infants primed with H, the rise of plasma glucose concentration after l -alanine administration is observed with low plasma insulin levels and without stimulation of glucagon secretion. They suggest that H induced a reduced peripheral utilization of glucose by lowering the plasma levels of insulin and a production of glucose from alanine through gluconeogenesis.     

Growth and adrenal androgen status at 7 years in very low birth weight survivors with and without bronchopulmonary dysplasia.

AIMS: To evaluate whether 7 year old VLBW (very low birth weight, <1500 g) survivors with and without bronchopulmonary dysplasia (BPD) evince similar growth status and higher adrenal androgen (AA) levels than term controls, and whether AA levels are higher in VLBW children born small for gestational age (SGA) than in non-SGA cases. METHODS: Assessment of height standard deviation score (SDs), body mass index (BMI), and serum androstenedione and dehydroepiandrostenedione sulphate levels in 31 VLBW children with BPD, 33 without BPD (no-BPD group), and 33 term controls. RESULTS: Lower median (range) height SDs was found in BPD (-1.0 (-3.4 to 1.4) SD) and no-BPD (-0.9 (-2.9 to 2.2) SD) children than in term controls (0.3 (-1.5 to 1.9) SD). Low BMI (below 10th centile) was more common in both the BPD (18 (58%)) and no-BPD (16 (49%)) children compared to term cases (3 (9%)). The median (range) androstenedione levels tended to be higher in the BPD (0.8 (0 to 2.8) nmol/l) and no-BPD (0.8 (0 to 2.3) nmol/l) groups than in term controls (0.6 (0 to 1.8)). Higher median (range) dehydroepiandrostenedione sulphate levels were detected in the no-BPD compared to the term group (0.9 (0 to 4.1) v 0.3 (0 to 2.3) micro mol/l). VLBW children born SGA had higher AA levels compared to non-SGA cases. CONCLUSIONS: At 7 years of age, VLBW children are shorter and tend to have higher AA levels than term controls, but VLBW children with and without BPD do not differ from each other in growth or AA status. Those born SGA have higher AA levels compared to non-SGA cases. The consequences of these findings to final height and to later metabolic and vascular health remain to be determined.     

CORD BLOOD HAEMOGLOBIN, IRON AND FERRITIN STATUS IN MATERNAL ANAEMIA

ABSTRACT. Maternal and cord blood haemoglobin, serum iron, transferrin saturation and ferritin were studied in sets of 30 anaemic (haemoglobin <110 g/l) and 21 nonanaemic (haemoglobin ≧110 g/l) mothers. The cord serum iron, transferrin saturation and ferritin concentrations had significant correlation with maternal haemoglobin. The significant low levels of these parameters suggested that maternal anaemia adversely affected the iron status including iron stores of the newborns. The cord serum iron of 15.2±4.35 μmol/l and ferritin of 29.7±10.93 ng/ml seem to be effective to maintain cord haemoglobin levels. Thus, anaemic mothers with reasonably maintained ferritin and trasferrin saturation levels provide sufficient iron for maintenance of cord haemoglobin, although foetal iron stores are likely to be depleted.     

Role of excitatory aminoacids in neonatal hypoglycemia

Abstract Background: In many neurological disorders, injury to neurons may be due in part to overstimulation of the receptors for the excitatory amino acids glutamate and aspartate. The same excitotoxic mechanism and high aspartate levels in experimental studies led to this study of the concentrations of glutamate and aspartate and zinc, copper, and magnesium levels in the cerebrospinal fluid (CSF) of hypoglycemic newborns.
Methods: Aspartate and glutamate were determined by high-performance liquid chromatography, and magnesium, zinc and copper by atomic absorption spectrophotometer.
Results: The CSF levels of aspartate (3.98 ± 1.77 μmol/L) and glutamate (1.7 ± 1.05 μmol/L) in 20 hypoglycemic newborns were significantly higher when compared with the values of aspartate (2.19 ± 0.6 μmol/L) and glutamate (0.77 ± 0.34 μmol/L) of 10 control newborns. In the hypoglycemic patients, the concentration of zinc (0.57 ±0.13 μg/mL), but not copper (0.39 ± 0.40 μg/mL) was significantly lower when compared with the control values. There was no difference in the magnesium levels between the two groups.
Conclusions: The higher levels of excitatory amino acids found in the CSF of hypoglycemic infants than in controls were consistent with previous animal studies, which may indicate the role of excitatory amino acids in the late biochemical effects of hypoglycemia in newborn brain metabolism.     

Relationships Between Serum Free Fatty Acids and Zinc, and Attention Deficit Hyperactivity Disorder: A Research Note

The purpose of this study is to evaluate the relationships between serum free fatty acids (FFA) and zinc, and attention deficit hyperactivity disorder (ADHD). Forty eight children with ADHD (33 boys, 15 girls) were included in the patient group and 45 healthy volunteer children (30 boys, 15 girls) constituted the control group. The mean serum FFA level in the patient group was 0.176 ± 0.102 mEq/L and in control group, 0.562 ± 0.225 mEq/L ( p < .001). The mean serum zinc level of patient group was 60.6 ± 9.9 μg/dl and that of the control group. 105.8±13.2 μg/dl (p < .001). A statistically significant correlation was found between zinc and FFA levels in the ADHD group. These findings indicate that zinc deficiency may play a role in aetiopathogenesis of ADHD. Although we observed decreased FFA levels in ADHD cases, it is necessary to determine whether this condition is a principal cause of ADHD or is secondary to zinc deficiency.     

Serum zinc in small children with coeliac disease

In coeliac disease (CD) there is a gluten-induced small bowel enteropathy leading to malabsorption of various nutrients, vitamins and trace elements. Low levels of serum zinc have been reported in adults with untreated CD. In the present study we related the serum concentration of zinc to the morphology of the small bowel mucosa in 58 children, all under 4 years of age and under investigation for coeliac disease. The mean serum concentration of zinc (mean ± SD; μmol/L) was significantly lower in children with untreated CD (9.7 ± 2.0) (n = 11) compared to non-coeliac children without enteropathy (15.1 ± 2.3) (n = 16) (p < 0.001), coeliac children on a gluten-free diet without enteropathy (14.2 ± 1.6) (n = 14) (p < 0.001), coeliac children on gluten challenge with enteropathy (14.1 ± 2.1) (n = 12) (p < 0.001) and coeliac children on gluten challenge without enteropathy (13.8 ± 1.9) (n = 6) (p < 0.005).
Conclusion: Serum zinc concentration is decreased in untreated coeliac children with enteropathy and normalizes on gluten-free diet. A low serum zinc value in a child being investigated for possible CD on clinical grounds can thus be used as a complementary marker for enteropathy indicating further investigation with small bowel biopsy. The hypothetical role of zinc in the pathogenesis of CD is discussed.