Serum Zinc in Patients with Protein-Energy Malnutrition Retrospective Assessment of Levels

Yıl 2023, Cilt: 33 Sayı: 3, 274 - 277, 30.06.2023

Hasan Özen , Halil Haldun Emiroğlu , Melike Emiroğlu , Neriman Akdam , Alaaddin Yorulmaz

https://doi.org/10.54005/geneltip.1203102

Öz

Aim: This study aimed to investigate the frequency of serum zinc deficiency in children with PEM and to show the relationship between the degree of PEM and serum zinc level.
Methods: Retrospective study conducted at Pediatric Gastroenterology, Hepatology, and Nutrition clinic, in a Selçuk University Hospital, 506 patients who aged between 1 and 18 years and diagnosed with PEM according to the Waterlow (YGB, BGA) classification were included in the study.
Results: The prevalence of serum zinc deficiency in PEM patients was found to be 61.1%. The mean serum zinc levels of the patients in aged 1-5 founded significantly lower than the mean serum zinc levels of the patients in aged 5-12 and aged 12-18. There was no difference between PEM grades which calculated according to BGA and YGB criteria and serum zinc level averages. Although the relationship between the PEM grade calculated according to the BGA scale and the serum zinc level averages was not statistically significant degree, contrary to the increase in PEM grade, the mean decrease in serum zinc levels was noteworthy.
Conclusion: It is important to measure serum zinc levels routinely in patients with PEM and to initiate zinc supplementation if deficiency is detected.

Anahtar Kelimeler

Zinc;, Prevalence;, Protein-energy malnutrition.

Serum Zinc in Patients with Protein-Energy Malnutrition Retrospective Assessment of Levels

Öz

Amaç: Bu çalışmada, PEM'li çocuklarda serum çinko eksikliği sıklığını araştırmayı ve PEM derecesi ile serum çinko düzeyi arasındaki ilişkiyi göstermeyi amaçlandı.
Yöntemler: Selçuk Üniversitesi Hastanesi Çocuk Gastroenteroloji, Hepatoloji ve Beslenme kliniğinde yapılan retrospektif çalışmada, Waterlow (YGB, BGA) sınıflamasına göre PEM tanısı almış 1-18 yaş arası 506 hasta çalışmaya dahil edildi.
Bulgular: PEM hastalarında serum çinko eksikliği prevalansı %61,1 olarak bulundu. 1-5 yaş arası hastaların ortalama serum çinko düzeyleri, 5-12 yaş ve 12-18 yaş arası hastaların ortalama serum çinko düzeylerinden anlamlı derecede düşük bulundu. BGA ve YGB kriterlerine göre hesaplanan PEM dereceleri ile serum çinko düzeyi ortalamaları arasında fark yoktu. BGA skalasına göre hesaplanan PEM derecesi ile serum çinko düzeyi ortalamaları arasındaki ilişki istatistiksel olarak anlamlı derecede olmasa da PEM düzeyindeki artışın aksine serum çinko düzeylerindeki ortalama düşüş dikkat çekiciydi.
Sonuç: PEM'li hastalarda serum çinko düzeylerinin rutin olarak ölçülmesi ve eksiklik saptanırsa çinko desteğine başlanması önemlidir.

Anahtar Kelimeler

Zinc;, Prevalence;, Protein-energy malnutrition.

Kaynakça

• Black RE, Allen L.H, Bhutta Z.A, et al. Maternal and child undernutrition: global and regional exposures and health consequences, The lancet, 2008;371: 43-260.
• Ramstack M, Listernick R. Safety and efficacy of a new pediatric enteral product in the young child, Journal of Parenteral and Enteral Nutrition 1991;15 (1):89-92.
• Arnold JC, Engel R, Aguillon D, Caedo M. Utilization of Family Characteristics in nutritional classification of preschool children, The American journal of clinical nutrition, 1981;34(11); 2546-50.
• Ferreira HDS. Anthropometric assessment of children's nutritional status: a new approach based on an adaptation of Waterlow's classification. BMC Pediatr 2020 11;20(1):65.
• Taneli B. Zınc In Anatolıan Populatıon, Ege Tıp Dergisi 2005; 44 (1):71-3
• Ülger H, Coşkun A. Basic functions and metabolism, Düzce Medical Faculty Journal 2003;5(2):38-44.
• Waterlow JC. Classification and definition of protein-calorie malnutrition. Br Med J. 1972 Sep 2;3(5826):566-9.
• World Health Organization. Management of the Child With a Serious Infection or Severe Malnutrition: Guidelines at the First Referral Level in Developing Countries. Geneva, Switzerland: World Health Organization; 2000
• Penny ME. Protein-energy malnutrition: pathophysiology, clinical consequences, and treatment. Nutrition in pediatrics: basic science and clinical applications, 2003, Ed. 3:174-94.
• Tunçbilek E, Kurtuluş E, Hancıoğlu A. Nutrition of infants, children and mothers, Turkey Demographic and Health Survey 1998;128-34.
• Brown KH, Rivera JA, Bhutta Z, et al. International Zinc Nutrition Consultative Group (ZiNCG) technical document 1. Assessment of the risk of zinc deficiency in populations and options for its control. Food and nutrition bulletin, 2004;25(2):99-203.
• Wuehler SE, Peerson JM and Brown KH. Use of national food balance data to estimate the adequacy of zinc in national food supplies: methodology and regional estimates, Public health nutrition 2005;8(7):812-9.
• Tuerk MJ and Fazel N. Zinc deficiency. Current opinion in gastroenterology A2009;25(2):136-43.
• Prasad AS. Clinical spectrum of human zinc deficiency. In: Biochemistry of zinc. Springer, Boston, MA, 1993. p. 219-58.
• Leonard MB, Zemel BS, Kawchak DA, et al. Plasma zinc status, growth, and maturation in children with sickle cell disease, The Journal of pediatrics 1998;132(3):467-71.
• Da Costa GA, do Nascimento MD, Eulálio JML, et al. Erythrocytary zinc and the infant growth profile in northeast Brazil, Biological trace element research 2008;126(1), 15-20.
• Vuralli D, Tumer L and Hasanoglu A. Zinc deficiency in the pediatric age group is common but underevaluated, World Journal of Pediatrics 2017;13 (4):360-6.
• Dehghani S, Katibeh P, Haghighat M, et al. Prevalence of zinc deficiency in 3-18 years old children in Shiraz-Iran, Iranian Red Crescent Medical Journal 2011;13 (1):4.
• Arvanitidou V, Voskaki I, Tripsianis G, et al. Serum copper and zinc concentrations in healthy children aged 3-14 years in Greece, Biological trace element research 2007;115 (1):1.
• Singla PN, Chand P, Kumar A, Kachhawoba JS. Serum, zinc and copper levels in children with protein energy malnutrition. Clinical Trial Indian J Pediatr 1996;63(2):199-203