• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.53-61
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• 2024

Purpose: Although the 24-hours urinary copper excretion is useful for the diagnosis of Wilson disease (WD), there are practical difficulties in the accurate and timed collection of urine samples. The purpose of this study was to verify if the spot morning urinary Copper/Zinc (Cu/Zn) ratio could be used as a replacement parameter of 24-hours urinary copper excretion in the diagnosis of WD. Methods: A cross-sectional study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from June 2019 to May 2021 on 67 children over three years of age who presented with liver disease. Twenty-seven children who fulfilled the inclusion criteria for WD were categorized into the test group, and the remaining forty children were considered to have non-Wilsonian liver disease and were categorized into the control group. Along with other laboratory investigations, spot morning urinary samples were estimated for the urinary Cu/Zn ratio in all patients and were compared to the 24-hour urinary copper excretion. The diagnostic value of the Cu/Zn ratio was then analyzed. Results: Correlation of spot morning urinary Cu/Zn ratio with 24-hours urinary copper excretion was found to be significant (r=0.60). The area under ROC curve with 95% confidence interval of morning urinary Cu/Zn ratio measured using 24-hours urine sample was 0.84 (standard error, 0.05; p<0.001). Conclusion: Spot morning urinary Cu/Zn ratio seems to be a promising parameter for the replacement of 24-hours urinary copper excretion in the diagnosis of WD.

• Journal of Community Nutrition
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• v.1 no.1
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• pp.3-9
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• 1999

This study was performed to investigate the biochemical status of iron, zinc and copper for 125 preschool children (Males : 69, Females : 56) residing in a low-income area of Seoul. The number of subjects aged, 3, 4, 5 and 6 were 19, 41, 41 and 24, respectively. The hemoglobin level of the children aged 3 was 11.8 g/dl and was lower thant hat of the other groups(p<0.05). Similar results were found for hematocrit and serum zinc. The percentage of children with an iron deficiency assessed by Hb(3-5) years : <11.0g/dl, 6 years: <11.5g/dl), Hct(3-6 years : 33%, 6 years : <35%), serum transferrin(<16%) and serum ferritin(<10ng/ml) were 4.3%, 9.5%, 8.2% and 17.7%, respectively. The mean serum zinc was 67.9$\mu\textrm{g}$/dl and urinary zinc was 0.1300mg/day. Low serum zinc (61.0$\mu\textrm{g}$/dl) occurred in 28.0% of the children. The mean serum copper was 110.5$\mu\textrm{g}$/dl and urinary copper was 0.0126mg/day. The prevalence of children with elevated serum copper($\geq$ 130$\mu\textrm{g}$/dl) was 54.8%, which was higher than 7.4%, the prevalence of low serum copper(<70$\mu\textrm{g}$/dl). Children with higher status, more weight, larger girth of chest, or larger midarm circumference showed higher values of Hb. The height and weight of children also showed a positive crrelation with serum zinc(P<0.001-P<0.05).

• Korean Journal of Community Nutrition
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• v.3 no.3
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• pp.389-396
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• 1998

This study was intended to examine the zinc status and effect of zinc supplementation on the zinc nutritional status of the elderly living in the Ulsan area. The zinc intake of 207 subjects(male 97, female 110) was measured by a 24-hour dietary recall and food frequency method. Biochemical analysis were conducted from blood and urine samples to evaluate the changes of zinc nutriture with zinc supplementation. The average dietary zinc intake of subjects was $7.7\pm{2.8mg}$ for male and $7.5\pm{2.6mg}$ for female, which were 51.3% and 62.3% of Korean RDA respectively. The first source of zinc was cereal and grain(36%), and the second was eggs and milk group(27%). After 8 weeks of zinc supplementation, the serum zinc content was significantly increased(p<0.01), although the serum copper content was not significantly decrease. Serum HDL- cholesterol level was not significantly decreased with zinc supplementation. Serum alkaline phosphatase(ALP) activity and urinary zinc excretion were significantly increased(p<0.05). The urinary Zn/Cr was not significantly increased. It is suggested from the results that the daily zinc supplementation can be effective to improve zinc nutriture.

• Journal of the Korean Society of Food Science and Nutrition
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• v.19 no.5
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• pp.411-417
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• 1990

To compare the dietary and urinary minerals with serum lipid and minerals this study was carried out on 30 rural housewives in Kyunggi area. Mean intake of energy was 1770.3Kcal and protein 55.5g per day. Mineral intakes per day were measured; sodium 4330mg phos-phorus 485.7mg calcium 388.0mg zinc 8.99mg and copper 2.23mg Urinary minerals were analy-sed ; sodium 4379mg phosphorum 371.3mg calcium 190.0mg zinc 328.0mg and copper 49.6mg. Serum contents of lipid and minerals were : cholesterol 169.0mg% triglyceride 70.6mg% $\beta$-lipoprotein 304.9mg% sodium 142.3mM phosphorus 3.94mg% calcium 9.06mg% zinc 1215.7 ppb and cooper 620.0ppb. Eietary sodium and zinc urinary copper were significantly related with serum lipids.

• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.1-8
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• 1999

Objectives. We conducted this study to obtain basic data of urinary levels of arsenic, cadmium, and zinc in children of Ulsan industrial area and to evaluate the difference in urinary levels of these metals between industrial area and suburban area. Methods. The study subjects were composed of 348(male 182, female 166) school children residing in industrial area and 100(male 50, female 50) school children of suburban area. We analyzed urinary levels of arsenic, cadmium, and zinc using atomic absorption spectrophotometer. Results. The geometric means of urinary level of arsenic, cadmium, and zinc of study participants were 3.69, 0.99, $282.49{\mu}g/l$ respectively. The adjusted geometric means of urinary levels of arsenic, cadmium, and zinc of study participants were 3.92, 1.05, $299.92{\mu}g/g$ creatinine respectively. Conclusions. The children residing in industrial area had the higher urinary levels of arsenic and cadmium than suburban children with statistical significance(p<0.01).

• Preventive Nutrition and Food Science
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• v.9 no.1
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• pp.79-84
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• 2004

Zinc intake and status of South Koreans from rural, urban and metropolitan areas were investigated. The dietary habits of 760 healthy male and female adult subjects with a mean age of 54 were assessed using a food frequency questionnaire and were verified using 24 h dietary recall. Daily Zn intakes for men and women were 7.4$\pm$5.4 mg and 7.0$\pm$5.4 mg, respectively, which were 62% and 70% of the Korean RDA. The phytate : zinc and phytate ${\times}$ calcium : zinc molar ratios were 38 and 398, respectively. Both the low intake of zinc and the high extremely phytate and phytate ${\times}$ calcium ratios with Zinc suggest that South Koreans may be at risk of zinc deficiency. Plasma zinc (86$\pm$61 $\mu\textrm{g}$/dL), urinary zinc (33$\pm$27 $\mu\textrm{g}$/dL) and plasma alkaline phosphatase (102$\pm$52 mU/mL) levels within the normal range did not however suggest marked Zinc deficiency in these subjects. However, conventional zinc biomarkers aye known to be unreliable for assessment of marginal zinc deficiency. Based on zinc intake alone, it is likely that at least a proportion of these subjects were marginally zinc deficient and the wider consumption of zinc rich, phytate deficient foods, particularly in rural areas, would be beneficial.

• Korean Journal of Community Nutrition
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• v.10 no.1
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• pp.70-78
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• 2005

Zinc is known to have important effects on insulin activity and to increase the body fat deposition. The purpose of this study was to investigate the zinc status and obesity in 50 type 2 diabetic women visiting public health center and hospital. The mean age was 57.9 $\pm$ 6.9 years old. The mean of diabetic duration was 8.0 $\pm$ 6.5 years. Body mass index (BMI) of diabetes was $23.2 \pm 2.3 kg/m^2$. There were no significant differences of mean age, anthropometric indices, and insulin level other than fasting blood sugar (p < 0.001) and insulin resistance (p < 0.00l) between diabetes and control group. The obesity ratio of diabetes was $20\%$, $66\%$ and $84\%$ for BMI, waist circumference and waist/hip ratio (WHR), respectively. Plasma zinc level was not significantly different between diabetes and control group. However, urinary zinc excretion of diabetes was approximately twice of control group (p < 0.001). Urinary zinc loss was fivefold higher in the hyperglycemia ($HbA_{lc}> 10\%$) than in normal blood glucose (p < 0.001). Anthropometric indices were decreased in hyperglycemia. On the other hand, there were the tendency of increased urinary zinc in obese group for waist circumference and percent of body fat. These results suggested that controlled normal blood glucose could improve hyperzincuria and anthropometric changes in type 2 women diabeties.

• Korean Journal of Community Nutrition
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• v.3 no.1
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• pp.12-20
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• 1998

In this study, the food intake, feces and urine of 14 primary school age boys and girls were collected and intake and excretion of iron and zinc were measured. The boys and girls were 8-12 years old and measurement continued for four weeks during which they maintained their normal living pattern. Each boy's and girl's daily intake and excretion of iron and zinc were measured and apparent digestibility and balance were also calculated. The results are as follows. Mean daily intake of iron was $14.9\pm{0.6mg}$ for the boys and $12.4\pm{0.5mg}$ for the girls. Mean daily intake of zinc was $11.8\pm{1.2mg}$ for the boys and $11.5\pm{0.4mg}$ for the girls. Mean daily fecal loss and apparent digestibility of iron was $6.1\pm{0.3mg}$ and $58.8\pm{2.0%}$ for the boys and $6.8\pm{0.1mg}$ and $44.1\pm{2.0%}$ for the girls. Mean daily fecal loss and apparent digestibility of zinc was $9.3\pm{0.2mg}$ and $14.4\pm{5.1%}$ for the boys and $9.7\pm{0.4mg}$ and $14.3\pm{4.3%}$ for the girls. Mean daily urinary loss of iron was $1.1\pm{0.1mg}$ and showed the positive balance of $7.86\pm{0.6mg}$ for the boys and $0.5\pm{0.1mg}$ and showed the positive balance of $5.14\pm{0.4mg}$ for the girls. Mean daily urinary loss of zinc was $0.5\pm{0.1mg}$ and showed the positive balance of $1.03\pm{0.6mg}$ for the girls.

• Journal of the Korean Dietetic Association
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• v.13 no.4
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• pp.301-310
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• 2007

The purpose of this study was to analyze the relationships among zinc status, protein and phytate intake, and diabetic control indices of type 2 diabetic women. The mean age and the duration of diabetes were respectively 57.9±6.9 years old and 8.0±6.5 years. The mean daily energy intake of diabetic subjects was 1562 kcal. Both the zinc intake (6.2mg/day) and the zinc %RI (% of The Recommended Intake for zinc: 79.5%) of the diabetic participants were significantly lower than those of the control group (respectively p<0.01). As for the diabetic group, the higher the energy intake (kcal/day), the higher were the zinc intake (p<0.001) and %RI for zinc (p<0.001). Zinc intake was positively correlated with the protein (p<0.001), animal protein (p<0.001), and fat intake (p<0.001), but negatively correlated with the carbohydrate intake (p<0.001). Foods with high amount of phytate were the major source of zinc (p<0.01), but did not contribute to high zinc densities. The urinary zinc excretion was twice as high as in the diabetic group compared to the control group (p<0.001). In addition, the urinary zinc loss was positively correlated with the duration of diabetes (p<0.05), hyperglycemia (p<0.001) and insulin resistance (p<0.05). %RI for zinc was negatively correlated with the HbA1C (p<0.05). These results lead us to conclude that the appropriate intake of energy controlled by diet therapy could improve the total zinc intake and %RI for zinc in diabetic women. Also, normal blood glucose level controlled by diet therapy could improve the hyperzincuria. Dietetic practitioners should encourage consumption patterns that provide zinc-rich foods in the form of animal protein to improve the bioavailability as well as the total daily intake of zinc.

• Korean Journal of Community Nutrition
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• v.14 no.2
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• pp.229-235
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• 2009

This study was carried out to determine whether a short-term zinc supplementation could improve the zinc status without adverse changes in copper status among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were randomly divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc gluconate daily for 4 weeks. Dietary intakes of participants were measured for two non-consecutive days by 24-hour recall method. Nutritional status of zinc and copper were also evaluated by biochemical measurement of fasting plasma samples and spot urinary collection. At baseline, diabetic patients showed significantly lower levels of dietary zinc intake and higher urinary zinc excretion than the normal adult group(p<0.05, p<0.0001). Plasma level of zinc was not significantly different between diabetic and normal adults at baseline. However, plasma zinc level increased significantly in both diabetic patients and normal adults after zinc supplementation. The changes in plasma copper levels following zinc supplementation were not statistically significant in diabetic subjects as well as in normal adults. These results indicated that four weeks of zinc supplementation did not influence Cu status and that it may contribute to improving the zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve marginal zinc status of diabetic patients without interfering with their copper status