Strand Tor A, Adhikari Ramesh K, Chandyo Ram K, Sharma Pushpa R, Sommerfelt Halvor
Centre for International Health, University of Bergen, Norway.
Am J Clin Nutr. 2004 Mar;79(3):451-6. doi: 10.1093/ajcn/79.3.451.
Plasma and serum zinc concentrations are the most widely used markers of zinc status in individual persons and populations.
The objective was to identify factors that influence plasma zinc concentrations during acute childhood diarrhea.
This was a cross-sectional study of 1757 cases of acute diarrhea in 6-35-mo-old Nepalese children. The association between plasma zinc concentration and several clinical, anthropometric, socioeconomic, and biochemical variables was estimated in simple and multiple linear regression analyses.
We observed a reduction in the mean plasma zinc concentration of 0.59 (95% CI: 0.44, 0.74) micro mol/L per degree ( degrees C) increase in axillary temperature. Having dysentery and an elevated plasma C-reactive protein concentration was also independently associated with lower plasma zinc. Children with clinical features of dehydration had higher plasma zinc concentrations than did those who were not dehydrated. Furthermore, a decrease in plasma albumin of 1 g/L was associated with a decrease in plasma zinc of 0.25 (95% CI: 0.21, 0.29) micro mol/L. The plasma albumin concentration confounded the associations between some clinical variables and plasma zinc, but the association between axillary temperature and dehydration on one hand and plasma zinc on the other was not substantially influenced by the albumin concentration. Moreover, the plasma zinc concentration increased with an increase in observed hemolysis.
Dehydration, clinical and biochemical indicators of inflammation and hemolysis, and, when possible, plasma albumin concentrations should be taken into account when the plasma zinc concentration is used to estimate zinc status during episodes of diarrhea in childhood.
血浆和血清锌浓度是个体和人群中最广泛使用的锌状态标志物。
确定影响儿童急性腹泻期间血浆锌浓度的因素。
这是一项对1757例6至35个月大的尼泊尔儿童急性腹泻病例的横断面研究。在简单和多元线性回归分析中估计血浆锌浓度与几个临床、人体测量、社会经济和生化变量之间的关联。
我们观察到腋窝温度每升高1摄氏度（℃），平均血浆锌浓度降低0.59（95%可信区间：0.44，0.74）微摩尔/升。患有痢疾和血浆C反应蛋白浓度升高也与较低的血浆锌独立相关。有脱水临床特征的儿童血浆锌浓度高于未脱水儿童。此外，血浆白蛋白每降低1克/升，血浆锌降低0.25（95%可信区间：0.21，0.29）微摩尔/升。血浆白蛋白浓度混淆了一些临床变量与血浆锌之间的关联，但腋窝温度和脱水一方面与血浆锌另一方面之间的关联并未受到白蛋白浓度的实质性影响。此外，观察到的溶血增加时血浆锌浓度升高。
在利用血浆锌浓度评估儿童腹泻期间的锌状态时，应考虑脱水、炎症和溶血的临床及生化指标，以及血浆白蛋白浓度（若可能）。
