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Serum Zinc Levels as a Predictor of Severity of Acute Diarrhea



To determine relationship between serum zinc levels and severity of diarrhea as determined by hydration status, duration of diarrhea and requirement for hospitalization. Also, to compare serum zinc levels in relation to rotavirus status.


A prospective observational study which included 254 children aged 6 mo to 5 y with diarrhea was conducted.


Serum zinc levels could be estimated in 198 children. Median (IQR) serum zinc levels of study population were 73.5 (59.11–92.86)μg/dl. Median (IQR) of serum zinc levels in children with dehydration and without dehydration were 69.64 (54.57–81.62) and 82.86 (64.1–103.48) μg/dl respectively (p < 0.001). Median (IQR) of serum zinc levels in hospitalised and non-hospitalished children were 63.28 (51.81–85.37) and 74.86 (61.75–95.78) μg/dl, respectively (p 0.013). Median (IQR) of total duration of diarrhea was 4.8 (3.5–6.0) d and it did not correlate with serum zinc levels. Median (IQR) of serum zinc levels in children, with rotavirus diarrhea was 66.8 (49.7–82.48) and non-rotavirus diarrhea was 80.0 (62.42–100.12) μg/dl (p < 0.001).


Children with dehydration and those with rotavirus diarrhea tend to have significantly lower serum zinc levels. Hospitalized children also have lower serum zinc levels than non-hospitalized children. Duration of diarrhea does not relate with serum zinc levels.

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  1. 1.

    Fontaine O. Effect of zinc on clinical course of acute diarrhea. J Health Popul Nutr. 2001;19:339–46.

    CAS  PubMed  Google Scholar 

  2. 2.

    Shrimpton R. Zinc deficiency: what are the most appropriate interventions? BMJ. 2005;330:347–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Arora R, Kulshreshtha S, Mohan G, Singh M, Sharma P. Estimation of serum zinc and copper in children with acute diarrhea. Biol Trace Elem Res. 2006;114:121–6.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Arica S, Arica V, Dag H. Serum zinc levels in children of 0–24 months diagnosed with pneumonia admitted to our clinic. Int J Clin Exp Med. 2011;4:227–33.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. 5.

    The Treatment of Diarrhea. A Manual for Physicians and Other Senior Health Workers. Geneva: World Health Organization; 2005.

  6. 6.

    Bhandari N, Bahl R, Taneja S, et al. Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children. Pediatrics. 2002;109:e86.

    Article  PubMed  Google Scholar 

  7. 7.

    Bitarakwate E, Mworozi E, Kekitiinwa A. Serum zinc status of children with persistent diarrhea admitted to the diarrhea management unit of Mulago hospital, Uganda. Afr Health Sci. 2003;3:54–60.

    PubMed  PubMed Central  Google Scholar 

  8. 8.

    Chaudhary S, Verma M, Dhawan V, et al. Plasma vitamin A, zinc and selenium concentrations in children with acute and persistent diarrhoea. J Diarrhoeal Dis Res. 1996;14:190–3.

  9. 9.

    Strand TA, Adhikari RK, Chandyo RK, Sharma PR, Sommerfelt H. Predictors of plasma zinc concentrations in children with acute diarrhea. Am J Clin Nutr. 2004;79:451–6.

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Ji-ling X, Xiao-tai H. Serum zinc level of rotaviral enteritis in children and the significance of zinc treatment. J Pediatr Pharm. 2010;1.

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Author information




AU and DS planned and supervised the study. AA, NKG, and VJ collected the data, reviewed the literature and prepared the manuscript. RKS provided biochemical results and critical inputs into the final version of manuscript. AA and DS analyzed the data and critically revised the manuscript for important intellectual content. AU will act as guarantor of study.

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Correspondence to Amit Upadhyay.

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CTRI Registration Number- CTRI/2012/12/003236.

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Agarwal, A., Gupta, N.K., Upadhyay, A. et al. Serum Zinc Levels as a Predictor of Severity of Acute Diarrhea. Indian J Pediatr 85, 179–183 (2018).

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  • Dehydration
  • Diarrhea
  • Duration
  • Rotavirus
  • Zinc levels