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Serum zinc and its relation to bone mineral density in β-thalassemic adolescents

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Abstract

Trace elements have been considered to play critical roles in bone metabolism. This study aims at determining the serum zinc profile and its association with bone mineral density (BMD) abnormalities in thalassemic patients. In 131 transfusion-dependent β-thalassemic patients, aged 10–20 yr, serum levels of zinc were measured by flame atomic absorption spectrophotometry (F-AAS). BMD values at the lumbar (L1–L4) and femoral neck were determined by dual X-ray absorptiometry (DXA). Dietary zinc intake and daily consumption of calcium were evaluated by a food-frequency questionnaire. Low serum zinc was found in 84.8% (in 44.7% severely low). Below −2 BMD Z-scores were observed in 68.7% and 17.6% of the patients at the lumbar and femoral regions, respectively. Female patients with severe zinc deficiency had lower lumbar BMD Z-scores in comparison to the other females (−3.26 vs −2.54). Serum zinc in females with femoral BMD Z-scores <−2 was significantly lower by 16.4 µg/dL than other females. Our study suggests that serum levels of zinc can be lowered in the thalassemic patients and partly affect the BMD.

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References

  1. T. Okano, Effects of essential trace elements on bone turnover-in relation to the osteoporosis, Nippon Rinsho 54(1), 148–154 (1996).

    PubMed  CAS  Google Scholar 

  2. J. Z. Ilich and J. E. Kerstetter, Nutrition in bone health revisited, a history beyond calcium, J. Am. Coll. Nutr. 19(6), 715–737 (2000).

    PubMed  CAS  Google Scholar 

  3. A. S. Prasad, J. A. Halsted, and M. Nadimi, Syndrome of iron deficiency anemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia, Am. J. Med. 31, 532–546 (1961).

    Article  PubMed  CAS  Google Scholar 

  4. M. Mahmoodi, M. Kimiagar, N. Valaie, et al., Prevalence of zinc deficiency in junior high schoolchildren in Tehran, Biol. Trace Element Res. 81, 93–103 (2001).

    Article  CAS  Google Scholar 

  5. F. Sharifi, M. Hedayati, P. Mirmiran, et al., Serum level of zinc, copper and iron in schoolchildren of 23 provinces in Iran, Irn. J. Endocrinol. Metab. 4, 275–286 (1999).

    Google Scholar 

  6. J. C. King and C. L. Keen, Zinc, in Modern Nutrition in Health and Disease, M. E. Shils, J. A. Olson, M. Shike, et al., eds., Lippincott Williams & Wilkins, Baltimore, MD, pp. 223–240 (1999).

    Google Scholar 

  7. G. J. Fuchs, P. Tienboon, S. Linpisarn, et al., Nutritional factors and thalassemia major, Arch. Dis. Child. 74, 224–227 (1996).

    PubMed  CAS  Google Scholar 

  8. N. Cappellini, A. Cohen, A. Eleftheriou, et al., Endocrine complications in thalassemia major, in Guidelines for the Clinical Management of Thalassemia, TIF, pp. 41–49 (2000).

  9. C. Pfaumi, L. Roccasalva, G. Pernicone, et al., Osteopenia in female beta-thalassemic patients, J. Pediatr. Endocrinol. Metab. 11(Suppl. 3), 989–991 (1998).

    Google Scholar 

  10. N. A. Johanson, Musculoskeletal problems in hemoglobinopathies, Orthop. Clin. North Am. 21, 191–198 (1990).

    PubMed  CAS  Google Scholar 

  11. F. Garofalo, A. Piga, R. Lala, et al., Bone metabolism in thalassemia, Ann. NY Acad. Sci. 850, 475–478 (1998).

    Article  PubMed  CAS  Google Scholar 

  12. M. M. Tanner and R. H. Whitehouse, Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty, Arch. Dis. Child. 51, 170–179 (1976).

    PubMed  CAS  Google Scholar 

  13. J. C. Smith, Jr., G. P. Butrimovitz, and W. C. Purdyteitz, Direct measurement of zinc in plasma by atomic absorption spectrophotometry, Clin. Chem. 25, 1487 (1979).

    PubMed  CAS  Google Scholar 

  14. S. Kajanachumpol, T. Tatu, W. Sasanakul, Zinc and copper and status of thalassemic children, Southeast Asian J. Trop. Med. Public Health 28(4), 877–880 (1997).

    PubMed  CAS  Google Scholar 

  15. A. Arcasoy and A. O. Cavdar, Changes of trace minerals (serum iron, zinc, copper and magnesium) in thalassemia, Acta Hematol. 53(6), 341–346 (1975).

    CAS  Google Scholar 

  16. A. Arcasoy, D. Canata, B. Sinav, et al., Serum zinc levels and zinc binding capacity in thalassemia, J. Trace Elements Med. Biol. 15(2–3), 85–87 (2001).

    Article  CAS  Google Scholar 

  17. M. Modarresi, M. Hashemipour, N. Sepahvand, et al., Comparison of hair zinc in patients with thalassemia major and controls, New Aspects Pediatr. 619–624 (2000).

  18. N. A. Bashir, Serum zinc and copper levels in sickle cell anaemia and beta-thalassaemia in North Jordan, Ann. Trop. Paediatr. 15(4), 291–293 (1995).

    PubMed  CAS  Google Scholar 

  19. E. Y. Kwan, A. C. Lee, A. M. Li, et al., A cross-sectional study of growth, puberty and endocrine function in patients with thalassaemia major in Hong Kong, J. Paediatr. Child Health 31(2), 83–87 (1995).

    PubMed  CAS  Google Scholar 

  20. J. Eminians, J. G. Rainhold, and G. A. Kfoury, Zinc nutrition of children in Fars province of Iran, Am. J. Clin. Nutr. 20, 734–742 (1967).

    PubMed  CAS  Google Scholar 

  21. U. Dogru, A. Arcasoy, and A. O. Cavdar, Zinc levels of plasma, erythrocytes, hair and urine in homozygous beta-thalassemia, Acta Haematol. 62, 41–44 (1979).

    CAS  Google Scholar 

  22. Z. Uysal, N. Akar, S. Kemahli, et al., Desferrioxamine and urinary zinc excretion in beta-thalassemia major, Pediatr. Hematol Oncol. 10(3), 257–260 (1993).

    PubMed  CAS  Google Scholar 

  23. Y. Aydinok, C. Coker, K. Kavakli, et al., Urinary zinc excretion and zinc status of patients with beta-thalassemia major, Biol. Trace Element Res. 70(2), 165–172 (1999).

    CAS  Google Scholar 

  24. F. Rea, L. Perrone, A. Mastrobuono, et al., Zinc levels of serum, hair and urine in homozygous beta-thalassemic subjects under hypertransfusional treatment, Acta Haematol. 71(2), 139–142 (1984).

    Article  PubMed  CAS  Google Scholar 

  25. J. B. John and P. D. Anderson, Minerals, in Krause’s Food, Nutrition, & Diet Therapy, 10th ed., L. K. Mahan and S. Escott-Stump, eds., W.B. Saunders, Philadelphia, pp. 132–139 (2000).

    Google Scholar 

  26. M. T. Baer and J. C. King, Tissue zinc levels and zinc excretion during experimental zinc depletion in young men, Am. J. Clin. Nutr. 39, 556–570 (1984).

    PubMed  CAS  Google Scholar 

  27. P. E. Johnson, J. R. Hunt, and N. V. C. Ralston, The effect of past and current dietary Zn intake on Zn absorption and endogenous excretion in the rat, J Nutr. 118, 1205–1209 (1988).

    PubMed  CAS  Google Scholar 

  28. C. M. Taylor, J. R. Bacon, P. J. Aggett, et al., Homeostatic regulation of zinc absorption and endogenous losses in zinc-deprived men, Am. J. Clin. Nutr. 53, 755–763 (1991).

    PubMed  CAS  Google Scholar 

  29. J. C. King, D. M. Shames, and L. R. Woodhouse, Zinc homeostasis in humans, J Nutr. 131, 1360–1366 (2000).

    Google Scholar 

  30. L. Strause, P. Saltman, K. T. Smith, et al., Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals, J Nutr. 124, 1060–1064 (1994).

    PubMed  CAS  Google Scholar 

  31. O. S. Atik, Zinc and senile osteoporosis, J Am. Geriatr. Soc. 31, 790–791 (1983).

    PubMed  CAS  Google Scholar 

  32. C. E. Jensen, S. M. Tuck, J. E. Agnew, et al., High prevalence of low bone mass in thalassemia major, Br. J. Hematol. 103, 911–915 (1998).

    Article  CAS  Google Scholar 

  33. M. L. Anapliotou, I. T. Kastanias, and P. Psara, The contribution of hypogonadism to the development of osteoporosis in thalassemia major, new therapeutic approaches, Clinic. Endocrinol. 42, 279–287 (1995).

    CAS  Google Scholar 

  34. E. P. Vichinsky, The morbidity of bone disease in thalassemia, Ann. NY Acad. Sci. 850, 344–348 (1998).

    Article  PubMed  CAS  Google Scholar 

  35. V. De Sanctis and B. Wonke, Zinc deficiency, in Growth in Thalasaemia, Mediprint, Rome, pp. 39–40 (1994).

    Google Scholar 

  36. R. Honda, I. Tsuritani, M. Ishizaki, et al., Zinc and copper levels in ribs of cadmium-exposed persons with special reference to osteomalacia, Environ. Res. 75, 41–48 (1997).

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences and Health Services, Tehran, Iran

    Reza Bekheirnia, Alireza Abdollah Shamshirsaz, Mohammad Kamgar & Bagher Larijani

  2. Charity Foundation for Special Diseases, Iran

    Reza Bekheirnia, Alireza Abdollah Shamshirsaz, Mohammad Kamgar, Navid Bouzari, Nima Pourzahedgilani, Seyed Mahmood Tabatabaie, Fatemeh Ezzati & Bagher Larijani

  3. Shahid Beheshti University of Medical Sciences and Health Services, Iran

    Seyed Mahmood Tabatabaie, Amirhooshang Abdollah Shamshirsaz & Masood Kimiagar

  4. Iran University of Medical Sciences and Health Services, Iran

    Ghazaleh Erfanzadeh

  5. Mahdad Medical Centre, Iran

    Reza Bekheirnia, Alireza Abdollah Shamshirsaz, Mohammad Kamgar & Amirhooshang Abdollah Shamshirsaz

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  1. Reza Bekheirnia
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  2. Alireza Abdollah Shamshirsaz
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  4. Navid Bouzari
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Bekheirnia, R., Shamshirsaz, A.A., Kamgar, M. et al. Serum zinc and its relation to bone mineral density in β-thalassemic adolescents. Biol Trace Elem Res 97, 215–224 (2004). https://doi.org/10.1385/BTER:97:3:215

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  • DOI: https://doi.org/10.1385/BTER:97:3:215

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