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The effect of inflammation on serum zinc concentrations and the prevalence estimates of population-level zinc status among Congolese children aged 6–59 months

European Journal of Clinical Nutrition volume 71, pages 1467–1470 (2017)Cite this article

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Abstract

Background/Objectives:

Zinc is a negative acute-phase reactant; hence, its concentration decreases in the presence of inflammation. There is no current consensus on how to control for the effect of inflammation on serum zinc, which has implications for accurate estimates of population-level zinc status. We aimed to measure the association between inflammation and serum zinc concentrations and to compare the means and the prevalence of zinc deficiency using unadjusted and inflammation-adjusted serum zinc concentrations among Congolese children.

Subjects/Methods:

Non-fasting blood was collected in the afternoon in trace element-free vacutainers from 744 apparently healthy children aged 6–59 months in the Democratic Republic of the Congo. Serum was analyzed for zinc, C-reactive protein (CRP) and α-1 acid glycoprotein (AGP) for 665 children with complete data for all three biomarkers. Linear regression was used to generate correction factors (CFs) based on three stages of inflammation: incubation (CRP >5 mg/l and normal AGP), early convalescence (CRP >5 mg/l and AGP >1 g/l) and late convalescence (AGP >1 g/l and normal CRP), relative to no inflammation.

Results:

Overall unadjusted mean±s.d. serum zinc concentration was 9.4±2.1 μmol/l. Study-generated CFs (95% confidence interval) for incubation, early and late convalescence were 1.01 (0.88, 1.14), 1.15 (1.11, 1.21) and 1.07 (1.03, 1.11), respectively. After applying the CFs, overall adjusted mean±s.d. serum zinc concentration was 10.1±2.2 μmol/l, and prevalence of zinc deficiency (<8.7 μmol/l) decreased from 35% (n=234/665) to 24% (n=160/665).

Conclusions:

Adjustment of zinc concentrations for inflammation is warranted when assessing population-level zinc status.

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Acknowledgements

We thank Tze Lin Chai, Jen Foley, Kyly Whitfield and Sarah Harvey, The University of British Columbia for their contributions to this work; Juergen Erhardt, Willstaett, Germany, for conducting the inflammation biomarker analyses, and Karl Bailey, University of Otago, Dunedin, New Zealand for conducting the serum zinc analyses. This research was supported by HarvestPlus, a challenge program of the Consultative Group on International Agricultural Research (CGIAR) Research Program on Agriculture for Nutrition and Health (grant number 2014H8307). This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the Clinical Research Ethics Board at the University of British Columbia (H14-01279), the Université de Kinshasa (ESP/CE/033/14) and the Université Catholique de Bukavu (UCB/CIE/NC/25/2014). Written informed consent was obtained from all subjects.

Author contributions

CDK designed the research, conducted the data analysis and drafted the research manuscript; SIB, E Boy, E Bahizire, PLT, PZA, LAH and TJG contributed to the preparation of the manuscript; CDK had primary responsibility for the final content. All authors read and approved the manuscript.

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Authors and Affiliations

  1. Food, Nutrition and Health, The University of British Columbia, Vancouver, British Columbia, Canada

    C D Karakochuk & S I Barr

  2. BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada

    C D Karakochuk

  3. HarvestPlus, International Food Policy Research Institute, Washington, DC, USA

    E Boy

  4. Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo

    E Bahizire

  5. Faculty of Medicine, University of Goma, Goma, Democratic Republic of the Congo

    P L Tugirimana

  6. Department of Nutrition, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo

    P Z Akilimali

  7. Department of Human Nutrition, The University of Otago, Dunedin, New Zealand

    L A Houghton

  8. Theme of Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, Australia

    T J Green

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  1. C D Karakochuk
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Corresponding author

Correspondence to C D Karakochuk.

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Competing interests

The authors declare no conflict of interest. HarvestPlus contributed to the study design, but did not have a role in the analysis of samples or data, or the final interpretation of findings.

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Karakochuk, C., Barr, S., Boy, E. et al. The effect of inflammation on serum zinc concentrations and the prevalence estimates of population-level zinc status among Congolese children aged 6–59 months. Eur J Clin Nutr 71, 1467–1470 (2017). https://doi.org/10.1038/ejcn.2017.127

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