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Malekahmadi M, Soltani S, Pahlavani N, Sharifi Zahabi E, Kazemizadeh H, Hadavi S, Farsani GM. Zinc status in cystic fibrosis patients; a systematic review and meta-analysis. Heliyon 2024; 10:e33686. [PMID: 39027558 PMCID: PMC11255513 DOI: 10.1016/j.heliyon.2024.e33686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/20/2024] Open
Abstract
Background Cystic fibrosis (CF) is an autosomal recessive hereditary disease causes concentration of secretions and this affects the lungs and digestive system. These patients are exposed to zinc (zn) deficiency. In this review, we decided to investigate the status of zn in CF patients compared to control group. Also, the clinical trials that have so far performed zinc supplementation in these patients are examined. Method ISI Web of Science, Scopus, PubMed/Medline, and Cochrane database were searched, up to December 2023, for studies that reported the association between zn levels of CF patients compared to a healthy control group. A random-effect model was used to compute the pooled weighted mean difference (WMD) with 95 % confidence intervals (CI). Subgroup analysis was done for region, sample and method of measurement, zinc supplementation and age. Result Overall, meta-analysis of 9 studies (n = 383 participants) revealed that the zn levels were significantly lower in children and adolescents with CF compared with healthy subjects (WMD = -11.97 μg/dL, 95 % CI: -22.57 to -1.37; I2 = 92.83 %). Meta-analysis of 8 studies (n = 320 participants) revealed that the serum and plasma level of zn was significantly lower in CF patients compared with healthy subjects (WMD = -14.31 μg/dL, 95 % CI: -25.09 to -3.53; I2 = 88.14 %, P-heterogeneity <0.001) While the zn level in saliva and sputum was significantly higher in CF patients. Conclusion CF patients have decreased zn levels in circulatory reservoirs. zn may effective for the diminish the respiratory and gastrointestinal symptoms in CF patients, further well-designed clinical trial studies is required to prove these effects.
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Affiliation(s)
- Mahsa Malekahmadi
- Imam Khomaini hospital complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Naseh Pahlavani
- Social Determinants of Health Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Elham Sharifi Zahabi
- School of nutrition sciences and food technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Kazemizadeh
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Hadavi
- Treatment Department of Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Mohammadi Farsani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
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Videla LA, Hernandez-Rodas MC, Metherel AH, Valenzuela R. Influence of the nutritional status and oxidative stress in the desaturation and elongation of n-3 and n-6 polyunsaturated fatty acids: Impact on non-alcoholic fatty liver disease. Prostaglandins Leukot Essent Fatty Acids 2022; 181:102441. [PMID: 35537354 DOI: 10.1016/j.plefa.2022.102441] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/25/2022]
Abstract
Polyunsaturated fatty acids (PUFA) play essential roles in cell membrane structure and physiological processes including signal transduction, cellular metabolism and tissue homeostasis to combat diseases. PUFA are either consumed from food or synthesized by enzymatic desaturation, elongation and peroxisomal β-oxidation. The nutritionally essential precursors α-linolenic acid (C18:3n-3; ALA) and linoleic acid (C18:2n-6; LA) are subjected to desaturation by Δ6D/Δ5D desaturases and elongation by elongases 2/5, enzymes that are induced by insulin and repressed by PUFA. Maintaining an optimally low n-6/n-3 PUFA ratio is linked to prevention of the development of several diseases, including nonalcoholic fatty liver disease (NAFLD) that is characterized by depletion of PUFA promoting hepatic steatosis and inflammation. In this context, supplementation with n-3 PUFA revealed significant lowering of hepatic steatosis in obese patients, whereas prevention of fatty liver by high-fat diet in mice is observed in n-3 PUFA and hydroxytyrosol co-administration. The aim of this work is to review the role of nutritional status and nutrient availability on markers of PUFA biosynthesis. In addition, the impact of oxidative stress developed as a result of NAFLD, a redox imbalance that may alter the expression and activity of the enzymes involved, and diminished n-3 PUFA levels by free-radical dependent peroxidation processes will be discussed.
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Affiliation(s)
- Luis A Videla
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Adam H Metherel
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rodrigo Valenzuela
- Nutrition Department, Faculty of Medicine, University of Chile, Santiago, Chile; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Hernández MC, Rojas P, Carrasco F, Basfi-Fer K, Valenzuela R, Codoceo J, Inostroza J, Ruz M. Fatty acid desaturation in red blood cell membranes of patients with type 2 diabetes is improved by zinc supplementation. J Trace Elem Med Biol 2020; 62:126571. [PMID: 32534376 DOI: 10.1016/j.jtemb.2020.126571] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/14/2020] [Accepted: 05/26/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND/OBJECTIVE Membrane flexibility can be a determining factor in pathophysiological mechanisms of type 2 diabetes (T2D). As a cofactor of delta-5 desaturase (D5D) and delta-6 desaturase (D6D), and gene expression regulator, zinc may play a role modulating membrane flexibility by increasing membrane polyunsaturated fatty acids (PUFA) abundance. The objective of this study was to evaluate the effect of a 24-month zinc supplementation (30 mg elemental zinc) on membrane fatty acid composition in patients with T2D. SUBJECTS/METHODS Sixty patients with T2D were evaluated. Thirty were randomly assigned to the zinc supplemented group and thirty to the placebo group. Fatty acid composition in red blood cell (RBC) membranes was determined by gas chromatography. Expression of gene encoding for D5D (FADS1), and D6D (FADS2) were evaluated in peripheral blood mononuclear cells by real-time polymerase chain reaction. RESULTS After 24 months of supplementation, a greater abundance of docosapentaenoic acid (C22:5 n-3), arachidonic acid (C20:4 n-6), adrenic acid (C22:4 n-6), and total n-6 PUFA was found (p = 0.001, p = 0.007, p = 0.033, p = 0.048, respectively). The unsaturated fatty acids/saturated fatty acids ratio, and unsaturation index was increased in the zinc supplemented group at month 24 (p = 0.003 and p = 0.000, respectively). FADS1 gene was upregulated in the zinc group in relation to placebo at month 12 (p = 0.020). CONCLUSIONS Supplementation with 30 mg/d elemental zinc during 24 months in patients with T2D had an effect on the composition of RBC membranes increasing PUFA abundance and in turn, improving membrane flexibility. This effect may be mediated by induction of D5D gene expression.
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Affiliation(s)
| | - Pamela Rojas
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Carrasco
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Karen Basfi-Fer
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rodrigo Valenzuela
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Juana Codoceo
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Jorge Inostroza
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Manuel Ruz
- From the Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.
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Knez M, Stangoulis JCR, Glibetic M, Tako E. The Linoleic Acid: Dihomo-γ-Linolenic Acid Ratio (LA:DGLA)-An Emerging Biomarker of Zn Status. Nutrients 2017; 9:E825. [PMID: 28763004 PMCID: PMC5579618 DOI: 10.3390/nu9080825] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 11/19/2022] Open
Abstract
Zinc (Zn) deficiency is a common aliment predicted to affect 17% of the world's population. Zinc is a vital micronutrient used for over 300 enzymatic reactions and multiple biochemical and structural processes in the body. Although whole blood, plasma, and urine zinc decrease in severe zinc deficiency, accurate assessment of zinc status, especially in mild to moderate deficiency, is difficult as studies with these biomarkers are often contradictory and inconsistent. Hence, as suggested by the World Health Organization, sensitive and specific biological markers of zinc status are still needed. In this review, we provide evidence to demonstrate that the LA:DGLA ratio (linoleic acid:dihomo-γ-linolenic acid ratio) may be a useful additional indicator for assessing Zn status more precisely. However, this biomarker needs to be tested further in order to determine its full potential.
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Affiliation(s)
- Marija Knez
- College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia.
| | - James C R Stangoulis
- College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
| | - Maria Glibetic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia.
| | - Elad Tako
- USDA/ARS (US Department of Agriculture, Agricultural Research Service), Robert W. Holley Centre for Agriculture and Health, Cornell University, Ithaca, NY 14853, USA.
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Smit EN, Muskiet FAJ, Boersma ER. The possible role of essential fatty acids in the pathophysiology of malnutrition: a review. Prostaglandins Leukot Essent Fatty Acids 2004; 71:241-50. [PMID: 15301795 DOI: 10.1016/j.plefa.2004.03.019] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2003] [Accepted: 03/17/2004] [Indexed: 10/26/2022]
Abstract
Biochemical evidence of essential fatty acid deficiency (EFAD) may exist in protein-energy malnutrition (PEM). EFAD is characterised by low 18:2omega6, often in combination with low 20:4omega6 and 22:6omega3, and high 18:1omega9 and 20:3omega9. Some PEM symptoms, notably skin changes, impaired resistance to infections, impaired growth rate and disturbed development may at least partly be explained by EFAD. One or more of the following factors could induce EFAD in PEM: low EFA intake, poor lipid digestion, absorption, transport, desaturation and increased EFA beta-oxidation and peroxidation. EFAD may perpetuate itself by decreasing lipid absorption and transport, and aggravate PEM by impairing nutrient absorption and dietary calorie utilisation. Micronutrient deficiencies may contribute to the impaired EFA bioavailability and metabolism. Nutritional rehabilitation strategies in PEM may consider adequate intakes of EFA and micronutrients, e.g. by promoting breastfeeding. More research is required to gain detailed insight into the role of EFAD in PEM.
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Affiliation(s)
- Ella N Smit
- Department of Pathology and Laboratory Medicine, c/o Prof. Dr. Frits A.J. Muskiet, CMC-V, Y1.147, Groningen University Hospital, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
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Abstract
The objectives of this study were to measure plasma and red blood cell (RBC) zinc concentrations in patients with cystic fibrosis (CF), and examine their relationship to nutritional status and pulmonary function. Plasma and RBC zinc levels were compared in 53 CF patients ranging in age from 0.5-46 years. Their relationships to weight (% ideal weight) and forced expired volume in 1 sec (FEV(1)) (% predicted value) were examined. After excluding improperly handled specimens, RBC zinc levels in 51 patients and plasma zinc concentrations in 40 patients were included for analysis. Sixteen of 51 (31%) patients had low RBC zinc levels compared to 4 of 40 (10%) with low plasma zinc concentrations (P < 0.01). Thirteen of 38 patients (34%) in whom both values were obtained had low RBC zinc concentrations compared to 4 of 38 (11%) with low plasma zinc levels (P < 0.022). Neither low RBC nor plasma zinc levels correlated with nutritional status or lung function. In conclusion, about one third of patients with CF had low RBC zinc levels. Plasma zinc concentrations may not adequately reflect overall zinc status. This deficiency did not appear to be related to either nutritional status or lung function. The significance of low RBC zinc in CF is unknown.
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Affiliation(s)
- Leyla Akanli
- Division of Pediatric Allergy, Immunology and Pulmonary Children's Hospital at Loma Linda Medical Center, Loma Linda University, Loma Linda, California 92354, USA.
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Squali Houssaïni FZ, Foulon T, Payen N, Iraqi MR, Arnaud J, Groslambert P. Plasma fatty acid status in Moroccan children: increased lipid peroxidation and impaired polyunsaturated fatty acid metabolism in protein-calorie malnutrition. Biomed Pharmacother 2001; 55:155-62. [PMID: 11325213 DOI: 10.1016/s0753-3322(01)00041-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
In previous studies on plasma fatty acid and antioxidant status in 29 malnourished Moroccan children (12 with mild protein-calorie malnutrition, 17 with severe protein-calorie malnutrition) compared to 15 healthy control children from the same area, we pointed out that these populations were heterogeneous in terms of their essential fatty acid and antioxidant status. The aim of the present study was to classify the children using the Waterlow classification and their essential fatty acid status. The discrepancies in lipid parameters, nutritional and inflammatory markers, blood oxidative indexes, antioxidant micronutrients or trace elements (selenium, zinc, vitamin E) related to polyunsaturated fatty acids were checked in these populations. Eight of the control subjects and nine of the severe protein-calorie malnutrition children were essential fatty acid-deficient, compared to only one of the mild protein-calorie malnutrition group. Examination of the essential fatty acid-sufficient subjects with mild protein-calorie malnutrition, compared to the essential fatty acid-sufficient control subjects, showed only a decrease in Z scores and a non-significant decrease in selenium and vitamin E. In severely malnourished children, albumin, cholesterol and low density lipoprotein (LDL) cholesterol, plasma selenium, vitamin E and zinc were low, whereas inflammatory proteins and triglycerides were high. These features worsened with essential fatty acid deficiency. In all protein-calorie malnutrition subjects, there was oxidative stress (increase in thiobarbituric-acid reactants, imbalance between plasma polyunsaturated fatty acid, vitamin E and selenium levels), even in the absence of essential fatty acid deficiency. Monounsaturated fatty acids, oleic acid/stearic acid (C18:1 n-9/C18:0) delta9 desaturase and n-3 and n-6 elongase activity indexes increased. The C18:1/C18:0 delta9 desaturase activity index was negatively correlated to Z scores (r = -0.44, P< 0.01 for Z score weight, r = -0.39, P < 0.01 for Z score height), albumin (r = -0.82, P < 0.01) and zinc (r = -0.51, P< 0.01) levels. In essential fatty acid-deficient, severe protein-calorie malnutrition subjects, delta6 desaturase activity was impaired, and there was a non-significant decrease in arachidonic acid. Essential fatty acid deficiency is a type of malnutrition, and is associated with an aggravation of all parameters in severe protein-calorie malnutrition. The increase in the C18:1/C18:0 delta9 desaturase activity and enhanced lipid peroxidation without any essential fatty acid deficiency could be early markers of protein-calorie malnutrition.
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Affiliation(s)
- A Christophe
- Department of Endocrinology and Metabolic Diseases, University of Ghent, University Hospital, Belgium
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Christophe AB, Warwick WJ, Holman RT. Serum fatty acid profiles in cystic fibrosis patients and their parents. Lipids 1994; 29:569-75. [PMID: 7990664 DOI: 10.1007/bf02536629] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Fatty acid compositions of the major serum lipid classes from 43 cystic fibrosis (CF) homozygotes (CF patients), 36 obligate heterozygotes (parents of CF patients) and 34 controls were determined by capillary gas chromatography. Fatty acid compositions of the homozygote CF patients were skewed in the direction of relative essential fatty acid deficiency in comparison with the controls. Less pronounced, but similar deviations from normal, were observed in the heterozygotes. Homozygotes with normal fatty acid compositions and heterozygotes with considerably disturbed fatty acid profiles were found.
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Affiliation(s)
- A B Christophe
- Department of Endocrinology and Metabolic Diseases, University of Ghent, Belgium
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Koletzko B, Abiodun PO, Laryea MD, Bremer HJ. Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition. Eur J Pediatr 1986; 145:109-15. [PMID: 3089792 DOI: 10.1007/bf00441868] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The fatty acid (FA) composition of the main plasma lipids was analysed in eight well-nourished, generally healthy Nigerian children aged 14.1 +/- 7.2 months and in 17 malnourished children (8 marasmus, 9 kwashiorkor) aged 14.6 +/- 3.8 months within the first 2 days of admission at the Dept. of Child Health, University of Benin. In comparison to the control group, the malnourished children showed a marked decrease of polyunsaturated FA with low linoleic acid, mainly in sterol esters (STE), and severely reduced linoleic acid metabolites, including arachidonic acid, in all lipid fractions. omega-3-FA were not altered except for a reduction of docosapentaenoic and docosahexaenoic acids in phospholipids. Clearly increased values were found for saturated FA in STE and for the non-essential monoenoic FA in all lipid classes. This pattern indicates the presence of essential fatty acid deficiency in the malnourished children. There was no significant difference between marasmus and kwashiorkor. Eight malnourished children were followed up in the early phase of recovery during hospital treatment 14.0 +/- 3.1 days after obtaining the first sample. Linoleic acid had increased again in STE, but its metabolites were as low or even lower than before. An impaired activity of delta-6-desaturase, the rate limiting enzyme of linoleic acid metabolism, in suggested by elevated substrate-product-ratios of this enzyme in untreated children with protein energy malnutrition and in the early phase of recovery, which may be due to low insulin levels, protein and zinc deficiency. The trientetraen ratio (20:3 omega 9/20:4 omega 6) thus is not a reliable indicator of essential FA status in protein-energy malnutrition.
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