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J Pediatr Gastroenterol Nutr. 2013 Sep;57(3):348-55. doi: 10.1097/MPG.0b013e31829b4e9e.

Associations between intestinal mucosal function and changes in plasma zinc concentration following zinc supplementation.

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1
Department of Nutrition, University of California, Davis, Davis, CA 95616, USA.

Abstract

OBJECTIVES:

Subclinical environmental enteropathy is associated with malabsorption of fats, carbohydrates, and vitamins A, B12, and folate; however, little information is available on mineral absorption. We therefore investigated the relation between intestinal mucosal function (measured by the lactulose:mannitol permeability test and plasma citrulline concentration), and zinc (Zn) absorption, as estimated by the change in plasma Zn concentration (PZC) following short-term Zn or placebo supplementation.

METHODS:

We conducted a randomized, partially masked, placebo-controlled trial among 282 apparently healthy children 6 to 23 months of age in Burkina Faso. After completing baseline intestinal function tests, participants received either 5 mg Zn, as zinc sulfate, or placebo, daily for 21 days.

RESULTS:

At baseline, mean ± standard deviation PZC was 62.9 ± 11.9 μg/dL; median (interquartile range) urinary lactulose:mannitol (L:M) recovery ratio and plasma citrulline concentrations were 0.04 (0.03-0.07) and 11.4 (9.0-15.6) μmol/L, respectively. Change in PZC was significantly greater in the Zn-supplemented versus placebo group (15.6 ± 13.3 vs 0.02 ± 10.9 μg/dL; P < 0.0001), and was negatively associated with initial urinary L:M recovery ratio (-1.1 μg/dL per 50% increase in urinary L:M recovery ratio; P = 0.014); this latter relation did not differ between supplementation groups (P = 0.26). Baseline plasma citrulline concentration was not associated with change in PZC.

CONCLUSIONS:

Although altered intestinal permeability may reduce dietary Zn absorption, it likely does not undermine the efficacy of Zn supplementation, given the large increases in PZC following short-term Zn supplementation observed in this study, even among those with increased urinary L:M recovery ratios.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00944853.

PMID:
23689263
PMCID:
PMC4627695
DOI:
10.1097/MPG.0b013e31829b4e9e
[Indexed for MEDLINE]
Free PMC Article
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