Jornal de Pediatria (Aug 2009)
Baixas concentrações plasmáticas de zinco em pacientes pediátricos com cirrose Low plasma zinc concentrations in pediatric patients with cirrhosis
Abstract
OBJETIVO: Determinar a concentração plasmática de zinco em crianças e adolescentes cirróticos e investigar a associação entre esses resultados e a ingestão dietética de zinco, os dados antropométricos e a gravidade da doença hepática. MÉTODOS: As concentrações plasmáticas de zinco foram avaliadas por espectrofotometria de absorção atômica em 30 crianças e adolescentes com cirrose (105,0±60,0 meses; 22 meninas) e 27 hígidas e sem doença hepática (122,3±47,3 meses, 14 meninas). Os dados relacionados ao zinco dietético foram avaliados por registro de ingestão alimentar de 3 dias. A antropometria incluiu peso, altura, espessura da dobra cutânea, circunferência braquial e área muscular do braço. A gravidade da doença hepática foi classificada de acordo com os critérios de Child-Pugh, MELD e PELD. RESULTADOS: As concentrações plasmáticas de zinco dos indivíduos controles e dos pacientes foram 105,69±19,46 e 75,44±24,45 μg/dL, respectivamente (p OBJECTIVE: To determine plasma zinc concentrations in children and adolescents with cirrhosis and to investigate the association between these results and dietary zinc intake, anthropometric data, and severity of liver disease. METHODS: Plasma zinc concentration was assessed by atomic absorption spectrophotometry in 30 children and adolescents with cirrhosis (105.0±60.0 months; 22 girls) and 27 without liver disease (122.3±47.3 months, 14 girls). Dietary zinc data were evaluated by 3-day food intake records. Anthropometry measures included height, weight, skinfold thickness, brachial circumference, and upper arm muscle size. Severity of liver disease was classified according to the Child-Pugh, MELD, and PELD criteria. RESULTS: The mean (± standard deviation) plasma zinc concentrations in control subjects and patients were 105.69±19.46 and 75.44±24.45 μg/dL, respectively (p < 0.001). No associations were found between anthropometric measures, dietary zinc intake, and plasma zinc concentration. There was statistical difference related to plasma zinc concentrations between Child-Pugh B + C patients and control subjects (p < 0.001), and concerning PELD, between patients below the cutoff score of 15 and those above (p = 0.002). CONCLUSION: The prevalence of hypozincemia was 43% for patients with cirrhosis. Although low plasma zinc concentration was associated with more severe liver disease, it was present even in some Child-Pugh A patients. Therefore, zinc supplementation should be considered for cirrhotic children.
Keywords
