Role of zinc, copper, and ascorbic acid in some common clinical paediatric problems.
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Biomedical subjects
Publications and source records attributed to S I Ette.
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Concentrations of retinol, vitamins E and C in cord and maternal blood samples were studied in rural health centres, polyclinics and maternities in Cross River State, Nigeria. Plasma concentrations of retinol, vitamins E and C were followed up for 12 months of post natal life. At birth cord blood levels of retinol and vitamin E were significantly lower than the maternal levels but vitamin C levels were higher. During the first twelve months of post natal life, there was a significant increase in the levels of these fat-soluble blood components but the mean was still less than one-third of the mother's level either at birth or at six weeks. However, vitamin C levels in infants showed a decrease at three months. The results are discussed in terms of nutritional and non-nutritional factors.
Studies on plasma and leukocyte ascorbic acid and cholesterol concentrations in 102 nomads from rural communities in Oyo State of Nigeria, as well as in 88 controls, showed no significant differences between study group and controls with respect to leukocyte ascorbic acid values; no correlation was found between ascorbic acid and cholesterol levels; no cases of clinical scurvy were observed. These findings are compared with similar results from Kenya and elsewhere. The findings suggest low but acceptable levels of plasma ascorbic acid in nomadic groups; there was no correlation between ascorbic acid and cholesterol concentrations in cases where plasma vitamin C deficiency was mild or moderate with close to normal levels of leukocyte ascorbic acid; prolonged low levels of plasma ascorbic acid may exist without overt clinical manifestations of scurvy.
Transketolase activity was studied in rats fed a peasant diet containing 5.9% protein, carbohydrate diets (sucrose, glucose, lactose and starch, each containing 5.0% protein) and a normal diet which contained 21% protein. The activity of the enzyme in red cell hemolysate was independent of the protein content of these diets. However, rats fed a low protein diet had significantly higher hepatic transketolase activity than those fed the normal diet. The hepatic transketolase activity was highest in rats fed a diet containing 4 mg thiamine/kg diet. Further dietary increase in the levels of this vitamin did not cause any further increase in the level of activity of the enzyme, thus suggesting that excess dietary thiamine may have a minimal effect on the activity of this enzyme.
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Erythrocyte transketolase activity (ETKA) and the percentage thiamine pyrophosphate (TPP) effects have been measured in a group of 10 healthy children and 50 malnourished subjects (23 oedematous and 27 non-oedematous cases). The observed ETKA values and percentage TPP effects for the two malnourished groups of subjects differed significantly (P less than 0.001) from the values for the control group. These values reverted almost to normal in 24 subjects who were re-tested after 6 weeks of thiamine therapy. Suggestions are made for this apparent biochemical thiamine deficiency without manifestations in these subjects.
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The fat-soluble vitamin E (alpha-tocopherol) status of 47 malnourished children was assessed and compared with that of a control group of ten age-matched normal children. Plasma levels of alpha-tocopherol, total lipid and the ratio of alpha-tocopherol to total lipid were determined. The plasma vitamin E level was low, with a value of less than 11.61 mumol/l (500 micrograms/dl) in 40 (85%) of the malnourished children while the remaining seven (15%) children had values that ranged between 11.61 and 17.20 mumol/l (500-741 micrograms/dl). On the other hand, the tocopherol/total lipid ratio was less than 0.8 mg/g of total lipid in only seven of the malnourished children. The remaining 40 (85%) subjects had values that ranged between 0.8 and 1.96 mg/g of total lipid, whereas in the control group, both the plasma tocopherol levels and the tocopherol/lipid ratio were greater than 11.61 mumol/l (500 micrograms/dl) and 0.8 mg/g of plasma total lipid respectively.
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The fasting plasma levels of zinc and copper during the acute phase of protein-energy malnutrition (PEM) and after recovery have been measured in 51 malnourished children and 10 healthy control subjects. Recovery time was four weeks after the initial presentation when oedema had disappeared and both appetite and temperament had improved. There was no statistically significant difference between the zinc and copper values, both initially and at recovery in all the malnourished children; besides all these values were significantly lower than those for the control group. The evidence was that the dietary intake of these two trace elements was inadequate. It is suggested that in order to hasten catch-op growth during recovery from PEM, both zinc and copper should be added to the rehabilitating diets.
This report discusses vitamins and trace elements profiles in Nigerians suffering from chronic leg ulcers. The levels of vitamin A, C and E are significantly lower than levels in healthy Nigerian controls. Copper values are almost the same in the two groups, but the results indicate deficiency of zinc. The relationship of these nutrients to wound healing is discussed; the addition of vitamin E in the management of leg ulcers is recommended.
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Vitamin E (tocopherol) concentrations were measured at various stages of gestation and at delivery in a group of Nigerian women who were not given any vitamin supplements during pregnancy. Levels in the third trimester of pregnancy were found to be significantly higher than in the first and second trimesters (P less than 0.001). There were no correlations between mean maternal vitamin E levels at delivery and the corresponding mean cord plasma levels. However, the mean maternal vitamin E level at delivery was nearly five times higher than the mean cord plasma level. The mean cord plasma vitamin E was found to increase with increase in the mean birthweight but the maternal vitamin E levels did not show any consistent pattern with infant sex or birthweight.
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In normal weanling male rats, the intraperitoneal administration of zinc sulphate (ZnSO4) resulted in a decreased hepatic and an increased plasa concentration of vitamin A after 2 h. In an in vitro study, the vitamin A concentrations of liver homogenates were markedly increased when homogenized livers were treated with ZnSO4, ZnSO4, however, did not show any effect on plasma and liver concentrations of vitamin E. These results indicate that zinc may be specifically involved in mobilizing vitamin A from liver to the circulation of normal animals within a short period. The trace element, therefore, could be used only to treat cases of depressed vitamin A in plasma but also to treat hepatic toxicity from hypervitaminosis A.
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