• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.1
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• pp.53-61
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• 2024

Purpose: Although the 24-hours urinary copper excretion is useful for the diagnosis of Wilson disease (WD), there are practical difficulties in the accurate and timed collection of urine samples. The purpose of this study was to verify if the spot morning urinary Copper/Zinc (Cu/Zn) ratio could be used as a replacement parameter of 24-hours urinary copper excretion in the diagnosis of WD. Methods: A cross-sectional study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from June 2019 to May 2021 on 67 children over three years of age who presented with liver disease. Twenty-seven children who fulfilled the inclusion criteria for WD were categorized into the test group, and the remaining forty children were considered to have non-Wilsonian liver disease and were categorized into the control group. Along with other laboratory investigations, spot morning urinary samples were estimated for the urinary Cu/Zn ratio in all patients and were compared to the 24-hour urinary copper excretion. The diagnostic value of the Cu/Zn ratio was then analyzed. Results: Correlation of spot morning urinary Cu/Zn ratio with 24-hours urinary copper excretion was found to be significant (r=0.60). The area under ROC curve with 95% confidence interval of morning urinary Cu/Zn ratio measured using 24-hours urine sample was 0.84 (standard error, 0.05; p<0.001). Conclusion: Spot morning urinary Cu/Zn ratio seems to be a promising parameter for the replacement of 24-hours urinary copper excretion in the diagnosis of WD.

• Journal of Nutrition and Health
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• v.32 no.6
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• pp.705-712
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• 1999

The purpose of this study was to assess the zinc and copper nutritional status of 102 college women by measuring zinc and copper intake, hematological parameters of zinc and copper, hair zinc and urinary excretion of zinc and copper. The mean zinc intake was 5.5mg(45.8% RDA) with food analysis and 4.5mg(37.8% RDA) with computation from food composition table. The copper intake with food analysis was 2.3mg and 1.2mg with computation. Mean serum zinc concentration was 77.02ug/dl and the proportion of subjects with zinc deficiency estimated by serum zinc(<70ug/dl)was 23.0%. Mean serum copper concentration was 121.80ug/dl and 4.1% of subjects showed serum copper less than 70ug/dl, The mean ceruloplasmin concentration was 22.63mg/dl and the proportion of subjects whose ceruloplasmin was lower than 18-40mg/dl was 6.6%. The mean hair zinc of subjects was 143.8ppm and the mean hair copper was 11.2ppm. The mean urinary excretion of zinc was 0.43mg/day and the proportion of subjects with marginal deficiency estimated by urinary zinc excretion( <0.3mg/day) was 23.3%. The mean urinary copper excretion was 0.044mg/day which was within the normal range(0.01-0.06mg/day). Assessing by zinc content in hair, urine and serum, 22.9-23.3% of college women had bordeline zinc deficiency or zinc deficiency. Whereas 4.1-6.6% of college women was assessed copper deficiency estimated by serum copper and ceruloplasmin.

• Preventive Nutrition and Food Science
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• v.2 no.3
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• pp.225-231
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• 1997

Thirteen healthy control, 13 pre-eclamptic, 7 diabetic(DM) and 12 gestational diabetic(GDM) pregnant women participated in a study ofthe interrelationships between the levels of protein, calcium, magnesium, phosphorus, zinc and copper in urine. Urinary protein, magnesium and copper levels were significantly higher (p<0.0005, p<0.0003, p<0.005 respectively) in pre-eclamptic women than those of control, DM and GDM women. Urinary zinc excretion in pre-eclamptic women (1.61 mg/g creatinine) was higher than that of DM women (0.81mg/g creatinine); urinary zinc losses of control and GDM women were wre between the other two rups. The GDM women excreted significantly ore phosphorus in their urine in comparison to control and preeclamptic women (p<0.02), but this was not seen in DM women. Among the DM women, urinary protein excretion was positively correlated with glycosylated hemoglobin(r=0.940) and fasting blood glucose concentration (r=0.889). Urinary zinc excretion also was correlated with glycosylated hemoglobin (r=0.853) and fasting blood glucose (r=0.956). In the GDM and pre-eclamptic women there were also significant correlations between urinar calcium and magnesium (r=0.857, r=0.749 respectively) and between urinary protein and copper(r=0.638, r=0.778 respectively).

• Journal of Community Nutrition
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• v.1 no.1
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• pp.3-9
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• 1999

This study was performed to investigate the biochemical status of iron, zinc and copper for 125 preschool children (Males : 69, Females : 56) residing in a low-income area of Seoul. The number of subjects aged, 3, 4, 5 and 6 were 19, 41, 41 and 24, respectively. The hemoglobin level of the children aged 3 was 11.8 g/dl and was lower thant hat of the other groups(p<0.05). Similar results were found for hematocrit and serum zinc. The percentage of children with an iron deficiency assessed by Hb(3-5) years : <11.0g/dl, 6 years: <11.5g/dl), Hct(3-6 years : 33%, 6 years : <35%), serum transferrin(<16%) and serum ferritin(<10ng/ml) were 4.3%, 9.5%, 8.2% and 17.7%, respectively. The mean serum zinc was 67.9$\mu\textrm{g}$/dl and urinary zinc was 0.1300mg/day. Low serum zinc (61.0$\mu\textrm{g}$/dl) occurred in 28.0% of the children. The mean serum copper was 110.5$\mu\textrm{g}$/dl and urinary copper was 0.0126mg/day. The prevalence of children with elevated serum copper($\geq$ 130$\mu\textrm{g}$/dl) was 54.8%, which was higher than 7.4%, the prevalence of low serum copper(<70$\mu\textrm{g}$/dl). Children with higher status, more weight, larger girth of chest, or larger midarm circumference showed higher values of Hb. The height and weight of children also showed a positive crrelation with serum zinc(P<0.001-P<0.05).

• Journal of Nutrition and Health
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• v.29 no.10
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• pp.1112-1120
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• 1996

This study was carried out to estimate the relationship between dietary intakes, blood levels, and urinary excretions of zine, copper, and iron and serum lipids in 30 healthy adults living in Korean rural area. Analyses for the nutritional status of the subjects were performed by 3-day intake recored, duplicated diet collections, 24-hour urine collection, and venous blood sampling before measuring of blood pressure. The daily intakes of zinc, copper, and iron estimated for 3 days were 8.2mg, 3.0mg, and 12.7mg in men and 8.4mg, 3.7mg, and 12.3mg in women, respectively. The serum contents of cholesterol, triglyceride, and HDL-cholesterol were 165.9mg/dl, 119.4mg/dl, and 43.7mg/dl in men and 154.1mg/dl, 88.2mg/dl, and 47.1mg/dl in women, respectively. The serum levels of zine, copper, and iron were 146.0ug/dl, 120.3ug/dl, and 131.1ug/dl in men and 140.6ug/dl, 117.3ug/dl, and 112.2ug/dl in women, respectively. In the relation between dietary intakes, serum levels, and urinary excretions of these minerals, there were significantly positive correlation between zine intake and copper intake(p<0.05), copper intake and urinary excretion(p<0.001), and iron intake and serum zine level(p<0.05). In the relation between these minerals and serum lipids, dietary zine showed positive correlation with triglyceride(p<0.05), and serum zine/copper ratio showed negative correlation with HDL-cholesterol (p<0.05).

• Journal of the Korean Society of Food Science and Nutrition
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• v.19 no.5
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• pp.411-417
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• 1990

To compare the dietary and urinary minerals with serum lipid and minerals this study was carried out on 30 rural housewives in Kyunggi area. Mean intake of energy was 1770.3Kcal and protein 55.5g per day. Mineral intakes per day were measured; sodium 4330mg phos-phorus 485.7mg calcium 388.0mg zinc 8.99mg and copper 2.23mg Urinary minerals were analy-sed ; sodium 4379mg phosphorum 371.3mg calcium 190.0mg zinc 328.0mg and copper 49.6mg. Serum contents of lipid and minerals were : cholesterol 169.0mg% triglyceride 70.6mg% $\beta$-lipoprotein 304.9mg% sodium 142.3mM phosphorus 3.94mg% calcium 9.06mg% zinc 1215.7 ppb and cooper 620.0ppb. Eietary sodium and zinc urinary copper were significantly related with serum lipids.

• Journal of Nutrition and Health
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• v.41 no.7
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• pp.612-620
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• 2008

This study assessed the effects of soy isoflavones supplementation with exercise on urinary mineral (calcium, magnesium, copper, zinc) excretion as an index of bone resorption rates in 67 postmenopausal women. A total subjects were assigned to Isoflavone (90 mg/day) or placebo groups. These groups were further divided into groups that undergone a regular exercise or a rather sedentary state performing daily activity only. We conducted study eight week period. Result showed urinary zinc excretion was more significantly decreased in the isoflavone-sedentary group ($-180.76\;{\pm}\;171.30\;ug/day$) than in the placebo-sedentary group ($-31.23\;{\pm}\;146.60\;ug/day$), placebo-exercise group ($40.93\;{\pm}\;193.44\;ug/day$) and isoflavione-exercise group ($-1.21\;{\pm}\;160.61\;ug/day$) (p < 0.05), but no significant changes in the differences between the values of the pre and post study values in urinary calcium, magnesium and copper excretion. These results suggest that Isoflavone supplementation decrease urinary zinc excretion rate in postmenopausal subjects.

• Journal of Nutrition and Health
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• v.38 no.1
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• pp.56-66
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• 2005

The purpose of this study was to assess the zinc and copper status of type 2 diabetic women and to analyse the relation-ship among zinc and copper status, and diabetic control indices of diabetes. The mean age of diabetes was 57.9 years old. The mean duration of diabetes was 8.0 $\pm$ 6.5 years. The mean daily energy intake of diabetes was 1562 kcal. There were no significant differences of age, BMI, %body fat, nutritional intakes, total energy intake, and energy composition from carbohydrate, protein, and fat between diabetes (n = 50) and control group (n = 68). However, both zinc intake density (4.15 mg/1000 kcal) and zinc %RDA (62.0%) of diabetes were significantly lower than control group (p <0.05, P < 0.01, respectively). The plasma zinc level was not significantly different between diabetes and control group (90$\mu$g/dl, 91$\mu$g/dl respectively). The proportion of diabetic women whose plasma zinc levels were lower than 76 $\mu$g/dl(borderline zinc deficiency) was 18.8%. This was about 38% higher than control group. It has been suggested that insulin secretion might decrease in borderline plasma zinc and copper deficiency and increase in normal plasma zinc and copper status. The urinary zinc excretion was twice higher in diabetes than in control group (p < 0.001). The urinary zinc loss was positively correlated with the duration of diabetes (p < 0.05), hyperglycemia (p < 0.001) and insulin resistance (p < 0.05). These results lead us to conclude that normal blood glucose level controlled by diet therapy could improve the hyperzincuria in diabetic women.

• Journal of Veterinary Clinics
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• v.15 no.2
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• pp.455-459
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• 1998

Ten sheeps from one farm had sudden onset of anorexia, jaundice and hemoglobinuria and died within 3 days after showing clinical signs during 3 months period. Postmortom examination was performed on one case and copper concentrations in the livers kidney and serum of the necmpsied minim were analysed. Grossly, the conjunctive, subcutaneous tissue and abdominal fat were generally icteric. The liver was enlarged with yellowish orange in color. The kidney was enlarged with dark red in color and the urinary bladder was filled with dark red urine. Histopathologically, centrilobular hepatocellular necrosis, neutrophilic infiltrations bile stasis and aggregation of fine granules-laden macrophages in the portal area were noted in the liver. Most of the Bowman's spaces and renal tubules were filled with homogenous eosinophilic fluid. Extramedullary hematopoiesis was noted in the submandibular lymph node. Copper concentrations in serum, liver and kidney of the necropsied animal were 25.0, 2732.8 and 471.3 ppm respectively. Based on the gross and histopathological findings and the high copper concentrations in the organs, this case was diagnosed as chronic copper toxicosis. Possible etiology on this outbreak is also discussed.

• Korean Journal of Community Nutrition
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• v.14 no.2
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• pp.229-235
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• 2009

This study was carried out to determine whether a short-term zinc supplementation could improve the zinc status without adverse changes in copper status among type 2 diabetic patients. Seventy-six diabetic subjects and 72 normal adults participated in this study. Subjects were randomly divided into supplemented and control groups. Forty-four diabetic patients and 34 normal subjects were supplemented with 50 mg zinc gluconate daily for 4 weeks. Dietary intakes of participants were measured for two non-consecutive days by 24-hour recall method. Nutritional status of zinc and copper were also evaluated by biochemical measurement of fasting plasma samples and spot urinary collection. At baseline, diabetic patients showed significantly lower levels of dietary zinc intake and higher urinary zinc excretion than the normal adult group(p<0.05, p<0.0001). Plasma level of zinc was not significantly different between diabetic and normal adults at baseline. However, plasma zinc level increased significantly in both diabetic patients and normal adults after zinc supplementation. The changes in plasma copper levels following zinc supplementation were not statistically significant in diabetic subjects as well as in normal adults. These results indicated that four weeks of zinc supplementation did not influence Cu status and that it may contribute to improving the zinc status. Therefore, we suggest that Zn supplementation for a short-term period may improve marginal zinc status of diabetic patients without interfering with their copper status