9 1992 by The Humana Press, Inc. All rights of any nature, whatsoever, reserved. 0163-4984/92/3201-34)053 $02.00
Plasma Chromium Concentrations in Normal Infants and Cystic Fibrosis Patients DOMINIQUE BOUGLE,* FRANCOIS BUREAU, JOEL VOIR1N, DOMINIQUE NEUVILLE, MICHEL DROSDOWSKY, AND JEAN-FRANCOIS DUHAMEL
Departement de Pediatrie et Laboratoire de Biochimie A, CHU de Caen, France
ABSTRACT Plasma Cr concentrations have been studied in normal children aged 0-14 yr. Levels ranged from 0.65 to 0.88 I~g/1and did not change with age. Plasma concentrations of CF patients given 0.5-0.75 I~g Cr/kg/d in addition to their diet were similar to normal values. There was no correlation between these plasma values and growth retardation. Index Entries: Chromium; plasma; infants; cystic fibrosis.
INTRODUCTION Chromium (Cr) plays an active role in carbohydrate and lipid metabolism, and in protein synthesis (J,2). In addition, it is linked to nucleic acids. It is present in a number of tissues and organs. High concentrations are found in caudate nucleus in the brain (3). Therefore, it may be a critical trace element for growing children (3). This study intends to give Cr values of normal children and of cystic fibrosis (CF) patients. CF is characterized by thick mucus leading to pulmonary and pancreatic insufficiency (4). These children could be prone to develop Cr deficiency, because of digestive malabsorption and increased urine losses during acute exacerbations of lung disease. *Author to whom all correspondence and reprint requests should be addressed. Biological Trace Element Research
53
VoL 32, 1992
54
Bougle
et
al.
SUBJECTS AND METHODS Cr dosage has been examined in blood collected for a routine examination of healthy children attending our out-patient clinic. The diagnosis of most of the CF patients has been made by a neonatal screening. It permits the early institution of an intensive care program, including lung physiotherapy and a diet high in energy (150 kcal/kg/d) in proteins and medium-chain triglycerides, but poor in long-chain triglycerides. Gastroprotected pancreatic enzyme supplementation is instituted between 6-12 mo of age. In addition, children are given a polyvitamin and mineral supplementation providing 0.5-0.75 p,g Cr/kg/d (5). Blood has been collected using polypropylene tubes. These tubes had been previously checked and found to be free of Cr contamination. They have also been used for sample preparation and storage. After blood was drawn, it was centrifuged and kept frozen until analysis. The determination of Cr concentration was made on 1 + 1 (Triton 100 plus Mg [No3]/2 0.05 mg/L) diluted samples by atomic absorption spectrometry (Perkin Elmer 3030, Le Vaudreuil; France with Zeeman effect). An aliquot was delivered to pyrocoated graphite tubes and L'vov platforms (Perkin Elmer) by an auto sampler. The detection wavelength was 357 nm. Graphite furnace temperature program was: drying 140~ (20 s), ashing 1300~ (15 s), and atomization 2500~ (5 s). The Cr standard used was Cr Titrisol (Merck Lab, France). Routine reference materials were Urine Metals Control (Levels 1 and 2) (BIO. RAD, Munich) and Seronorm trace elements (NYCOMED, Sweden). Cr concentrations were also determined in 3 low-birth weight formulas, 16 standard formulas, and 8 human milk samples. Four or five batches of each formula were assayed.
RESULTS AND DISCUSSION Plasma Cr values are given in Table 1. Previous reports of data from normal children were lacking, yet they are needed to allow studies of sick subjects. Our children's values are slightly higher than those of adults, which are usually 0.01-0.3 ~g/L (1). They do not show the trend to decrease with age, which has been described for some tissue concentrations (1,2). However, a recent study did not display any significant change with age in liver chromium levels from birth to age 65 yr (6). CF is characterized by thick mucus, which leads to progressive respiratory failure with acute infections and pancreatic insufficiency (4). Owing to low intraluminal concentrations of digestive enzymes, digestive function is severely impaired. In spite of enzyme replacement, these children often present with protein energy malnutrition and retarded growth. It has been shown that Cr deficiency could worsen growth impairment in malnourished children (3). Biological Trace Element Research
Vol. 32, 1992
55
C h r o m i u m Concentrations in N e w b o r n s
Table 1 Plasma Cr Concentrations of Normal and Cystic Fibrosis Children ~g/L (n)" Normal, 115 children
Age First month Second to third month Fourth to twelfth month Second to third year Fourth to sixth year Seventh to fourteenth year
0.72 0.64 0.88 0.77 0.77 0.65
+ 0.34 _+ 0.41 -+ 0.14 _+ 0.09 -+ 0.07 _+ 0.12
(19) (31) (13) (14) (16)
CF, 35 children 0.67 0.74 0.75 0.98 0.83
0.44 (1) _+ 0.18 _+ 0.06 _+ 0.13 + 0.14 +_ 0.08
(3) (7) (12) (16)
"Mean + SEM.
More, acute illness can increase Cr u r i n a r y losses a n d lead to Cr deficiency, such as d e s c r i b e d for o t h e r trace e l e m e n t s (7). H o w e v e r , our data s u g g e s t that c u r r e n t dietary m a n a g e m e n t of CF patients p r e v e n t s Cr deficiency; on the o t h e r h a n d , Cr deficiency d o e s not s e e m to contribute to g r o w t h i m p a i r m e n t in that disease.
CONCLUSION This s t u d y gives n o r m a l values of Cr plasma levels in children a g e d 0-14 yr. T h e y do not s h o w a n y c h a n g e with time. CF patients receiving 0.5-0.75 ~g Cr/kg/d p r e s e n t with n o r m a l plasma levels.
REFERENCES 1. R. A. Anderson, Trace Elements in Human and Animal Nutrition, vol. 1, W. Mertz, ed. Academic Press, New York, 1987, pp. 225-244. 2. E. G. Offenbacher and F. X. Pisunyer, Aml. Rev. Nutr. 8, 543-563 (1988). 3. G. Saner, Nutrit. 2, 213-220 (1986). 4. A. Silverman and C. C. Roy, Pediatric Clinic Gastroenterology; 3rd edition. Chap. 27. Excessive pancreatic insufficiency. CV Mosby Company, St. Louis, 1983, pp. 814-837. 5. J. F. Duhamel, G. Travert, S. Briere et al., Arch. Fr. Pediatr. 43, 229-233 (1986). 6. B. G. Shah and B. Belonje, Trace Elem. Med. 7, 11-18 (1990). 7. M. Van Caillie-Bertrand, F. de Bieville, H. Neijens et al., Acta Paediatr. Scand. 71, 203-207 (1982).
Biological Trace Element Research
Vol. 32, 1992
Plasma Chromium Concentrations in Normal Infants and Cystic Fibrosis Patients DOMINIQUE BOUGLE,* FRANCOIS BUREAU, JOEL VOIR1N, DOMINIQUE NEUVILLE, MICHEL DROSDOWSKY, AND JEAN-FRANCOIS DUHAMEL
Departement de Pediatrie et Laboratoire de Biochimie A, CHU de Caen, France
ABSTRACT Plasma Cr concentrations have been studied in normal children aged 0-14 yr. Levels ranged from 0.65 to 0.88 I~g/1and did not change with age. Plasma concentrations of CF patients given 0.5-0.75 I~g Cr/kg/d in addition to their diet were similar to normal values. There was no correlation between these plasma values and growth retardation. Index Entries: Chromium; plasma; infants; cystic fibrosis.
INTRODUCTION Chromium (Cr) plays an active role in carbohydrate and lipid metabolism, and in protein synthesis (J,2). In addition, it is linked to nucleic acids. It is present in a number of tissues and organs. High concentrations are found in caudate nucleus in the brain (3). Therefore, it may be a critical trace element for growing children (3). This study intends to give Cr values of normal children and of cystic fibrosis (CF) patients. CF is characterized by thick mucus leading to pulmonary and pancreatic insufficiency (4). These children could be prone to develop Cr deficiency, because of digestive malabsorption and increased urine losses during acute exacerbations of lung disease. *Author to whom all correspondence and reprint requests should be addressed. Biological Trace Element Research
53
VoL 32, 1992
54
Bougle
et
al.
SUBJECTS AND METHODS Cr dosage has been examined in blood collected for a routine examination of healthy children attending our out-patient clinic. The diagnosis of most of the CF patients has been made by a neonatal screening. It permits the early institution of an intensive care program, including lung physiotherapy and a diet high in energy (150 kcal/kg/d) in proteins and medium-chain triglycerides, but poor in long-chain triglycerides. Gastroprotected pancreatic enzyme supplementation is instituted between 6-12 mo of age. In addition, children are given a polyvitamin and mineral supplementation providing 0.5-0.75 p,g Cr/kg/d (5). Blood has been collected using polypropylene tubes. These tubes had been previously checked and found to be free of Cr contamination. They have also been used for sample preparation and storage. After blood was drawn, it was centrifuged and kept frozen until analysis. The determination of Cr concentration was made on 1 + 1 (Triton 100 plus Mg [No3]/2 0.05 mg/L) diluted samples by atomic absorption spectrometry (Perkin Elmer 3030, Le Vaudreuil; France with Zeeman effect). An aliquot was delivered to pyrocoated graphite tubes and L'vov platforms (Perkin Elmer) by an auto sampler. The detection wavelength was 357 nm. Graphite furnace temperature program was: drying 140~ (20 s), ashing 1300~ (15 s), and atomization 2500~ (5 s). The Cr standard used was Cr Titrisol (Merck Lab, France). Routine reference materials were Urine Metals Control (Levels 1 and 2) (BIO. RAD, Munich) and Seronorm trace elements (NYCOMED, Sweden). Cr concentrations were also determined in 3 low-birth weight formulas, 16 standard formulas, and 8 human milk samples. Four or five batches of each formula were assayed.
RESULTS AND DISCUSSION Plasma Cr values are given in Table 1. Previous reports of data from normal children were lacking, yet they are needed to allow studies of sick subjects. Our children's values are slightly higher than those of adults, which are usually 0.01-0.3 ~g/L (1). They do not show the trend to decrease with age, which has been described for some tissue concentrations (1,2). However, a recent study did not display any significant change with age in liver chromium levels from birth to age 65 yr (6). CF is characterized by thick mucus, which leads to progressive respiratory failure with acute infections and pancreatic insufficiency (4). Owing to low intraluminal concentrations of digestive enzymes, digestive function is severely impaired. In spite of enzyme replacement, these children often present with protein energy malnutrition and retarded growth. It has been shown that Cr deficiency could worsen growth impairment in malnourished children (3). Biological Trace Element Research
Vol. 32, 1992
55
C h r o m i u m Concentrations in N e w b o r n s
Table 1 Plasma Cr Concentrations of Normal and Cystic Fibrosis Children ~g/L (n)" Normal, 115 children
Age First month Second to third month Fourth to twelfth month Second to third year Fourth to sixth year Seventh to fourteenth year
0.72 0.64 0.88 0.77 0.77 0.65
+ 0.34 _+ 0.41 -+ 0.14 _+ 0.09 -+ 0.07 _+ 0.12
(19) (31) (13) (14) (16)
CF, 35 children 0.67 0.74 0.75 0.98 0.83
0.44 (1) _+ 0.18 _+ 0.06 _+ 0.13 + 0.14 +_ 0.08
(3) (7) (12) (16)
"Mean + SEM.
More, acute illness can increase Cr u r i n a r y losses a n d lead to Cr deficiency, such as d e s c r i b e d for o t h e r trace e l e m e n t s (7). H o w e v e r , our data s u g g e s t that c u r r e n t dietary m a n a g e m e n t of CF patients p r e v e n t s Cr deficiency; on the o t h e r h a n d , Cr deficiency d o e s not s e e m to contribute to g r o w t h i m p a i r m e n t in that disease.
CONCLUSION This s t u d y gives n o r m a l values of Cr plasma levels in children a g e d 0-14 yr. T h e y do not s h o w a n y c h a n g e with time. CF patients receiving 0.5-0.75 ~g Cr/kg/d p r e s e n t with n o r m a l plasma levels.
REFERENCES 1. R. A. Anderson, Trace Elements in Human and Animal Nutrition, vol. 1, W. Mertz, ed. Academic Press, New York, 1987, pp. 225-244. 2. E. G. Offenbacher and F. X. Pisunyer, Aml. Rev. Nutr. 8, 543-563 (1988). 3. G. Saner, Nutrit. 2, 213-220 (1986). 4. A. Silverman and C. C. Roy, Pediatric Clinic Gastroenterology; 3rd edition. Chap. 27. Excessive pancreatic insufficiency. CV Mosby Company, St. Louis, 1983, pp. 814-837. 5. J. F. Duhamel, G. Travert, S. Briere et al., Arch. Fr. Pediatr. 43, 229-233 (1986). 6. B. G. Shah and B. Belonje, Trace Elem. Med. 7, 11-18 (1990). 7. M. Van Caillie-Bertrand, F. de Bieville, H. Neijens et al., Acta Paediatr. Scand. 71, 203-207 (1982).
Biological Trace Element Research
Vol. 32, 1992
