Acta PEdiatr 81: 700-1. 1992
SHORT COMMUNICATION
Zinc, copper and iron in serum and hair of newborns and their correlation with clinical data N Pop-Jordanova and M Bogdanova’ Pediatric Clinic and Biochemical Institute‘, Medical Faculty. University of Skopje, Skopje, Yugoslavia
Zinc deficiency has been related to behavioral and dermatological changes, poor appetite and growth retardation (1 -5). Copper deficiency provokes neurw logical disturbances, hair changes, anemia with neutropenia and ricket-like osteopathy (6-9). Iron-deficiency results in anemia and psychomotor disabilities in newborns (1 0). In our previous research we found low zinc concentrations in hair and blood of children with celiac disease, nephrotic syndrome and malnutrition. On the other hand, babies manifesting Leiner’s disease had very high zinc levels in hair and in crustae lacteae in addition to low zinc levels in blood (1 I - 14). In the present study we investigated newborn children with regard to the level of trace metals (zinc, copper and iron) in blood and hair, and correlated the results with clinical data (mother’s age, parity, gestational age, birth weight, Apgar score and acid-base parameters). Samples of umbilical blood were taken from 79 newborns just after delivery with a plastic syringe fitted with a stainless steel needle and placed in a trace metalfree glass tube with a clean rubber cork. The blood was allowed to clot and then centrifuged and the serum frozen. The samples of hair were collected from the suboccipital area of the head. The trace metals in blood and hair were estimated by atomic absorption spectrophotometry (Opton FMD 3). The pH and base excess were evaluated by Radiometer Copenhagen ABL 3. The statistical method used was Pearson’s linear regression procedure. The mean age of the mothers was 24.9 k4.7 years; the youngest was 15 years of age and the oldest was 37 years. The birth rank (parity) was as follows: 40 were primiparas, 23 were having a second delivery and 16 a third. The mean birth weight was 3284 584 g, while the mean gestational age (GA) was 276.5k9.0 days. Almost all
newborns were full term. The levels of trace elements in serum and hair are presented in Table 1. The results obtained for zinc and copper were similar to the results of Sann et al. (7,8) and slightly higher than the results for copper presented by Hillman (6). The iron levels obtained were above the limit of the normal values for this age. Linear regression was performed to show the correlation between serum trace metal levels and the clinical variables outlined above. The results proved to be statistically significant and are presented in Table 2. The mother’s age appeared not to be correlated with the level of evaluated trace metals in newborns. The results showed a strong negative correlation between serum zinc levels and GA and agreed with the results obtained by Sann (7,8). The serum copper level was not correlated with GA of the newborns. Serum iron concentrations also showed a negative correlation with GA . Birth weight showed a negative correlation with serum iron level, which corresponds to the previous results concerning GA. Serum zinc and copper appeared not to be correlated with birth weight. Our study also showed a negative correlation between Apgar score and iron serum level, while the correlation between this variable and serum zinc and copper was not significant. The pregnancy rate (parity) showed a negative correlation with levels of zinc. The other two metals were not related to pregnancy rate, although we expected lower levels of oligoelements in infants of multiparous women because we supposed reserves to be exhausted by each succeeding pregnancy. The parameters of acid-base balance were independent of oligoelement levels. Finally, we did not find any correlation between the
Table I . Serum and hair levels of zinc (Zn), copper (Cu) and iron (Fe) in newborns.
Hair (pmol/g)
Serum bmol/l)
Zn
cu Fe
Mean
SD
Min.
Max.
Mean
SD
Min.
Max.
9.6 12.1 30.7
1.9 3.7 15.2
5.8 6.3 9.8
16.9 38.1 87.0
47.8 8.2 10.9
26.2 4.9 3.7
14.2 1.7 4.6
136.4 35.4 22.4
Correlation of levels of trace metals and clinical data in newborns
ACTA PKDIATR 81 (1992)
Table 2. Pearson’s coefficient of correlation (r) between the newborn variables and the serum trace metals.
Variable Gestational age/Zn Gestational age/Fe Birth weight/Fe Apgar score/Fe Parity/Zn
r
p value
-0.34 -0.23 -0.24 -0.25 -0.25
0.002 0.038 0.030 0.026 0.029
levels of the metals themselves. This means that zinc, copper and iron metabolisms are mutually independent. The results obtained could be useful for the future follow up of the growth and development of infants, as well as in the prescription of optimal nutrition schemes for pregnant women and newborns.
References I . Bandon J. Acrodermatitis enteropathica. Arch Fr Pediatr 1978;35:63 2. Elmes M. Zinc in human medicine. Lancet 1975;2:351 3. Halsted JA, Smith JC. Plasma zinc in health and disease. Lancet 1970;I :322 4. Hambidge KM, Hambidge C, Jacobs M, Baum JD. Low levels of zinc in hair, anorexia, poor growth and hypogeusia in children. Pediatr Res 1972;6:8
70 1
5 . Solmons N, Rosenfield R, Jacob R, Sanstead H. Growth
retardation and zinc nutrition. Pediatr Res 1976; 10:923 6. Hillman L. Serial serum copper concentrations in premature and SGAinfantsduring the first 3 monthsoflife. JPediatr 1981;98:305 7. Sann L, David L, Galy G, Rowand-Monier M. Copper deficiency and hypocalcemic rickets in small for date infants. Acta Paediatr Scand 1978;67:303 8. Sann L, Riga1 D, Galy G, Bienvenu F, Bourgeois J. Serum copper and zinc concentration in premature and small for date infants. Pediatr Res 1980;14:1040 9. Sass-Kortsak A, Bearn A. Hereditary disorders of copper metabolism. In: Stanbury J, Wangaarden J, Frederickson D, eds 4th Edn. The Metabolic Basis of Inherited Disease. New York: McGraw-Hill 1980:1098-1127 10. Dommergues JP. Neonatal iron deficiency-risk factors and correlation with psychomotor development. Clin Invest 1987;10:32 11. Pop-Jordanova N, Bogdanova M. Hair zinc in various clinical disorders. Jugosl Pediatr 1988;4 169 12. Pop-Jordanova N, Fustic S, Peova S. Leiner’s disease-infection or immunological disturbance. Proceedings of the XI11 Pediatric Congress, Paris, 1989:378 13. Pop-Jordanova (Kozinkova) N, Bogdanova M. Zinc level in different diseases in childhood. God Zb Med Fak Skopje 1981;27:135 14. Tasic V, Pop-Jordanova N, Delidzakova M. On acrodermatitis enteropathica in infant age. God Zb Med Fak Skopje 1981;27:I 19
-
Received April 20, 1990. Accepted Dec. 20, 1991 Prof. Nada Pop-Jordanova. Pediafric Clinic, Medical Faculty. Universify of Skopje, 9IOOO Skopje, Yugoslavia
SHORT COMMUNICATION
Zinc, copper and iron in serum and hair of newborns and their correlation with clinical data N Pop-Jordanova and M Bogdanova’ Pediatric Clinic and Biochemical Institute‘, Medical Faculty. University of Skopje, Skopje, Yugoslavia
Zinc deficiency has been related to behavioral and dermatological changes, poor appetite and growth retardation (1 -5). Copper deficiency provokes neurw logical disturbances, hair changes, anemia with neutropenia and ricket-like osteopathy (6-9). Iron-deficiency results in anemia and psychomotor disabilities in newborns (1 0). In our previous research we found low zinc concentrations in hair and blood of children with celiac disease, nephrotic syndrome and malnutrition. On the other hand, babies manifesting Leiner’s disease had very high zinc levels in hair and in crustae lacteae in addition to low zinc levels in blood (1 I - 14). In the present study we investigated newborn children with regard to the level of trace metals (zinc, copper and iron) in blood and hair, and correlated the results with clinical data (mother’s age, parity, gestational age, birth weight, Apgar score and acid-base parameters). Samples of umbilical blood were taken from 79 newborns just after delivery with a plastic syringe fitted with a stainless steel needle and placed in a trace metalfree glass tube with a clean rubber cork. The blood was allowed to clot and then centrifuged and the serum frozen. The samples of hair were collected from the suboccipital area of the head. The trace metals in blood and hair were estimated by atomic absorption spectrophotometry (Opton FMD 3). The pH and base excess were evaluated by Radiometer Copenhagen ABL 3. The statistical method used was Pearson’s linear regression procedure. The mean age of the mothers was 24.9 k4.7 years; the youngest was 15 years of age and the oldest was 37 years. The birth rank (parity) was as follows: 40 were primiparas, 23 were having a second delivery and 16 a third. The mean birth weight was 3284 584 g, while the mean gestational age (GA) was 276.5k9.0 days. Almost all
newborns were full term. The levels of trace elements in serum and hair are presented in Table 1. The results obtained for zinc and copper were similar to the results of Sann et al. (7,8) and slightly higher than the results for copper presented by Hillman (6). The iron levels obtained were above the limit of the normal values for this age. Linear regression was performed to show the correlation between serum trace metal levels and the clinical variables outlined above. The results proved to be statistically significant and are presented in Table 2. The mother’s age appeared not to be correlated with the level of evaluated trace metals in newborns. The results showed a strong negative correlation between serum zinc levels and GA and agreed with the results obtained by Sann (7,8). The serum copper level was not correlated with GA of the newborns. Serum iron concentrations also showed a negative correlation with GA . Birth weight showed a negative correlation with serum iron level, which corresponds to the previous results concerning GA. Serum zinc and copper appeared not to be correlated with birth weight. Our study also showed a negative correlation between Apgar score and iron serum level, while the correlation between this variable and serum zinc and copper was not significant. The pregnancy rate (parity) showed a negative correlation with levels of zinc. The other two metals were not related to pregnancy rate, although we expected lower levels of oligoelements in infants of multiparous women because we supposed reserves to be exhausted by each succeeding pregnancy. The parameters of acid-base balance were independent of oligoelement levels. Finally, we did not find any correlation between the
Table I . Serum and hair levels of zinc (Zn), copper (Cu) and iron (Fe) in newborns.
Hair (pmol/g)
Serum bmol/l)
Zn
cu Fe
Mean
SD
Min.
Max.
Mean
SD
Min.
Max.
9.6 12.1 30.7
1.9 3.7 15.2
5.8 6.3 9.8
16.9 38.1 87.0
47.8 8.2 10.9
26.2 4.9 3.7
14.2 1.7 4.6
136.4 35.4 22.4
Correlation of levels of trace metals and clinical data in newborns
ACTA PKDIATR 81 (1992)
Table 2. Pearson’s coefficient of correlation (r) between the newborn variables and the serum trace metals.
Variable Gestational age/Zn Gestational age/Fe Birth weight/Fe Apgar score/Fe Parity/Zn
r
p value
-0.34 -0.23 -0.24 -0.25 -0.25
0.002 0.038 0.030 0.026 0.029
levels of the metals themselves. This means that zinc, copper and iron metabolisms are mutually independent. The results obtained could be useful for the future follow up of the growth and development of infants, as well as in the prescription of optimal nutrition schemes for pregnant women and newborns.
References I . Bandon J. Acrodermatitis enteropathica. Arch Fr Pediatr 1978;35:63 2. Elmes M. Zinc in human medicine. Lancet 1975;2:351 3. Halsted JA, Smith JC. Plasma zinc in health and disease. Lancet 1970;I :322 4. Hambidge KM, Hambidge C, Jacobs M, Baum JD. Low levels of zinc in hair, anorexia, poor growth and hypogeusia in children. Pediatr Res 1972;6:8
70 1
5 . Solmons N, Rosenfield R, Jacob R, Sanstead H. Growth
retardation and zinc nutrition. Pediatr Res 1976; 10:923 6. Hillman L. Serial serum copper concentrations in premature and SGAinfantsduring the first 3 monthsoflife. JPediatr 1981;98:305 7. Sann L, David L, Galy G, Rowand-Monier M. Copper deficiency and hypocalcemic rickets in small for date infants. Acta Paediatr Scand 1978;67:303 8. Sann L, Riga1 D, Galy G, Bienvenu F, Bourgeois J. Serum copper and zinc concentration in premature and small for date infants. Pediatr Res 1980;14:1040 9. Sass-Kortsak A, Bearn A. Hereditary disorders of copper metabolism. In: Stanbury J, Wangaarden J, Frederickson D, eds 4th Edn. The Metabolic Basis of Inherited Disease. New York: McGraw-Hill 1980:1098-1127 10. Dommergues JP. Neonatal iron deficiency-risk factors and correlation with psychomotor development. Clin Invest 1987;10:32 11. Pop-Jordanova N, Bogdanova M. Hair zinc in various clinical disorders. Jugosl Pediatr 1988;4 169 12. Pop-Jordanova N, Fustic S, Peova S. Leiner’s disease-infection or immunological disturbance. Proceedings of the XI11 Pediatric Congress, Paris, 1989:378 13. Pop-Jordanova (Kozinkova) N, Bogdanova M. Zinc level in different diseases in childhood. God Zb Med Fak Skopje 1981;27:135 14. Tasic V, Pop-Jordanova N, Delidzakova M. On acrodermatitis enteropathica in infant age. God Zb Med Fak Skopje 1981;27:I 19
-
Received April 20, 1990. Accepted Dec. 20, 1991 Prof. Nada Pop-Jordanova. Pediafric Clinic, Medical Faculty. Universify of Skopje, 9IOOO Skopje, Yugoslavia
