Background

Measurements of copper and zinc in transfusion-dependent thalassemia (TDT) show contradictory results.

Aim of the study

To examine serum levels of these minerals in TDT in relation to iron overload indices and erythron variables.

Methods

This study recruited 60 children with TDT and 30 healthy controls aged 3–12 years old.

Results

Zinc was significantly higher in TDT children than in controls, while copper and the copper to zinc ratio were significantly lowered in TDT. Serum zinc was significantly associated with the number of blood transfusions and iron overload variables (including serum iron and TS%) and negatively with erythron variables (including hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin). Serum copper was significantly and negatively associated with the same iron overload and erythron variables. The copper to zinc ratio was significantly correlated with iron, TS%, ferritin, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin. Albumin levels were significantly higher in TDT children than in control children.

Conclusion

Our results suggest that the increase in zinc in children with TDT may be explained by iron loading anemia and hemolysis and the consequent shedding of high amounts of intracellular zinc into the plasma. Increased albumin levels and treatment with Desferral may further contribute towards higher zinc levels in TDT. We suggest that the elevations in zinc in TDT are a compensatory mechanism protecting against infection, inflammation, and oxidative stress. Previous proposals for prophylactic use of zinc supplements in TDT may not be warranted.

中文翻译：

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输血依赖性地中海贫血患儿的锌和白蛋白增加，但铜降低

背景

输血依赖性地中海贫血 (TDT) 中铜和锌的测量显示出相互矛盾的结果。

研究目的

检查 TDT 中这些矿物质的血清水平与铁过载指数和红细胞变量的关系。

方法

本研究招募了 60 名 TDT 儿童和 30 名 3-12 岁的健康对照。

结果

TDT 儿童的锌显着高于对照组，而铜和铜锌比在 TDT 中显着降低。血清锌与输血次数和铁过载变量（包括血清铁和 TS%）显着相关，与红细胞变量（包括血红蛋白、平均红细胞体积、平均红细胞血红蛋白）呈负相关。血清铜与相同的铁过载和红细胞变量显着负相关。铜锌比与铁、TS%、铁蛋白、血红蛋白、平均红细胞体积和平均红细胞血红蛋白显着相关。TDT 儿童的白蛋白水平显着高于对照组儿童。

结论

我们的研究结果表明，TDT 儿童中锌的增加可能是由于铁负荷性贫血和溶血以及随之而来的大量细胞内锌释放到血浆中。白蛋白水平升高和去铁治疗可能进一步导致 TDT 中锌水平升高。我们认为 TDT 中锌的升高是一种防止感染、炎症和氧化应激的补偿机制。以前在 TDT 中预防性使用锌补充剂的建议可能没有根据。