Abstract

Hypozincemia is a well-known phenomenon in patients with infection caused by the activation of the acute phase response (APR). Zn status is still based upon plasma Zn levels in venous blood samples. Recent trials have questioned the validity of this measurement in infected patients. The aim of this study was to assess plasma levels of Zn, albumin and Zinc-binding capacity in patients during and following infection. Furthermore, to assess if an assay for albumin-corrected Zn could potentially replace or add knowledge to existing tools for assessment of Zinc-status. A prospective clinical observational trial was conducted. Associations between P-Zn, -Albumin, -Albumin-corrected Zn and Zn binding capacity were analyzed. Analyzes were based upon two venous blood samples drawn during and following infection, respectively. Twenty-three patients admitted to a medical ward showing paraclinical signs of infection were included in the study. Significantly lower levels of Zn and albumin were found during infection compared with the levels post-infection. These findings corresponded to the changes found in Zn binding capacity. About 52% of patients were deemed Zn deficient by plasma Zn levels during infection but after applying the correction for P-Albumin, all patients were found to be within normal ranges of Zn levels. Furthermore, we found no statistically significant difference between albumin-corrected Zn during infection and P-Zn post-infection. The new assay was found to accurately estimate the ‘true’ Zn levels in infected patients. Based on our findings, we propose albumin-corrected P-Zn as a promising new tool, which may result in more precise diagnostics and treatment.

摘要

低锌血症是由急性期反应 (APR) 激活引起的感染患者的一种众所周知的现象。锌状态仍然基于静脉血样本中的血浆锌水平。最近的试验质疑这种测量在感染患者中的有效性。本研究的目的是评估感染期间和感染后患者的血浆锌水平、白蛋白和锌结合能力。此外，评估白蛋白校正锌的测定是否可能替代或增加现有工具的知识，以评估锌状态。进行了一项前瞻性临床观察试验。分析了 P-Zn、-Albumin、-Albumin-corrected Zn 和 Zn 结合能力之间的关联。分析分别基于感染期间和感染后抽取的两个静脉血样本。该研究纳入了 23 名入住内科病房的患者，这些患者表现出感染的临床症状。与感染后的水平相比，感染期间发现的锌和白蛋白水平显着降低。这些发现对应于锌结合能力的变化。大约 52% 的患者在感染期间被血浆 Zn 水平视为缺锌，但在应用 P-白蛋白校正后，发现所有患者的 Zn 水平都在正常范围内。此外，我们发现感染期间白蛋白校正的 Zn 和感染后 P-Zn 之间没有统计学上的显着差异。发现新的检测方法可以准确估计受感染患者的“真实”锌水平。根据我们的发现，我们提出白蛋白校正的 P-Zn 作为一种有前途的新工具，