Assessments of nutritional status and immunological responses in head trauma: alterations in zinc and C-reactive protein.
A prospective longitudinal evaluation of zinc and C-reactive protein (CRP) in serum and 24-hour urine was carried out in 24 head-trauma patients. The patients were divided into two groups: group I (14 patients) with Glasgow Coma Scale scores between 4 and 8, and group II (10 patients) with Glasgow Coma Scale scores between 9 and 13. To understand the influence of severity of injury on the two acute-phase reactants, all patients were studied for a period of up to 20 days after hospital admission. The average serum zinc concentration in all patients decreased from day 1 to day 5, but gradually increased thereafter. The hypozincemia was more severe in group I than in group II. All patients lost zinc throughout the study period and urinary zinc excretion was greater in group I than in group II patients. In group I, the mean peak urinary zinc loss exceeded 5000 micrograms/day (normal value less than 800 micrograms/day). Serum C-reactive protein levels were markedly elevated on admission especially in group I, then gradually declined but were still above the normal range on day 20. Acute zinc deficiency with concomitant elevation of CRP supports the hypothesis that acute hypozincemia observed in our patients may be stress-induced and zinc activity may be part of altered nutritional and metabolic responses to severe head injury.
Lin
C N
CN
Department of Surgery, Kaoshiung Medical College, Taiwan, Republic of China.
Howng
S L
SL
Hu
S H
SH
Huang
T J
TJ
D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis*; D006259:Craniocerebral Trauma / Q000276:immunology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D015032:Zinc / Q000097:blood*
D002097:C-Reactive Protein; D015032:Zinc