title: Perturbed zinc homeostasis in rural 3-5-y-old Malawian children is associated with abnormalities in intestinal permeability attributed to tropical enteropathy.
abstract: Tropical enteropathy and zinc deficiency are major public health problems worldwide. Tropical enteropathy is characterized by reduced mannitol absorption with normal or increased lactulose absorption when a dual sugar absorption test is administered, the results of which are reported as the lactulose:mannitol ratio (L:M). Zinc homeostasis is quantified with a dual stable isotope test. This study tested the hypothesis that endogenous fecal zinc (EFZ) was correlated with the L:M. A dual sugar absorption test and dual stable isotope test were performed on 25 asymptomatic Malawian children aged 3-5 y at risk for tropical enteropathy and zinc deficiency. EFZ and net zinc retention were estimated and correlated with the L:M. Twenty-two children (88%) had an abnormal L:M (L:M>0.10), and the L:M was 0.24+/-0.10 (mean+/-SD). EFZ was 1.68+/-1.06 mg/d, a quantity greater than is seen in healthy populations from the developed world. EFZ was positively correlated with the L:M (r=0.62, p<0.001). Net zinc retention (0.67+/-1.6 mg/d) was negatively correlated with the L:M (r=-0.47, p=0.02). This suggests that perturbed zinc homeostasis is associated with subclinical enteropathy in these children.
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, and St. Louis Children's Hospital, St. Louis, MO 63110, USA.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Manary
authors.forename: Steven A
authors.initials: SA
authors.lastname: Abrams
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Griffin
authors.forename: Megan M
authors.initials: MM
authors.lastname: Quimper
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
authors.forename: Maria G
authors.initials: MG
authors.lastname: Hamzo
authors.forename: Zhensheng
authors.initials: Z
authors.lastname: Chen
authors.forename: Kenneth
authors.initials: K
authors.lastname: Maleta
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Manary
mesh_terms: D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D003906:Developing Countries; D005243:Feces / Q000737:chemistry; D005260:Female; D006706:Homeostasis; D006801:Humans; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism*; D007792:Lactulose; D008286:Malabsorption Syndromes / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D008295:Malawi; D008297:Male; D008353:Mannitol; D010539:Permeability; D012424:Rural Population; D015032:Zinc / Q000097:blood / Q000172:deficiency*
chemical_list: D015415:Biomarkers; D008353:Mannitol; D007792:Lactulose; D015032:Zinc