title: Renal zinc clearance/glomerular filtration rate ratio as an indicator of marginal zinc deficiency associated with iron deficiency in childhood.
abstract: OBJECTIVE
  To evaluate the usefulness of renal zinc clearance/glomerular filtration rate ratio (R(ClZn)/GFR) as an indicator of marginal zinc deficiency that is generally associated with iron deficiency in childhood.
  
  
  METHODS
  Zinc status was evaluated in 36 iron-deficient children (22 boys and 14 girls) who ranged in age from 1 to 10 years using serum zinc concentration and U(Zn/Cr) and R(ClZn)/GFR ratios. The results were compared with the zinc status of 36 similar-aged healthy children (24 boys and 12 girls).
  
  
  RESULTS
  Serum zinc concentrations were 96.72 +/- 2.13 microg/dL and 93.93 +/- 1.95 microg/dL in iron-deficient and healthy subjects, respectively (p > 0.05). U(Zn/Cr) ratios were 0.54 +/- 0.04 microg/mg and 0.88 +/- 0.04 microg/mg (p < 0.0001); R(ClZn)/GFR ratios were 2.27 x 10(-3) +/- 0.20 and 3.32 x 10(-3) +/- 0.20 (p < 0.001) in iron-deficient and healthy subjects, respectively. Individual values of R(ClZn)/GFR and U(Zn/Cr) ratios correlated with hemoglobin (Hb) concentrations (r = 0.34, p < 0.01 and r = 0.26, p < 0.05). Data grouped according to the ranges of Hb concentrations and R(ClZn)/GFR and U(Zn/Cr) ratios fit the following equations: The statistically significant difference in U(Zn/Cr) and R(ClZn)/GFR ratios between groups indicates decreased urinary estimation of marginal zinc deficiency, whereas no change was observed in serum zinc concentrations. According to the regression equation, it can be postulated that the R(ClZn)/GFR ratio is a linear function of Hb concentration and the U(Zn/Cr) ratio.
  
  
  CONCLUSIONS
  R(ClZn)/GFR ratio was a reliable indicator for reduction in urinary zinc excretion; it estimated the marginal zinc deficiency associated with iron deficiency. The R(ClZn)/GFR ratio can be calculated using one sample of blood and urine; thus it could serve as an alternative indicator of marginal zinc deficiency, especially in routine health care.
authors.affiliation: GATA Haydarpasa Teaching Hospital, Department of Pediatrics, Tibbiye Cd 34668 Uskudar Istanbul, Turkey. drcihanm@yahoo.com
authors.forename: Ersin
authors.initials: E
authors.lastname: Tural
authors.forename: Cihan
authors.initials: C
authors.lastname: Meral
authors.forename: Selami
authors.initials: S
authors.lastname: Suleymanoglu
authors.forename: Ferhan
authors.initials: F
authors.lastname: Karademir
authors.forename: Secil
authors.initials: S
authors.lastname: Aydinoz
authors.forename: Halit
authors.initials: H
authors.lastname: Ozkaya
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gültepe
authors.forename: Osman Metin
authors.initials: OM
authors.lastname: Ipcioglu
authors.forename: Ismail
authors.initials: I
authors.lastname: Gocmen
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications*; D015415:Biomarkers / Q000097:blood / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D003677:Deficiency Diseases / Q000175:diagnosis / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000378:metabolism; D008297:Male; D015032:Zinc / Q000097:blood / Q000172:deficiency* / Q000652:urine*
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D003404:Creatinine; D015032:Zinc