title: Zinc homeostasis and gut function in children with celiac disease.
abstract: BACKGROUND
  Celiac disease (CD) is an immunologic enteropathy triggered by the intake of gluten. It is thought that the enteropathy impairs gut function and absorption.
  
  
  OBJECTIVE
  We assessed the zinc-absorption capacity and small-bowel integrity in children with CD.
  
  
  METHODS
  Children in whom a diagnosis of CD was considered clinically and either confirmed (n = 16; Marsh score ≥3) or not (n = 22; Marsh score of 0) with a small-bowel biopsy (SBB) were recruited. The fractional absorption of zinc (FAZ) was determined by the administration of an oral (67)Zn dose (2.5 mg) and an intravenous (70)Zn dose (0.2 mg) 2 h before and during the SBB, respectively. Spot urine samples were collected, and zinc isotopic ratios were determined by ion-coupled plasma mass spectrometry. Gut health was assessed by the ingestion of (13)C-sucrose (20 g) after an overnight fast, and breath samples were collected and analyzed by isotope ratio mass spectrometry.
  
  
  RESULTS
  There was no difference in FAZ between children with a Marsh score ≥3 (mean ± SEM: 0.68 ± 0.05) and children with a Marsh score of 0 (0.74 ± 0.05). The exchangeable zinc pool (EZP) was significantly (P < 0.05) lower in children with a Marsh score ≥3 (2.6 ± 0.8 mg/kg) than in children with a Marsh score of 0 (3.8 ± 1.4 mg/kg). Gut function in children with a Marsh score ≥3 (4.5 ± 0.7% cumulative dose recovered at 90 min) was lower than the lower cutoff of a normal gut-function breath test (5.06% cumulative dose recovered at 90 min) but not significantly different from that in children with a Marsh score of 0 (4.9 ± 0.4%). There was a significant (P < 0.01) correlation between zinc absorption and gut function in children with CD.
  
  
  CONCLUSIONS
  Zinc absorption did not appear below usual amounts in subjects with CD. Children with CD have impaired gut function that may affect their zinc nutritional status as shown by a smaller EZP. However, the EZP decrease in children with CD was not compared with that in healthy control subjects, and its biological meaning is uncertain.
authors.affiliation: Gastroenterology Unit, Children, Youth and Women's Health Service, Adelaide, Australia. cuong.tran@health.sa.gov.au
authors.forename: Cuong D
authors.initials: CD
authors.lastname: Tran
authors.forename: Rosa
authors.initials: R
authors.lastname: Katsikeros
authors.forename: Nick
authors.initials: N
authors.lastname: Manton
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Krebs
authors.forename: K Michael
authors.initials: KM
authors.lastname: Hambidge
authors.forename: Ross N
authors.initials: RN
authors.lastname: Butler
authors.forename: Geoff P
authors.initials: GP
authors.lastname: Davidson
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001706:Biopsy; D001944:Breath Tests; D002247:Carbon Isotopes; D002446:Celiac Disease / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003677:Deficiency Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006706:Homeostasis; D006801:Humans; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D012720:Severity of Illness Index; D013021:South Australia / Q000453:epidemiology; D013395:Sucrose / Q000378:metabolism; D015032:Zinc / Q000172:deficiency / Q000378:metabolism* / Q000652:urine; D015033:Zinc Isotopes
chemical_list: D002247:Carbon Isotopes; D015033:Zinc Isotopes; D013395:Sucrose; D015032:Zinc