Zinc Supplementation Increases Procollagen Type 1 Amino-Terminal Propeptide in Premenarcheal Girls: A Randomized Controlled Trial.
BACKGROUND
Data have shown that healthy children and adolescents have an inadequate intake of zinc, an essential nutrient for growth. It is unclear whether zinc supplementation can enhance bone health during this rapid period of growth and development.


OBJECTIVE
The primary aim of this study was to determine the effect of zinc supplementation on biochemical markers of bone turnover and growth in girls entering the early stages of puberty. The secondary aim was to test moderation by race, body mass index (BMI) classification, and plasma zinc status at baseline.


METHODS
One hundred forty seven girls aged 9-11 y (46% black) were randomly assigned to a daily oral zinc tablet (9 mg elemental zinc; n = 75) or an identical placebo (n = 72) for 4 wk. Fasting plasma zinc, procollagen type 1 amino-terminal propeptide (P1NP; a bone formation marker), carboxy-terminal telopeptide region of type 1 collagen (ICTP; a bone resorption marker), and insulin-like growth factor I (IGF-I) were assessed at baseline and post-test. Additional markers of bone formation (osteocalcin) and resorption (urinary pyridinoline and deoxypyridinoline) were also measured.


RESULTS
Four weeks of zinc supplementation increased plasma zinc concentrations compared with placebo [mean change, 1.8 μmol/L (95% CI: 1.0, 2.6) compared with 0.2 μmol/L (95% CI: -0.3, 0.7); P < 0.01]. Zinc supplementation also increased serum P1NP concentrations compared with placebo [mean change, 23.8 μmol/L (95% CI: -14.9, 62.5) compared with -31.0 μmol/L (95% CI: -66.4, 4.2); P = 0.04). There was no effect from zinc supplementation on osteocalcin, ICTP, pyridinoline, deoxypyridinoline, or IGF-I. There was no moderation by race, BMI classification, or plasma zinc status at baseline.


CONCLUSIONS
Our data suggest that 4 wk of zinc supplementation increases bone formation in premenarcheal girls. Further studies are needed to determine whether supplemental zinc can improve childhood bone strength. This trial was registered at clinicaltrials.gov as NCT01892098.
Department of Foods and Nutrition, The University of Georgia, Athens, GA; Departments of.
Paige K
PK
Berger
Pediatrics and.
Norman K
NK
Pollock
Department of Foods and Nutrition, The University of Georgia, Athens, GA; Departments of.
Emma M
EM
Laing
Department of Foods and Nutrition, The University of Georgia, Athens, GA; Departments of.
Valerie
V
Chertin
Pediatric Endocrine Specialists of Georgia, Duluth, GA; and.
Paul J
PJ
Bernard
Department of Foods and Nutrition, The University of Georgia, Athens, GA; Departments of.
Arthur
A
Grider
Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
Sue A
SA
Shapses
Neuroscience and Regenerative Medicine, Georgia Regents University, Augusta, GA;
Ke-Hong
KH
Ding
Neuroscience and Regenerative Medicine, Georgia Regents University, Augusta, GA;
Carlos M
CM
Isales
Department of Foods and Nutrition, The University of Georgia, Athens, GA; Departments of rlewis@fcs.uga.edu.
Richard D
RD
Lewis
D000596:Amino Acids / Q000652:urine; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D001846:Bone Development / Q000187:drug effects* / Q000502:physiology; D016723:Bone Remodeling / Q000187:drug effects / Q000502:physiology; D002648:Child; D024042:Collagen Type I / Q000097:blood; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood; D010919:Placebos; D011347:Procollagen / Q000097:blood*; D011627:Puberty / Q000502:physiology*; D015032:Zinc / Q000008:administration & dosage* / Q000097:blood
D000596:Amino Acids; D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D010919:Placebos; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D015675:Osteocalcin; C015484:pyridinoline; D007334:Insulin-Like Growth Factor I; C036020:deoxypyridinoline; D015032:Zinc
bone; bone turnover; children; growth; zinc