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Low serum zinc concentrations predict mortality in patients referred to coronary angiography

  • Stefan Pilz (a1) (a2), Harald Dobnig (a2), Brigitte M. Winklhofer-Roob (a3), Wilfried Renner (a4), Ursula Seelhorst (a5), Britta Wellnitz (a5), Bernhard O. Boehm (a6) and Winfried März (a4) (a7)...

Abstract

Zinc deficiency is common among the elderly and has been associated with oxidative stress, immune dysfunction and CVD. We examined whether low zinc concentrations are associated with total, cardiovascular and non-cardiovascular mortality. Serum zinc concentrations were measured in 3316 patients from the Ludwigshafen Risk and Cardiovascular Health study, who were routinely referred to coronary angiography at a single tertiary care centre in Southwest Germany. After a median follow-up period of 7·75 years, 769 patients had died, including 484 deaths due to cardiovascular and 261 due to non-cardiovascular causes. After adjustments for cardiovascular risk factors and other possible confounders, the hazard ratios in the first when compared with the fourth zinc quartile, and per quartile decrease were 1·44 (95 % CI 1·13, 1·83; P = 0·001) and 1·15 (95 % CI 1·07, 1·24; P < 0·001) for total mortality, 2·20 (95 % CI 1·42, 3·42; P < 0·001) and 1·32 (95 % CI 1·16, 1·50; P < 0·001) for non-cardiovascular mortality and 1·24 (95 % CI 0·92, 1·66; P = 0·162) and 1·10 (95 % CI 1·01, 1·21; P = 0·038) for cardiovascular mortality. Furthermore, serum zinc concentrations correlated negatively with age and markers of inflammation and positively with antioxidants. The present results suggest that zinc deficiency may contribute to a reduced life expectancy in patients scheduled for coronary angiography.

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Corresponding author

*Corresponding author: Stefan Pilz, fax +43 316 673216, email stefan.pilz@chello.at

References

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1 Walsh, CT, Sandstead, HH, Prasad, AS, et al. (1994) Zinc: health effects and research priorities for the 1990s. Environ Health Perspect 102, 546.
2 Mocchegiani, E, Malavolta, M, Marcellini, F, et al. (2006) Zinc, oxidative stress, genetic background and immunosenescence: implications for healthy aging. Immun Ageing 3, 6.
3 Prasad, AS (2007) Zinc: mechanisms of host defense. J Nutr 137, 13451349.
4 Hennig, B, Meerarani, P, Ramadass, P, et al. (1999) Zinc nutrition and apoptosis of vascular endothelial cells: implications in atherosclerosis. Nutrition 15, 744748.
5 Beattie, JH & Kwun, IS (2004) Is zinc deficiency a risk factor for atherosclerosis? Br J Nutr 91, 177181.
6 Hyun, TH, Barrett-Connor, E & Milne, DB (2004) Zinc intake and plasma concentrations in men with osteoporosis: the Rancho Bernardo study. Am J Clin Nutr 80, 715721.
7 Zhou, W, Park, S, Liu, G, et al. (2005) Dietary iron, zinc, and calcium and the risk of lung cancer. Epidemiology 16, 772779.
8 Kok, FJ, Van Duijn, CM, Hofman, A, et al. (1988) Serum copper and zinc and the risk of death from cancer and cardiovascular disease. Am J Epidemiol 128, 352359.
9 Reunanen, A, Knekt, P, Marniemi, J, et al. (1996) Serum calcium, magnesium, copper and zinc and risk of cardiovascular death. Eur J Clin Nutr 50, 431437.
10 Marniemi, J, Järvisalo, J, Toikka, T, et al. (1998) Blood vitamins, mineral elements and inflammation markers as risk factors of vascular and non-vascular disease mortality in an elderly population. Int J Epidemiol 27, 799807.
11 Wu, T, Sempos, CT, Freudenheim, JL, et al. (2004) Serum iron, copper and zinc concentrations and risk of cancer mortality in US adults. Ann Epidemiol 14, 195201.
12 Leone, N, Courbon, D, Ducimetiere, P, et al. (2006) Zinc, copper, and magnesium and risks for all-cause, cancer, and cardiovascular mortality. Epidemiology 17, 308314.
13 Soinio, M, Marniemi, J, Laakso, M, et al. (2007) Serum zinc level and coronary heart disease events in patients with type 2 diabetes. Diabetes Care 30, 523528.
14 Clemons, TE, Kurinij, N, Sperduto, RD, et al. (2004) Associations of mortality with ocular disorders and an intervention of high-dose antioxidants and zinc in the Age-Related Eye Disease study: AREDS report No. 13. Arch Opthalmol 122, 716726.
15 Winkelmann, BR, März, W, Boehm, BO, et al. (2001) Rationale and design of the LURIC study: a resource for functional genomics, pharmacogenomics and long-term prognosis of cardiovascular disease. Pharmacogenomics 2, 173.
16 Austen, WG, Edwards, JE, Frye, RL, et al. (1975) A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 51, 450.
17 Levey, AS, Coresh, J, Balk, E, et al. (2003) National kidney foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139, 137147.
18 Makino, T, Saito, M, Horiguchi, D, et al. (1982) A highly sensitive colorimetric determination of serum zinc using water-soluble pyridylazo dye. Clin Chim Acta 120, 127135.
19 Johnsen, O & Eliasson, R (1987) Evaluation of a commercially available kit for the colorimetric determination of zinc in human seminal plasma. Int J Androl 10, 435440.
20 März, W, Tiran, B, Seelhorst, U, et al. (2007) N-Terminal pro-B-type natriuretic peptide predicts total and cardiovascular mortality in individuals with or without stable coronary artery disease: the Ludwigshafen Risk and Cardiovascular Health study. Clin Chem 53, 10751083.
21 Aebischer, CP, Schierle, J & Schüep, W (1999) Simultaneous determination of retinol, tocopherols, carotene, lycopene, and xanthophylls in plasma by means of reversed-phase high-performance liquid chromatography. Methods Enzymol 299, 348362.
22 Yokoi, K, Egger, NG, Ramanujam, VM, et al. (2003) Association between plasma zinc concentrations and zinc kinetic parameters in premenopausal women. Am J Physiol Endocrinol Metab 285, 10101020.
23 Lee, DH, Folsom, AR & Jacobs, DR Jr (2005) Iron, zinc, and alcohol consumption and mortality from cardiovascular diseases: the Iowa Women's Health study. Am J Clin Nutr 81, 787791.
24 Sandstead, HH, Henriksen, LK, Greger, JL, et al. (1982) Zinc nutriture in the elderly in relation to taste acuity, immune response, and wound healing. Am J Clin Nutr 36, 10461059.
25 King, JC (1990) Assessment of zinc status. J Nutr 120, 14741479.
26 Bogden, JD, Oleske, JM, Munves, EM, et al. (1987) Zinc and immunocompetence in the elderly: baseline data on zinc nutriture and immunity in unsupplemented subjects. Am J Clin Nutr 46, 101109.
27 Prasad, AS, Beck, FW, Bao, B, et al. (2007) Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress. Am J Clin Nutr 85, 837844.
28 Minqin, R, Watt, F, Huat, BT, et al. (2003) Correlation of iron and zinc levels with lesion depth in newly formed atherosclerotic lesions. Free Radic Biol Med 34, 746752.
29 Hennig, B, Meerarani, P, Toborek, M, et al. (1999) Antioxidant-like properties of zinc in activated endothelial cells. J Am Coll Nutr 18, 152158.
30 Alissa, EM, Bahjri, SM, Ahmed, WH, et al. (2006) Trace element status in Saudi patients with established atherosclerosis. J Trace Elem Med Biol 20, 105114.
31 Martin-Moreno, JM, Gorgojo, L, Riemersma, RA, et al. (2003) Myocardial infarction risk in relation to zinc concentrations in toenails. Br J Nutr 89, 673678.
32 Katzi, TG, Afridi, HI, Kazi, N, et al. (2008) Distribution of zinc, copper and iron in biological samples of Pakistani myocardial infarction (1st, 2nd and 3rd heart attack) patients and controls. Clin Chim Acta 389, 114119.
33 Singh, RB, Niaz, MA, Rastogi, SS, et al. (1998) Current zinc intake and risk of diabetes and coronary artery disease and factors associated with insulin resistance in rural and urban populations of North India. J Am Coll Nutr 17, 564570.
34 Ren, M, Rajendran, R, Ning, P, et al. (2006) Zinc supplementation decreases the development of atherosclerosis in rabbits. Free Radic Biol Med 41, 222225.
35 Jenner, A, Ren, M, Rajendran, R, et al. (2007) Zinc supplementation inhibits lipid peroxidation and the development of atherosclerosis in rabbits fed a high cholesterol diet. Free Radic Biol Med 42, 559566.
36 Maret, W & Sandstead, HH (2006) Zinc requirements and the risks and benefits of zinc supplementation. J Trace Elem Med Biol 20, 318.
37 Tielsch, JM, Kathry, SK, Stoltzfus, RJ, et al. (2007) Effect of daily supplementation on child mortality in southern Nepal: a community-based, cluster randomised, placebo-controlled trial. Lancet 370, 12301239.
38 Hambidge, KM (2006) Zinc and pneumonia. Am J Clin Nutr 83, 991992.
39 Krebs, NF & Hambidge, KM (2007) Complementary feeding: clinically relevant factors affecting timing and composition. Am J Clin Nutr 85, 639645.
40 Sandstead, HH (1999) Improving study design. Am J Clin Nutr 70, 110.
41 Solomons, NW, Ruz, M & Gibson, RS (1999) Single-nutrient interventions with zinc. Am J Clin Nutr 70, 111112.
42 Thompson, RP (1991) Assessment of zinc status. Proc Nutr Soc 50, 1928.
43 Wood, RJ (2000) Assessment of marginal zinc status in humans. J Nutr 130, 13501354.
44 Feillet-Coudrey, C, Meunier, N, Rambeau, M, et al. (2005) Long-term moderate zinc supplementation increases exchangeable zinc pool masses in late-middle-aged men: the Zenith study. Am J Clin Nutr 82, 103110.
45 Lowe, NM, Woodhouse, LR, Sutherland, B, et al. (2004) Kinetic parameters and plasma zinc concentrations correlate well with net loss and gain of zinc from men. J Nutr 134, 21782181.
46 Hess, SY, Peerson, JM, King, JC, et al. (2007) Use of serum zinc concentration as an indicator of population zinc status. Food Nutr Bull 28, Suppl. 3, S403S429.
47 Alberda, C, Graf, A & McCargar, L (2006) Malnutrition: etiology, consequences, and assessment of a patient at risk. Best Pract Res Clin Gastroenterol 226, 419439.

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