Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;56(12):3768-3776.
doi: 10.1002/ppul.25666. Epub 2021 Sep 17.

Zinc status and growth in infants and young children with cystic fibrosis

Sarah E Bauer  1 , HuiChuan J Lai  2   3   4 , Catherine M McDonald  5 , Fadi Asfour  6 , James E Slaven  7 , Clement L Ren  1
Affiliations

Zinc status and growth in infants and young children with cystic fibrosis

Sarah E Bauer et al. Pediatr Pulmonol. 2021 Dec.

Abstract

Background: Zinc deficiency is associated with poor growth in children without cystic fibrosis (CF), but its impact on growth in children with CF is unknown.

Objective: To determine the prevalence of low serum Zn (sZn) and its relationship with growth in the first 3 years of life in children with CF.

Methods: We utilized data from infants with CF who were enrolled in a longitudinal study of nutrition and lung health and had sZn measured as part of clinical care. Cross-sectional correlations between sZn levels and growth z scores were assessed by Pearson's correlation coefficient. To identify factors associated with sZn status and its association to longitudinal growth patterns, multiple regression analysis with repeated measures were performed using generalized estimating equations.

Results: A total of 106 sZn measurements from 53 infants were identified. Seventeen infants (32%) had intermittent Zn insufficiency, defined as at least one sZn <70 mcg/dl in their first 3 years of life. There were no significant cross-sectional associations between sZn and growth z scores. However, analysis of longitudinal growth patterns revealed that weight- and length-for-age z scores in children with intermittent Zn insufficiency were lower during early infancy and their weight-for-length z scores at age 3 years were also lower compared to those who were always Zn sufficient.

Conclusion: Low sZn occurs in one-third of children with CF in the first 3 years of life. Cross-sectional and longitudinal analyses revealed discrepant associations between sZn and growth. Therefore, prospective studies are needed to understand the role of Zn in growth in CF.

Keywords: growth; infant; nutrition; zinc.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest/Disclosures: The authors have no conflict of interest to disclose.

Figures

Figure 1.
Figure 1.
Serum Zn concentration in the first 3 years of life. Data are presented for all 53 subjects in Panel A. Panel B shows the initial measurement of Zn for all 53 subjects. Panels C and D show any additional measurements, with the second measurement in blue triangles and the third measurement in red circles.
Figure 2.
Figure 2.
Cross-sectional correlation between the first serum Zn and growth z-scores by age (<6 & 12–36 months). At each panel, correlation between Serum Zn and Z-score is indicated by Pearson’s correlation coefficient (r) and p value
Figure 3.
Figure 3.
Growth in the first 3 years of life in Zn sufficient (always >70) shown in black crosses and sometimes insufficient (at least 1 measurement <70) shown in black circles. The GEE p values are adjusted for birth weight, age, sex, race, prematurity, F508del status, pancreatic insufficiency, and Zn supplementation.
See this image and copyright information in PMC

References

    1. Sanders DB, et al., Early Life Growth Trajectories in Cystic Fibrosis are Associated with Pulmonary Function at Age 6 Years. J Pediatr, 2015. 167(5): p. 1081–8.e1. - PMC - PubMed
    1. Lai HJ, Shoff SM, and Farrell PM, Recovery of Birth Weight z Score Within 2 Years of Diagnosis Is Positively Associated With Pulmonary Status at 6 Years of Age in Children With Cystic Fibrosis. 2009. 123(2): p. 714–722. - PMC - PubMed
    1. Konstan M, et al., Growth and nutritional indexes in early life predict pulmonary function in cystic fibrosis. The Journal of Pediatrics, 2003. 142(6): p. 624–630. - PubMed
    1. Yen EH, Quinton H, and Borowitz D, Better nutritional status in early childhood is associated with improved clinical outcomes and survival in patients with cystic fibrosis. J Pediatr, 2013. 162(3): p. 530–535.e1. - PubMed
    1. Sanders DB, et al., Early Life Height Attainment in Cystic Fibrosis Is Associated with Pulmonary Function at Age 6 Years. Ann Am Thorac Soc, 2021. - PubMed

Publication types

LinkOut - more resources