Zinc homeostasis and gut function in children with celiac disease123

• Published in: The American journal of clinical nutrition Vol. 94; no. 4; pp. 1026 - 1032
• Main Authors: Tran, Cuong D., Katsikeros, Rosa, Manton, Nick, Krebs, Nancy F, Hambidge, K Michael, Butler, Ross N., Davidson, Geoff P.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2011
• Subjects: CD; SBB; SBT; CYWHS; EZP; FAZ
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.111.018093

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. Design: 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 67Zn dose (2.5 mg) and an intravenous 70Zn 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 13C-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.