Abstract
Tropical enteropathy and zinc deficiency are major public health problems worldwide. Tropical enteropathy is characterized by reduced mannitol absorption with normal or increased lactulose absorption when a dual sugar absorption test is administered, the results of which are reported as the lactulose:mannitol ratio (L:M). Zinc homeostasis is quantified with a dual stable isotope test. This study tested the hypothesis that endogenous fecal zinc (EFZ) was correlated with the L:M. A dual sugar absorption test and dual stable isotope test were performed on 25 asymptomatic Malawian children aged 3–5 y at risk for tropical enteropathy and zinc deficiency. EFZ and net zinc retention were estimated and correlated with the L:M. Twenty-two children (88%) had an abnormal L:M (L:M >0.10), and the L:M was 0.24 ± 0.10 (mean ± SD). EFZ was 1.68 ± 1.06 mg/d, a quantity greater than is seen in healthy populations from the developed world. EFZ was positively correlated with the L:M (r = 0.62, p < 0.001). Net zinc retention (0.67 ± 1.6 mg/d) was negatively correlated with the L:M (r = −0.47, p = 0.02). This suggests that perturbed zinc homeostasis is associated with subclinical enteropathy in these children.
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Abbreviations
- EFZ:
-
endogenous fecal zinc
- FAZ:
-
fractional absorbed zinc
- L:M:
-
lactulose-to-mannitol ratio
- NZR:
-
net zinc retention
- TAZ:
-
total dietary absorbed zinc
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Supported by Cooperative Agreement 58-6250-6001 from the US Department of Agriculture Agricultural Research Service and the International Atomic Energy Agency Contract 14586.
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Manary, M., Abrams, S., Griffin, I. et al. Perturbed Zinc Homeostasis in Rural 3–5-y-Old Malawian Children Is Associated With Abnormalities in Intestinal Permeability Attributed to Tropical Enteropathy. Pediatr Res 67, 671–675 (2010). https://doi.org/10.1203/PDR.0b013e3181da44dc
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DOI: https://doi.org/10.1203/PDR.0b013e3181da44dc
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