Indicators of zinc status at the population level: a review of the evidence
Indicators of zinc status at the population level: a review of the evidence
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DOI：
10.1017/s0007114508006818
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发表时间：
2008-06-01
影响因子：
3.6
通讯作者：
Brown, Kenneth H.
中科院分区：
文献类型：
--
作者：
Gibson, Rosalind S.;Hess, Sonia Y.;Brown, Kenneth H.
缺锌是导致发病率和线性增长受阻的重要原因，因此需要确定人口锌状况的指标。推荐了三个指标--锌摄入量低于估计平均需要量(EAR)的发生率、血清锌浓度低的百分比以及5岁以下发育迟缓儿童的百分比。这篇综述概述了估计摄入不足的流行率的步骤，并根据国际锌营养合作组织设置的耳朵来确认它们的有效性。(A)血清锌浓度对锌摄入量的反应；(B)血清锌浓度对锌干预后功能反应的预测作用；(C)初始血清锌与干预后血清锌变化之间的关系。在锌补充试验和相关性研究中，在考虑了生长、传染病(腹泻、肺炎)和发育结果的反应后，身高或年龄长度被选为最佳功能结果。还讨论了其他锌生物标志物的潜力，如头发、细胞、锌金属酶和锌结合蛋白(如金属硫蛋白)中的锌浓度。利用逆转录聚合酶链式反应来测量金属硫蛋白和Zipi转运蛋白中的mRNA的分子技术，以及可交换锌库(EZP)和血浆锌周转率等动力学指标也是有希望的。需要更多的研究来确定这些新的生物标记物的有效性、特异性、敏感性和可行性，特别是在社区环境中。
The role of zinc deficiency as an important cause of morbidity and impaired linear growth has prompted the need to identify indicators of population zinc status. Three indicators have been recommended - prevalence of zinc intakes below the estimated average requirement (EAR), percentage with low serum zinc concentrations, and percentage of children aged < 5 years who are stunted. This review outlines steps to estimate the prevalence of inadequate intakes, and confirm their validity based on the EARs set by International Zinc Nutrition Collaborative Group. Next, the appropriateness of serum zinc as a biochemical marker for population zinc status is confirmed by a summary of: (a) the response of serum zinc concentrations to zinc intakes; (b) usefulness of serum zinc concentrations to predict functional responses to zinc interventions; (c) relationship between initial serum zinc and change in serum zinc in response to interventions. Height- or length-for-age was chosen as the best functional outcome after considering the responses of growth, infectious diseases (diarrhoea, pneumonia), and developmental outcomes in zinc supplementation trials and correlation studies. The potential of other zinc biomarkers such as zinc concentrations in hair, cells, zinc-metalloenzymes, and zinc-binding proteins, such as metallothionein, is also discussed. Molecular techniques employing reverse transcriptase (RT)-polymerase chain reaction to measure mRNA in metallothionein and ZIPI transporter hold promise, as do kinetic markers such as exchangeable zinc pools (EZP) and plasma zinc turnover rates. More research is needed to establish the validity, specificity, sensitivity, and feasibility of these new biomarkers, especially in community-settings.