Volume 10, Issue 2 (Vol.10 No.2 Jul 2021)                   rbmb.net 2021, 10(2): 173-182 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Zolfaghari B, Ghanbari M, Musavi H, Bavandpour Baghshahi P, Taghikhani M, Pourfallah F. Investigation of Zinc Supplement Impact on the Serum Biochemical Parameters in Pulmonary Tuberculosis: A Double Blinded Placebo Control Trial. rbmb.net. 2021; 10 (2) :173-182
URL: http://rbmb.net/article-1-544-en.html
Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Abstract:   (1018 Views)
Background: Zinc (Zn) is nutritionally essential trace element, and thus deficiency may severely affect human health. The results of cross-sectional studies indicate that micronutrient deficiencies are common in patients with tuberculosis. Our goal is to investigate whether Zn supplementation can increase the effects of anti-TB treatment or not.

Methods: Patients with newly diagnosed tuberculosis were divided in to 2 groups. One group (n= 37) received capsule contains 50 mg of elemental zinc (as zinc sulfate) for 6 months every other day (micronutrient group) and Group II (n= 37) received placebo. Both groups received the same anti-tuberculosis treatment recommended by the WHO. Clinical examination, BMI, chest X-ray, direct sputum examination, assessment of serum zinc levels (by atomic absorption spectrophotometry), and biochemical markers serum concentration (by using an RA1000 AutoAnalyzer) were carried out before and after 2- and 6-months anti-tuberculosis treatment.

Results: Plasma zinc concentrations in the micronutrient group was higher than placebo group After treatment. In the placebo group increasing in SGOT and SGPT concentrations were significantly higher than micronutrient group after 2 months of treatment (p< 0.05). The significant changes (p< 0.05) were observed on the serum levels of total protein, albumin. Alkaline phosphatase (ALP) levels, serum creatinine, uric acid and urea in groups were not significantly different.

Conclusions: Zinc supplementation results in earlier sputum smear conversion in the micronutrient group during the first 6 weeks. Increased body weight and serum zinc and serum albumin and decrease in total protein was observed in the micronutrient group.
Full-Text [PDF 274 kb]   (466 Downloads)    
Type of Article: Original Article | Subject: Biochemistry
Received: 2020/08/11 | Accepted: 2020/09/1 | Published: 2021/08/26

1. Jose J, Deepika G, George JH, Vignesh R, Chetty S, Ganesan R. Medication Adherence to Anti Tuberculosis Treatment Among Tuberculosis Patients in An Urban Private Tertiary Referral Hospital: A Prospective Cross Sectional Study. World Journal of Pharmaceutical Research. 2019;8(6):598-612.
2. Ter Beek L, Alffenaar JWC, Bolhuis MS, van der Werf TS, Akkerman OW. Tuberculosis-Related Malnutrition: Public Health Implications. J Infect Dis. 2019;220(2):340-341. [DOI:10.1093/infdis/jiz091] [PMID]
3. Burgos R, Joaquín C, Blay C, Vaqué C. Disease-related malnutrition in hospitalized chronic patients with complex needs. Clin Nutr. 2019;39(5):1447-1453. [DOI:10.1016/j.clnu.2019.06.006] [PMID]
4. Maret W. Regulation of Cellular Zinc Ions and Their Signaling Functions. Zinc Signaling. 2019:5-22. [DOI:10.1007/978-981-15-0557-7_2]
5. Mutiara DS, Sunardi D, Dewiasty E. Correlation between hair zinc level and cognitive function in elderly population. World Nutrition Journal. 2020;3(2):59. [DOI:10.25220/WNJ.V03.i2.0008]
6. McClung JP. Iron, zinc, and physical performance. Biol Trace Elem Res. 2019;188(1):135-139. [DOI:10.1007/s12011-018-1479-7] [PMID]
7. Shenta A, Saud K, Al-Shawi A. Assessment the Correlations of Hormones, Lipid Profiles, Oxidative Stress, and Zinc Concentration in Iraqi Women with Polycystic Ovary Syndrome. Rep Biochem Mol Biol. 2020;9(3)270-277. [DOI:10.29252/rbmb.9.3.270] [PMID] [PMCID]
8. Ariaee N, Farid R, Shabestari F, Shabestari M, Azad FJ. Trace elements status in sera of patients with allergic asthma. Rep Biochem Mol Biol. 2016;5(1):20-25.
9. Musavi H, Tabnak M, Sheini FA, Bezvan MH, Amidi F, Abbasi M. Effect of garlic (Allium sativum) on male fertility: a systematic review. J Herbmed Pharmacol. 2018;7(4):306-312. [DOI:10.15171/jhp.2018.46]
10. Okolie C. Serum Albumin/Globulin ratio in Tuberculosis and HIV Patients any Relationship?. Mycobacterial Diseases. 2016;6(1):199.
11. Nguyen H-HT. Mycobacterium tuberculosis proteins in diagnostic assays and devices for tuberculosis detection and diagnosis. Google Patents; 2019. CN110073215A.
12. Musavi H, Abazari O, Barartabar Z, Kalaki-Jouybari F, Hemmati-Dinarvand M, Esmaeili P, et al. The benefits of Vitamin D in the COVID-19 pandemic: biochemical and immunological mechanisms. Arch Physiol Biochem. 2020:1-9. [DOI:10.1080/13813455.2020.1826530] [PMID]
13. Bardenheier BH, Pavkov ME, Winston CA, Klosovsky A, Yen C, Benoit S, et al. Prevalence of Tuberculosis Disease Among Adult US-Bound Refugees with Chronic Kidney Disease. J Immigr Minor Health. 2019;21(6):1275-1281. [DOI:10.1007/s10903-018-00852-8] [PMID]
14. Marjani M, Fahim F, Sadr M, Dizaji MK, Moniri A, Khabiri S, et al. Evaluation of Silymarin for management of anti-tuberculosis drug induced liver injury: a randomized clinical trial. Gastroenterol Hepatol Bed Bench. 2019;12(2):138-142.
15. Prince SE, Martin SJ, Lavinya BU, Selvanathan K, Geetha A. Anti-tuberculosis drug-induced oxidative stress in kidneys: Role of brahmi as an antioxidant supplement. Pharmacognosy Magazine. 2019;15(62):12-16.
16. Ramakrishnan K, Shenbagarathai R, Kavitha K, Uma A, Balasubramaniam R, Thirumalaikolundu Subramanian P. Serum zinc and albumin levels in pulmonary tuberculosis patients with and without HIV. Jpn J Infect Dis. 2008;61(3):202-4.
17. Nizamani P, Afridi HI, Kazi TG, Talpur FN, Baig JA. Essential trace elemental levels (zinc, iron and copper) in the biological samples of smoker referent and pulmonary tuberculosis patients. Toxicology Reports. 2019;6:1230-1239. [DOI:10.1016/j.toxrep.2019.11.011] [PMID] [PMCID]
18. Feleke BE, Feleke TE, Mekonnen D, Beyene MB. Micronutrient levels of tuberculosis patients during the intensive phase, a prospective cohort study. Clin Nutr ESPEN. 2019;31:56-60. [DOI:10.1016/j.clnesp.2019.03.001] [PMID]
19. Abbasi M, Abazari OO. Probing the Biological evaluations of a new designed Palladium (II) complex using spectroscopic and theoretical approaches: Human Hemoglobin as a Target. Archives of Medical Laboratory Sciences. 2018;3(3).
20. Gammoh NZ, Rink L. Zinc and the Immune System. Springer. 2019:127-58. [DOI:10.1007/978-3-030-16073-9_8]
21. Ejemot-Nwadiaro RI, Itam EH, Ezedinachi EN. Zinc Supplementation as Adjunctive Therapy in Adults with Tuberculosis in Calabar, Nigeria: A Randomized Controlled Trial. Journal of Advances in Medicine and Medical Research. 2019;29(4):1-13. [DOI:10.9734/jammr/2019/v29i430079]
22. Beach RH, Sulser TB, Crimmins A, Cenacchi N, Cole J, Fukagawa NK, et al. Combining the effects of increased atmospheric carbon dioxide on protein, iron, and zinc availability and projected climate change on global diets: a modelling study. Lancet Planet Health. 2019;3(7):e307-e317. [DOI:10.1016/S2542-5196(19)30094-4]
23. Lin H-H, Wu C-Y, Wang C-H, Fu H, Lönnroth K, Chang Y-C, et al. Association of obesity, diabetes, and risk of tuberculosis: two population-based cohorts. Clin Infect Dis. 2018;66(5):699-705. [DOI:10.1093/cid/cix852] [PMID] [PMCID]
24. Tweed CD, Wills G, Crook AM, Dawson R, Diacon AH, Louw CE, et al. Liver toxicity associated with tuberculosis chemotherapy in the REMoxTB study. BMC Med. 2018;16(1):46. [DOI:10.1186/s12916-018-1033-7] [PMID] [PMCID]
25. Thompson NP, Caplin ME, Hamilton MI, Gillespie SH, Clarke SW, Burroughs AK, et al. Anti-tuberculosis medication and the liver: dangers and recommendations in management. Eur Respir J. 1995;8(8):1384-8. [DOI:10.1183/09031936.95.08081384] [PMID]
26. Abazari O, Shafaei Z, Divsalar A, Eslami-Moghadam M, Ghalandari B, Saboury AA, et al. Interaction of the synthesized anticancer compound of the methyl-glycine 1, 10-phenanthroline platinum nitrate with human serum albumin and human hemoglobin proteins by spectroscopy methods and molecular docking. Journal of the Iranian Chemical Society. 2020;17:1601-1614. [DOI:10.1007/s13738-020-01879-1]
27. Tweed CD, Wills G, Crook AM, Meredith SK, Nunn AJ, Mendel C, et al. S91 Liver function tests during tuberculosis treatment and the implications on monitoring for hepatotoxicity. BMJ Publishing Group Ltd. 2016;71(Suppl 3). [DOI:10.1136/thoraxjnl-2016-209333.97]
28. Stinchcombe S, McMillan K, Cooley E, Ladner S. Hepatotoxicity Monitoring in Active and Latent Tuberculosis (tb) Treatment. American Journal of Respiratory and Critical Care Medicine. 2020;201:A2116.
29. Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci. 2018;68:19-31. [DOI:10.1007/s12576-017-0571-7] [PMID] [PMCID]
30. Xie F, Xie L. Serum zinc level is associated with liver dysfunction caused by white smoke inhalation. Gastroenterology report. 2018;6(4):304-307. [DOI:10.1093/gastro/goy008] [PMID] [PMCID]
31. Hall RG, Leff RD, Gumbo T. Treatment of active pulmonary tuberculosis in adults: current standards and recent advances. Pharmacotherapy. 2009;29(12):1468-1481. [DOI:10.1592/phco.29.12.1468] [PMID] [PMCID]
32. Qureshi W, Hassan G, Kadri S, Khan G, Samuel B, Arshad A. Hyperuricemia and arthralgias during pyrazinamide therapy in patients with pulmonary tuberculosis. Laboratory medicine. 2007;38(8):495-497. [DOI:10.1309/7GBYQTY62PFEHDP1]
33. Mahantesh A, Hanumantharayappa B, Reddy M. Effect of pyrazinamide induced hyperuricemia on patient compliance undergoing DOTS therapy for tuberculosis. Research & Reviews: Journal of Pharmacology and Toxicological Studies. 2014;2:12-17.
34. Buziashvili M, Mirtskhulava V, Kipiani M, Blumberg H, Baliashvili D, Magee M, et al. Rates and risk factors for nephrotoxicity and ototoxicity among tuberculosis patients in Tbilisi, Georgia. Int J Tuberc Lung Dis. 2019;23(9):1005-1011. [DOI:10.5588/ijtld.18.0626] [PMID] [PMCID]
35. Zare Z, Dizaj TN, Lohrasbi A, Sheikhalishahi ZS, Asadi A, Zakeri M, et al. Silibinin inhibits TGF-β-induced MMP-2 and MMP-9 through Smad Signaling pathway in colorectal cancer HT-29 cells. Basic & Clinical Cancer Research. 2020;12(2):81-90. [DOI:10.18502/bccr.v12i2.5752]
36. Hussein O, Germoush M, Mahmoud A. Ruta graveolens Protects Agains Isoniazid/Rifampicin-Induced Nephrotoxicity through Modulation of Oxidative Stress and Inflammation. Global Journal of Biotechnology and Biomaterial Science. 2016.
37. Banu Rekha V, Santha T, Jawahar M. Rifampicin-induced renal toxicity during retreatment of patients with pulmonary tuberculosis. J Assoc Physicians India. 2005;53:811-3.
38. Mahmoud A, Morsy B, Abdel-Hady D, Samy R. Prunus armeniaca Leaves Extract Protects against Isoniazid and Rifampicin Induced Nephrotoxicity through Modulation of Oxidative stress and Inflammation. International Journal of Food and Nutritional Science. 2015;2(4):1-6. https://doi.org/10.15436/2377-0619.15.033 [DOI:10.15436/2377-0619.15.e003]
39. Hashmi N, Muhammad F, Javed I, Khan JA, Khan MZ, Khaliq T, et al. Nephroprotective effects of Ficus religiosa linn (peepal plant) stem bark against isoniazid and rifampicin induced nephrotoxicity in albino rabbits. Pakistan Veterinary Journal. 2013;33(3):330-4.

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Reports of Biochemistry and Molecular Biology

Designed & Developed by : Yektaweb