Association of Zinc with New Generation Cardiovascular Risk Markers in Childhood Obesity
Zinc (Zn) is a vital element required for growth and development particularly in children. It exhibits some protective effects against cardiovascular diseases (CVDs). Zn may be a potential biomarker of cardiovascular health. High sensitive cardiac troponin T (hs-cTnT) and cardiac myosin binding protein C (cMyBP-C) are new generation markers used for prediagnosis, diagnosis and prognosis of CVDs. The aim of this study is to determine Zn as well as new generation cardiac markers’ profiles in children with normal body mass index (N-BMI), obese (OB), morbid obese (MO) children and children with metabolic syndrome (MetS) findings. The association among them will also be investigated. Four study groups were constituted. The study protocol was approved by the institutional Ethics Committee of Tekirdag Namik Kemal University. Parents of the participants filled informed consent forms to participate in the study. Group 1 is composed of 44 children with N-BMI. Group 2 and Group 3 comprised 43 OB and 45 MO children, respectively. 45 MO children with MetS findings were included in Group 4. World Health Organization age- and sex-adjusted BMI percentile tables were used to constitute groups. These values were 15-85, 95-99 and above 99 for N-BMI, OB and MO, respectively. Criteria for MetS findings were determined. Routine biochemical analyses including Zn were performed. hs-cTnT and cMyBP-C concentrations were measured by enzyme-linked immunosorbent assay. Data were analyzed by using SPSS software. p < 0.05 was accepted as significant. Four groups were matched for age and gender. Decreased Zn concentrations were measured in Groups 2, 3 and 4 compared to Group 1. Groups did not differ from one another in terms of hs-cTnT. There were statistically significant differences between cMyBP-C levels of MetS group and N-BMI as well as OB groups. There was an increasing trend going from N-BMI group to MetS group. There were statistically significant negative correlations between Zn and hs-cTnT as well as cMyBP-C concentrations in MetS group. In conclusion, inverse correlations detected between Zn and new generation cardiac markers (hs-TnT and cMyBP-C) have pointed out that decreased levels of Zn accompany increased levels of hs-cTnT as well as cMyBP-C in children with MetS. This finding emphasizes that both Zn and these new generation cardiac markers may be evaluated as biomarkers of cardiovascular health during severe childhood obesity precipitated with MetS findings and also suggested as the messengers of the future risk in the adulthood periods of children with MetS.Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 377
 M. Knez, and M. Glibetic, “Zinc as a biomarker of cardiovascular health,” Front. Nutr., vol. 8, pp.686078, Jul. 2021.
 A. V. Skalny, M. Aschner M, and A. A. Tinkov, “Zinc,” Adv. Food Nutr. Res., vol.96, pp.251-310, May 2021.
 M. Jarosz, M. Olbert, G. Wyszogrodzka, K. Młyniec, and T. Librowski, “Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-κB signaling,” Inflammopharmacology, vol.25, no.1, pp.11-24, Feb. 2017.
 S. Choi, X. Liu, and Z. Pan, “Zinc deficiency and cellular oxidative stress: prognostic implications in cardiovascular diseases,” Acta Pharmacol. Sin., vol.39, no.7, pp.1120-1132, Jul. 2018.
 S. Wang, M. Luo, Z. Zhang, J. Gu, J. Chen, K. M. Payne, Y. Tan, Y. Wang, X. Yin, X. Zhang, G. C. Liu, K. Wintergerst, Q. Liu, Y. Zheng, and L. Cai, “Zinc deficiency exacerbates while zinc supplement attenuates cardiac hypertrophy in high-fat diet-induced obese mice through modulating p38 MAPK-dependent signaling,” Toxicol. Lett., vol.258, pp.134-146, Sep. 2016.
 H. Khorsandi, O. Nikpayam, R. Yousefi, M. Parandoosh, N. Hosseinzadeh, A. Saidpour, and A. Ghorbani, “Zinc supplementation improves body weight management, inflammatory biomarkers and insulin resistance in individuals with obesity: a randomized, placebo-controlled, double-blind trial,” Diabetol. Metab. Syndr., vol. 11, pp. 101, 2019.
 L. Huang, T. Teng, B. Bian, W. Yao, X. Yu, Z. Wang, Z. Xu, and Y. Sun, “Zinc levels in left ventricular hypertrophy,” Biol. Trace Elem. Res., vol.176, no.1, pp.48-55, Mar. 2017.
 M. J. Rios-Lugo, C. Madrigal-Arellano, D. Gaytán-Hernández, H. Hernández-Mendoza, and E. T. Romero-Guzmán, “Association of serum zinc levels in overweight and obesity,” Biol. Trace. Elem. Res., vol. 198, no.1, pp.51–57, Nov. 2020.
 S. M. Vivek, D. Dayal, R. Khaiwal, B. Bharti, A. Bhalla, S. Singh, H. Kaur, and S. V. Attri, “Low serum copper and zinc concentrations in North Indian children with overweight and obesity,” Pediatr. Endocrinol. Diabetes Metab., vol.26, no.2, pp.79-83, 2020.
 K. Gu, W. Xiang, Y. Zhang, K. Sun, and X. Jiang, “The association between serum zinc level and overweight/obesity: a meta-analysis,” Eur. J. Nutr., vol.58, no.8, pp.2971-2982, Dec. 2019.
 P. Pervanidou, A. Akalestos, D. Bastaki, F. Apostolakou, I. Papassotiriou, and G. Chrousos, “Increased circulating high-sensitivity troponin T concentrations in children and adolescents with obesity and the metabolic syndrome: a marker for early cardiac damage?” Metabolism., vol.62, no.4, pp.527-531, Apr. 2013.
 A. Milwidsky, E. Fisher, R. Y. Brzezinski, M. Ehrenwald, G. Shefer, N. Stern, I. Shapira, D. Zeltser, Z. Rosenbaum, D. Greidinger, S. Berliner, S. Shenhar-Tsarfaty, and O. Rogowski, “Metabolic syndrome is associated to high-sensitivity cardiac troponin T elevation,” Biomarkers., vol.24, no.2, pp.153-158, Mar. 2019.
 D. El Amrousy, H. Hodeib, G. Suliman, N. Hablas, E. R. Salama, and A. Esam, “Diagnostic and prognostic value of plasma levels of cardiac myosin binding protein-C as a novel biomarker in heart failure,” Pediatr. Cardiol., vol.38, no.2, pp.418-424, Feb. 2017.
 A. A. Khatab, B. A. El Gazzar, M. S. Rizk, and M. G. F. Abdel Ghani, “Value of plasma levels of cardiac myosin binding protein C as a diagnostic and prognostic biomarker in heart failure,” Menoufia Med. J., vol. 34, no. 1, pp. 221-225, Jan.-Mar. 2021.
 E. M. El-Moghazy, S. M. Morsy, S. H. Abdallah, and M. A. Ali, “Cardiac myosin binding protein C plasma level as a diagnostic and prognostic biomarker in heart failure in children,” Egyptian J. Hosp. Med., vol. 80, no. 3, pp. 1097-1201, July 2020.
 World Health Organization (WHO). The WHO Child Growth Standards. 2016 June. Access: http://www.who.int/childgrowth/en/
 P. Zimmet, K. G. AlbertiG, F. Kaufman, N. Tajima, M. Silink, S. Arslanian, G. Wong, P. Bennet, J. Shaw, S. Caprio, and IDF consensus group, “The metabolic syndrome in children and adolescents-an IDF consensus report,” Pediatr. Diabetes, vol.8, no.5, pp. 299-306, 2007.
 P. J. Little, R. Bhattacharya, A. E. Moreyra, and I. L. Korichneva, “Zinc and cardiovascular disease,” Nutrition, vol.26, no.11-12, pp. 1050-1057, Nov-Dec 2010.
 J. Smith, G. Butrimovitz, and W. Purdy, “Direct measurement of zinc in plasma by atomic absorption spectroscopy,” Clin. Chem., vol.25, pp.1487–1491, 1979.
 A. Chu, M. Foster, and S. Samman, “Zinc status and risk of cardiovascular diseases and Type 2 diabetes mellitus-A systematic review of prospective cohort studies,” Nutrients, vol.8, no.11, pp.707, Nov. 2016.
 X.Yu, L. Huang, J. Zhao, Z. Wang, W. Yao, X. Wu, J. Huang, and B. Bian, “The relationship between serum zinc level and heart failure: A JJmeta-analysis,” Biomed. Res. Int., vol. 2018, pp.2739014, Feb. 2018.
 L. Huang, T. Teng, J. Zhao, B. Bian, W. Yao, X. Yu, Z. Wang, Z. Xu, and Y. Sun, “The relationship between serum zinc levels, cardiac markers and the risk of acute myocardial infarction by zinc quartiles,” Heart, Lung and Circ., vol. 27, no. 1, pp. 66-72, 2018.
 A. El-Abd Ahmed, M. H. Hassan, N. I. Rashwan, M. M. Sayed, and A-R. M.A. Meki, “Myocardial injury induced by scorpion sting envenoming and evidence of oxidative stress in Egyptian children,” Toxicon, vol.153, pp.72-77, 2018.
 A. Aimo, J. L. Januzzi, G. Vergaro, A. Clerico, R. Latini, J. Meessen, I. S. Anand, J. N. Cohn, J. Gravning, T. Ueland, S. H. Nymo, H-P. Brunner-La Rocca, A. Bayes-Genis, J. Lupon, R. A. de Boer, A. Yoshihisa, Y. Takeishi, M. Egstrup, I. Gustafsson, H. K. Gaggin, K. M. Eggers, K. Huber, I. Tentzeris, A. Ripoli, C. Passino, and M. Emdin, “Revisiting the obesity paradox in heart failure: Per cent body fat as predictor of biomarkers and outcome,” Eur. J. Prev.Cardiol., vol.26, no.16, pp.1751-1759, 2019.