INDICATIONS OF ZINC INDICATIONS OF ZINC DEFICIENCY FOR LITHUANIAN DEFICIENCY FOR LITHUANIAN

POPULATION AND ITS POPULATION AND ITS GEOMEDICAL CONTROLGEOMEDICAL CONTROL

Marija JakubMarija Jakubėėniennienė*, ė*, Gediminas Žukauskas*, Gediminas Žukauskas*, Saulius Šliaupa**Saulius Šliaupa**

**Institute of Forensic Medicine of Institute of Forensic Medicine of Mykolas Romeris UniversityMykolas Romeris University** Institute of Geology and ** Institute of Geology and GeographyGeography

Vilnius, LithuaniaVilnius, Lithuania

SCIENTIFIC NETWORKING AND THE GLOBAL HEALTH SUPERCOURSE FOR THE PREVENTION OF THREAT FROM MAN MADE AND NATURAL DISASTERS

August 8-10, 2005, Kaunas, Lithuania

Worrying health and social Worrying health and social problemsproblems

• Increased general morbidity and Increased general morbidity and mortality in Lithuaniamortality in Lithuania

• The biggest suicide rate among The biggest suicide rate among European countries (44.5/100 000 European countries (44.5/100 000 inhabitants)inhabitants)

• Nearly epidemic status with Nearly epidemic status with tuberculosis (86/100 000)tuberculosis (86/100 000)

• High level of alcohol delirium High level of alcohol delirium • Increased number of alopecia among Increased number of alopecia among

young peopleyoung people

ESSENTIALITY OF ZINC FOR ESSENTIALITY OF ZINC FOR HUMANHUMAN

• Zinc functions as a required cofactor for over Zinc functions as a required cofactor for over 200 metalloenzymes;200 metalloenzymes;

• Zinc is an essential component of the Zinc is an essential component of the endogenous storage forms of pancreatic insulin;endogenous storage forms of pancreatic insulin;

• Zinc play a very important role in RNA and DNA Zinc play a very important role in RNA and DNA metabolism;metabolism;

• Zinc is essential for immune system, growth Zinc is essential for immune system, growth and sex hormones;and sex hormones;

• Zinc is involved in the pathophysiology and Zinc is involved in the pathophysiology and therapy of depression.therapy of depression.

BIOLOGICAL IMPORTANCE OF ZINC FOR BIOLOGICAL IMPORTANCE OF ZINC FOR LIVING ORGANIZMS LIVING ORGANIZMS

(HISTORY OF DISCAVERIES)(HISTORY OF DISCAVERIES)• J.Raulin (1869) – essentiality of zinc in the nutrition of J.Raulin (1869) – essentiality of zinc in the nutrition of

Aspergillus Niger;Aspergillus Niger;• V.Birckner (1919) – first indication of a function for zinc in V.Birckner (1919) – first indication of a function for zinc in

the higher animals;the higher animals;• A.Sommer, C.Lipman (1928) – the essentiality of zinc for the A.Sommer, C.Lipman (1928) – the essentiality of zinc for the

higher form of plant life;higher form of plant life;• W.Todd (1934) – first evidence that zinc is a dietary essential W.Todd (1934) – first evidence that zinc is a dietary essential

for the rat;for the rat;• W.Tucker, W.Salmon (1955) – zinc cures and prevents W.Tucker, W.Salmon (1955) – zinc cures and prevents

parakeratozis in pigs;parakeratozis in pigs;• B. O’Dell (1960) – zinc requirements for growth, feathering, B. O’Dell (1960) – zinc requirements for growth, feathering,

and skeletal development in poultry;and skeletal development in poultry;• A.Prasad (1961) – the relation of the occurrence of dwarfism A.Prasad (1961) – the relation of the occurrence of dwarfism

and hypogonadism in boys in parts of the Middle East.and hypogonadism in boys in parts of the Middle East.

CLINICAL MANIFESTATUIONS IN MILD TO MODERATE CASES OF ZINC DEFICIENCY

Oligospermia

Slight weight loss

Delayed wound healing

Taste abnormalities Abnormal dark adaption

CLINICAL MANIFESTATUIONS IN SEVERE CASES

OF ZINC DEFICIENCY

Bullous-pustulardermatitis

Infections

Hypogonadism in males

Emotional disorders(depression, paranoia)

Depletion of immunity

Alopecia Alcoholism

Other symptoms of Zinc deficiency (Each person manifests different symptoms)

Hypo-hyper-tension

Diabetes

Obesity Acne Infertility Thyroid disorders

Pfeiffer C.C., 1978Jensen B., 1983

Zn deficiency may lead to expressedFe, Cu, Cd, Pb accumulations,essentially on the background of alcohol abuse. They are functional antagonists to Zn.

Zn deficiency symptoms result

from

Nutritional

factors

Excessive alcohol use

Liver diseases

Malabsorption syndromes Renal disease

Sickle cell disease

Nutritional factors:Nutritional factors:

• Consumption of cereal proteins containing Consumption of cereal proteins containing high levels of fibers known as phylates;high levels of fibers known as phylates;

• Geochemical characteristics of soil Geochemical characteristics of soil (decreased level of zinc in cultures grown (decreased level of zinc in cultures grown in the regions with depleted content of zinc in the regions with depleted content of zinc in soil).in soil).

• 20% of the world’s people suffer from zinc 20% of the world’s people suffer from zinc deficient diet (the report of International deficient diet (the report of International Zinc Nutrition Consultative Group, 2004)Zinc Nutrition Consultative Group, 2004)

Zn content in soil of LithuaniaZn content in soil of Lithuania

Different filtering window

Rates of suicides in different regions of Rates of suicides in different regions of LithuaniaLithuania

3 5

4 0

4 5

5 0

5 5

6 0

6 5

7 0

7 5

8 0

8 5

9 0

9 5

1 0 0

3 73 83 94 04 14 24 34 44 54 64 74 84 95 05 15 25 35 45 55 65 75 85 96 06 16 2

Three anomaliesexcluded

Rates of suicides in different Rates of suicides in different regions of Lithuaniaregions of Lithuania (three (three anomalies excluded)anomalies excluded)

3 73 83 94 04 14 24 34 44 54 64 74 84 95 05 15 25 35 45 55 65 75 85 96 06 16 2

Zn in soil

0

10

20

30

40

50

60

70

80

90

Aly

taus

L

azdi

jųV

arėn

os

Jona

vos

Kai

šiad

orių

K

auno

K

ėdai

nių

Pri

enų

Ras

eini

ų K

laip

ėdos

Kre

ting

os

Skuo

do

Šilu

tės

Mar

ijam

pol

Šaki

ų V

ilka

višk

io

Bir

žų

Kup

iški

o P

anev

ėžio

P

asva

lio

Rok

iški

o A

kmen

ės

Joni

škio

K

elm

ės

Pak

ruoj

o R

advi

lišk

io

Šiau

lių

Jurb

arko

Ši

lalė

sT

aura

gės

Maž

eiki

ų P

lung

ės

Tel

šių

Any

kšči

ų Ig

nali

nos

Mol

ėtų

Ute

nos

Zar

asų

Šalč

inin

kų

Širv

intų

Šv

enči

onių

T

rakų

U

kmer

gės

Vil

niau

s

Su

icid

es r

ate,

N/1

00 0

00

The rates of suicides in different regions of Lithuania (average rate for four years:1999, 2001, 2002, 2003).

Average rate of suicides for 45 regions – 57.6/100 000Average rate in regions with low zinc content in soil – 63.2/100 000

Average rate in regions with highest zinc abundance in soil – 51.2/100 000

Concentration of ZN in the soil (top and bottom), circum-Baltic area

Lithuania (after Reimann et al., 2003)

Comparison of the average Zn content Comparison of the average Zn content in soil with rates of suicides in Nordic in soil with rates of suicides in Nordic

and Baltic countriesand Baltic countries

0

5

10

15

Rat

es o

f ho

mic

ides

Homicides

10

20

30

40

50

Rat

es o

f su

icid

es

Suicides

30

40

50

60

70Z

inc

cont

ent

Zn content

Est

onia

Fin

land

Lat

via

Lit

huan

ia

Nor

way

Swed

enE

sto

nia

Fin

lan

d La

tvia

Lith

ua

ni

a No

rwa

y Sw

ed

en

Concentration of zinc in various biomedia of patients with

alopecia accordingly to the age

4 8 12 16 20 24 28 32 36

0,3

0,4

0,5

0,6

0,7

0,8

a) Whole Blood

Con

cent

ratio

n of

Zn,

mg/

100

ml

Age of patients, years4 8 12 16 20 24 28 32 36

0,04

0,06

0,08

0,10

0,12

0,14

Fig. 2. Concentration of zinc in various biologicalmedia accordingly to the age of patients

b) Blood Plasma

Con

cent

ratio

n of

Zn,

mg/

100

ml

Age of patients, years

4 8 12 16 20 24 28 32 360,0

0,2

0,4

0,6

0,8

1,0

c) Urine

Con

cent

ratio

n of

Zn,

mg/

l

Age of patients, years4 8 12 16 20 24 28 32 36

0

5

10

15

20

25

30

35

40

45

50

55 d) Hair

Con

cent

ratio

n of

Zn,

mg/

100g

Age of patients, years

4 8 12 16 200,04

0,06

0,08

0,10

0,12

0,14

0,16

Fig. 4. Concentration of Zn in the Blood Plasma of Persons from Control Group

Con

cent

ratio

n of

Zn,

mg/

100m

l

Age of subjects, years

Zinc in blood plasma of persons

from control group

ZN DEFICIENCY AND ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (1)EXCESSIVE ALCOHOL USE (1)

02468

101214

Est

onia

Fin

land

Lat

via

Lit

huan

ia

Nor

way

Swed

en

Average sales of alcoholic beverages in litres in 1995-2002

ZN DEFICIENCY AND ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (2)EXCESSIVE ALCOHOL USE (2)

0

20

40

60

80E

sto

nia

Fin

lan

d

Lat

via

Lit

hu

ania

No

rway

Sw

eden

Rates of alkohol liver disease in 2002

Men

Women

ZN DEFICIENCY AND ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (3)EXCESSIVE ALCOHOL USE (3)

0 5 10 15 20 25 30 35

0.04

0.06

0.08

0.10

0.12

0.14

Con

cent

ratio

n, m

g/dL

Case number

Zn

Hepatitis

0 5 10 15 20 25

0.04

0.06

0.08

0.10

0.12

0.14

ZnCirrhosis

Zinc serum concentration in patients with hepatitis and liver cirrhosis

n=33 n=22

ZN DEFICIENCY AND EXCESSIVE ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (4)ALCOHOL USE (4)

a

a

a

Alcohol use

Liv

er d

isea

sesZn deficiency

Emotional disorder

Excessive alcohol use

Zn deficiency

Nutritional factors

Behavior disorder

Personality disorder

Anxiety disorder

Depressive disorder

Suicides

What are criteria for zinc What are criteria for zinc deficiency status for deficiency status for

human?human?• Necessity to have normal ranges of this Necessity to have normal ranges of this

element for specific population;element for specific population;• Depleted concentration of element in Depleted concentration of element in

blood compartments, selected tissues blood compartments, selected tissues and body fluids;and body fluids;

• Knowledge about interaction of zinc in Knowledge about interaction of zinc in organism with another elements;organism with another elements;

• The influence on health status of such The influence on health status of such geofactors as gravity and magnetic geofactors as gravity and magnetic field, sub-soil lithologies, relief, some field, sub-soil lithologies, relief, some other landscape feature, drinking water other landscape feature, drinking water and soil chemistry. and soil chemistry.

FUTURE INVESTIGATIONS:FUTURE INVESTIGATIONS:

1. Monitoring of elements in biological 1. Monitoring of elements in biological specimens for Lithuanian people and specimens for Lithuanian people and establishment of normal ranges;establishment of normal ranges;

2. Participation in comparative 2. Participation in comparative investigation of elements in biological investigation of elements in biological specimens for different populations;specimens for different populations;

3. Investigation of the influence of 3. Investigation of the influence of geofactors on health status of geofactors on health status of different population.different population.

Thank you very much Thank you very much for your attention !!!for your attention !!!