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PEDIATRICS Vol. 111 No. 5 May 2003, pp. 1002-1009

The Effect of Zinc Supplementation on Linear Growth, Body Composition, and Growth Factors in Preterm Infants

N. Marta Díaz-Gómez, PhD, MD^*,, Eduardo Doménech, PhD, MD^,¶, Flora Barroso, PhD, MD, Silvia Castells, PhD, Carmen Cortabarria, MD^,¶ and Alejandro Jiménez, PhD^*

^* Research Unit, University Hospital of the Canaries, La Laguna, Spain
Nursing School, University of La Laguna
Faculty of Medicine, University of La Laguna, La Laguna, Spain
^¶ Department of Paediatrics, University Hospital of the Canaries, Tenerife, Spain

--> Objective. The aim of our study was to evaluate the effect of zinc supplementation on linear growth, body composition, and growth factors in premature infants.

Design. Thirty-six preterm infants (gestational age: 32.0 ± 2.1 weeks, birth weight: 1704 ± 364 g) participated in a longitudinal double-blind, randomized clinical trial. They were randomly allocated either to the supplemental (S) group fed with a standard term formula supplemented with zinc (final content 10 mg/L) and a small quantity of copper (final content 0.6 mg/L), or to the placebo group fed with the same formula without supplementation (final content of zinc: 5 mg/L and copper: 0.4 mg/L), from 36 weeks postconceptional age until 6 months corrected postnatal age. At each evaluation, anthropometric variables and bioelectrical impedance were measured, a 3-day dietary record was collected, and a blood sample was taken. We analyzed serum levels of total alkaline phosphatase, skeletal alkaline phosphatase (sALP), insulin growth factor (IGF)-I, IGF binding protein-3, IGF binding protein-1, zinc and copper, and the concentrations of zinc in erythrocytes.

Results. The S group had significantly higher zinc levels in serum and erythrocytes and lower serum copper levels with respect to the placebo group. We found that the S group had a greater linear growth (from baseline to 3 months corrected age: score deviation standard length: 1.32 ± .8 vs .38 ± .8). The increase in total body water and in serum levels of sALP was also significantly higher in the S group (total body water: 3 months; corrected age: 3.8 ± .5 vs 3.5 ± .4 kg, 6 months; corrected age: 4.5 ± .5 vs 4.2 ± .4 kg; sALP: 3 months; corrected age: 140.2 ± 28.7 vs 118.7 ± 18.8 µg/L).

Conclusions. Zinc supplementation has a positive effect on linear growth in premature infants.

Key Words: zinc • insulin-like growth factors • preterm infants • growth • body composition

Abbreviations: GH, growth hormone • IGF, insulin growth factor • BP, binding protein • BI, bioelectrical impedance • S, supplemental • P, placebo • sALP, skeletal alkaline phosphatase • BW, birth weight • GA, gestational age • PCA, postconceptional age • CA, corrected postnatal age • TBW, total body water • BIA, bioelectrical impedance analysis • HSD, honest significance difference • SDS, score deviation standard • EZn, erythrocyte mean zinc

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Received for publication May 2, 2002; Accepted Sep 23, 2002.

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