Changes of Zinc Copper and Cu/Zinc ratio and impaired nutritional status in tuberculosis patients of Urmia, Northwest Iran

Abstract

Malnutrition is observed frequently in patients with pulmonary tuberculosis (TB), but their nutritional status, especially of micronutrients, is still poorly documented. The objective of this study was to investigate the nutritional status of patients with TB compared with that of healthy controls in Urmia, Iran. In a case-control study, 52 patients aged 17-86 y with untreated TB were compared with 58 healthy controls selected from neighbors of the patients. Anthropometric, clinical, serum biochemical and micronutrient status data were collected. Compared to controls, TB patients had significantly lower concentrations of serum albumin, Total iron-binding capacity, ferritin, and calcium (p<0.05). Serum zinc concentrations were significantly lower in patients than controls (p= 0.04). The average serum levels of copper and zinc in healthy volunteers were 3.90 +/- 2.17 and 17.04 +/- 2.85 mu g/dL, respectively. In tuberculosis patients, serum copper and zinc levels were 5.03 +/- 2.93 mu g/dL and 16.46 +/- 3.17 mu g/dL, respectively. Patients showed significantly higher serum copper level than controls (p= 0.01). The serum Cu/Zn ratio was significantly higher in the serum of TB patients, (0.30 vs 0.23, P=0.05). In conclusion, the nutritional status of patients with TB was poor compared with healthy subjects. Low level of serum Zn in patients with tuberculosis signifies importance of nutritional assessments, in particular micronutrients, for better management of TB.