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Effect of zinc supplementation on growth and body composition in children with sickle cell disease^1,2,3

¹ From the Divisions of Gastroenterology and Nutrition (BSZ, DAK, and VAS) and Hematology (KO-F), The Children's Hospital of Philadelphia, the University of Pennsylvania School of Medicine, Philadelphia, and the Division of Hematology, Oakland Children's Medical Center, Oakland, CA (EBF).

Background: Poor growth and delayed maturation in children with sickle cell disease (SCD) may be due, in part, to mild zinc deficiency.

Objective: The objective was to determine the effects of zinc supplementation on growth and body composition in children with SCD.

Design: Forty-two prepubertal children (20 girls and 22 boys) aged 4–10 y with SCD-SS were randomly assigned to receive 10 mg elemental Zn/d in cherry syrup (zinc group) or cherry syrup alone (control group). The 2 groups were stratified by sex and initial height status. Dietary intakes were evaluated and anthropometric, high-precision knee-height, and plasma zinc measurements were made at baseline and at 3, 6, and 12 mo. Body composition was determined every 6 mo with dual-energy X-ray absorptiometry, and z scores for anthropometric variables were computed from national reference data. Longitudinal-mixed-effects analysis was used to test for differences between the groups over the 12-mo observation period.

Results: Thirty-eight children completed the study. No significant differences were observed at baseline. After 12 mo, the zinc group had significantly greater mean (±SE) increases in height (0.66 ± 0.29 cm/y), sitting height (0.97 ± 0.40 cm/y), knee height (3.8 ± 1.2 mm/y), and arm circumference z scores (0.27 ± 0.12 cm/y). Height-for-age and weight-for-age z scores decreased significantly by 0.11 ± 0.04 and 0.13 ± 0.05, respectively, in the control group but did not change significantly in the zinc group.

Conclusions: Prepubertal children with SCD-SS may have zinc deficiency and may benefit from zinc supplementation to improve linear growth and weight gain.

Key Words: Sickle cell disease • zinc supplementation • growth • body composition • children

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