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Selenium (Se) is an essential micronutrient for human biology that executes its functions as the amino acid selenocysteine via selenoproteins, which have important functions in, for example, antioxidation, immunomodulation, thyroid metabolism, and human fertility. Se nutritional status is assessed using the quantification of blood Se biomarkers, which are influenced by several factors, including diet, age, gender, smoking status, alcohol consumption, health condition, and the genetic characteristics of individuals. Nutrigenetic studies have identified single nucleotide polymorphisms in selenoproteins that might clarify the high variability in values reported for biomarkers of Se nutritional status in different populations, and the response of these biomarkers to Se supplementation with either organic or inorganic forms of Se. This review aims to (1) define the basic aspects of Se biology, (2) describe the current most commonly used biomarkers of Se nutritional status, and (3) provide a summary of associations between functional single nucleotide polymorphisms in selenoproteins and biomarkers of Se status in healthy populations.

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BACKGROUND: The beneficial effects of selenium (Se) to human health are exerted by selenoproteins, which can be quantified in blood and used as biomarkers of Se status. Different responses of Se biomarkers after supplementation with selenomethionine and sodium selenite have been observed and some of them could be due to genetic polymorphisms, mainly single nucleotide polymorphisms (SNPs). Brazil nuts are known to be the richest natural source of Se. OBJECTIVE: Investigate how genetic variations in selenoprotein genes modulate biomarkers of Se status in response to Brazil nut supplementation. METHODS: The SU.BRA.NUT study was a four month interventional trial which involved healthy volunteers of both genders, selected in University of Sao Paulo. The supplementation was done with one Brazil nut a day for 8 weeks, followed by 8 weeks of washout. Blood samples were collected at 5 time points: baseline, 4 and 8 weeks of supplementation and 4 and 8 weeks of washout for analysis of five biomarkers of Se status - erythrocyte GPx1 (Glutathione Peroxidase 1) activity, plasma GPx3 activity, plasma Se, erythrocyte Se, and plasma selenoprotein P. The gene expression of GPX1, SELENOP, SELENOF and SELENOS was done before and after 8 weeks of supplementation. The volunteers were genotyped for SNPs in GPX1 (rs1050450, rs3811699 and rs1800699), GPX4 (rs713041), SELENOP (rs3877899 and rs7579), SELENOF (rs5845) and SELENOS (rs34713741). RESULTS: A total of 130 volunteers finished the protocol. The concentrations of four biomarkers of Se status increased significantly after 4 and 8 weeks of supplementation, being modulated by gender. In addition, erythrocyte GPx1 activity was associated with rs1050450, rs713041 and rs5845. Plasma Se was associated with rs7579 and selenoprotein P with plasma Se at baseline. Nut supplementation significantly increased GPX1 mRNA expression only in subjects with CC genotype at rs1050450. SELENOP mRNA expression was significantly lower in subjects with GG genotype at rs7579 before and after supplementation. CONCLUSION: Genetic variations in GPX1 and SELENOP genes are associated with different responses of molecular and biochemical biomarkers of Se status after Brazil nut supplementation in healthy Brazilians. The SU.BRA.NUT study was registred at www.clinicaltrials.gov as NCT 03111355.

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PURPOSE: Considering that oxidative stress is implicated in the pathogenesis and progression of different health conditions, we aimed to evaluate whether the redox balance of a healthy Brazilian population is associated with GPX1 polymorphisms, selenium status, lipid profile, and anthropometric and lifestyle parameters. METHODS: 343 healthy adults were assessed for redox balance markers [glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity; malondialdehyde (MDA) and oxygen radical absorption capacity (ORAC)]; genotyped for the polymorphisms GPX1 Pro198Leu (rs1050450), -602A/G (rs3811699) and Arg5Pro (rs8179169); evaluated for selenium biomarkers (plasma, erythrocyte, and urine) and intake; and assessed for lipid profile. Anthropometric (BMI) and lifestyle data (physical activity, current smoking habit and alcohol consumption) were collected. Multivariable regression models were applied to investigate the possible associations. RESULTS: Although there were no differences in GPx activity according to GPX1 Pro198Leu and -602A/G polymorphisms, this redox balance marker was positively associated with erythrocyte selenium and negatively associated with the presence of a minor allele of Pro198Leu. SOD activity was positively associated with the presence of a minor allele for these polymorphisms. ORAC showed the same pattern among Leu and G carriers and was positively associated with Leu allele presence, BMI and alcohol intake. MDA was only associated negatively with the male sex and plasma selenium. CONCLUSIONS: Our findings suggest that the redox balance of a Brazilian healthy population is associated with GPX1 polymorphisms (Pro198Leu and -602A/G), selenium status, BMI, sex, smoking habit and alcohol consumption.

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PURPOSE: The consumption of Brazil nuts has been associated with benefits to lipid metabolism and reductions in total cholesterol and LDL concentrations. They are the richest natural source of selenium which has essential functions in human physiology. Genetic polymorphisms in Selenoprotein P could impair lipid and glucose metabolisms. The aim of this work was to verify the influence of polymorphisms in genes for selenoproteins on blood lipid levels after dietary supplementation with Brazil nuts in healthy adults. METHODS: The study included 130 healthy volunteers selected at the University of São Paulo, Brazil. They were supplemented with one nut a day for 8 weeks, followed by 8 weeks without intervention. The following analyses were performed: anthropometric measurements, serum fasting glucose, lipid profile, C-reactive protein and plasma MDA levels. The volunteers were genotyped for SNPs rs1050450, rs3811699, rs1800699, rs713041, rs3877899, rs7579, rs34713741, and rs5845 in genes for selenoproteins. RESULTS: The concentrations of total cholesterol and fasting glucose levels decreased after 8 weeks of supplementation (p < 0.05). Glucose levels were modulated by rs3877899 in SEPP1, with significantly lower levels observed for individuals with the GA + AA genotype (p = 0.025). In addition, rs7579 was associated with cholesterol concentrations, which were significantly lower for individuals with the GG genotype (p = 0.053). CONCLUSIONS: Supplementation with one Brazil nut a day for 8 weeks reduced total cholesterol and glucose levels. Furthermore, our results suggest that rs3877899 might be associated with glucose concentrations and rs7579 with cholesterol concentrations. Therefore, the effect of genetic variations should be considered in future nutritional interventions evaluating the response to Brazil nut supplementation.

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Nutrimiromics studies the influence of the diet on the modification of gene expression due to epigenetic processes related to microRNAs (miRNAs), which may affect the risk for the development of chronic diseases. miRNAs are a class of non-coding endogenous RNA molecules that are usually involved in post-transcriptional gene silencing by inducing mRNA degradation or translational repression by binding to a target messenger RNA. They can be controlled by environmental and dietary factors, particularly by isolated nutrients or bioactive compounds, indicating that diet manipulation may hold promise as a therapeutic approach in modulating the risk of chronic diseases. This review summarizes the evidence regarding the influence of nutrients and bioactive compounds on the expression of miRNAs related to inflammation and chronic disease in several models (cell culture, animal models, and human trials).

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Brazil nuts are among the richest selenium food sources, and studies have considered this Amazonian nut as an alternative for selenium supplementation. Besides selenium, Brazil nuts present relevant content of other micronutrients such as magnesium, copper, and zinc. The nutritional composition of nuts, also characterized by adequate fatty acid profile and high content of protein and bioactive compounds, has many health benefits. In the present review, we examine the nutritional composition of Brazil nuts, comparing it with other nuts, and describe the relevance of possible contaminants and metal toxicants observed in this nut for human health. Furthermore, we report different trials available in the literature, which demonstrate positive outcomes such as modulation of the lipid serum profile, enhancement of the antioxidant system and improvement of anti-inflammatory response. These effects have been assessed under different conditions, such as cognitive impairment, dyslipidemia, cancer, and renal failure.

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Selenium (Se) is an essential micronutrient for human health. Its beneficial effects are exerted by selenoproteins, which can be quantified in blood and used as molecular biomarkers of Se status. We hypothesize that the presence of genetic polymorphisms in selenoprotein genes may: (1) influence the gene expression of specific selenoproteins and (2) influence the pattern of global gene expression after Brazil nut supplementation. The study was conducted with 130 healthy volunteers in Sao Paulo, Brazil, who consumed one Brazil nut (300 µg/Se) a day for eight weeks. Gene expression of GPX1 and SELENOP and genotyping were measured by real-time PCR using TaqMan Assays. Global gene expression was assessed by microarray using Illumina HumanHT-12 v4 BeadChips. Brazil nut supplementation significantly increased GPX1 mRNA expression only in subjects with CC genotype at rs1050450 (p < 0.05). SELENOP mRNA expression was significantly higher in A-carriers at rs7579 either before or after supplementation (p < 0.05). Genotype for rs713041 in GPX4 affected the pattern of blood cell global gene expression. Genetic variations in selenoprotein genes modulated both GPX1 and SELENOP selenoprotein gene expression and global gene expression in response to Brazil nut supplementation.

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Breast cancer is a global public health problem and accumulating evidence indicates early-life exposures as relevant factors in the disease risk determination. Recent studies have shown that paternal nutrition can influence offspring health including breast cancer risk. Selenium is a micronutrient with essential role in central aspects of embryogenesis, male fertility and cancer and that has been extensively studied as a chemopreventive agent in several breast cancer experimental models. Thus, we designed an animal study to evaluate whether paternal selenium deficiency or supplementation during preconception could affect the female offspring mammary gland development and breast cancer susceptibility. Male Sprague-Dawley rats were fed AIN93-G diet containing 0.15 ppm (control diet), 0.05 ppm (deficient diet) or 1 ppm (supplemented diet) of selenium for 9 weeks and mated with control female rats. Mammary carcinogenesis was induced with 7,12-dimethylbenz[a]anthracene (DMBA) in their female offspring. Paternal selenium deficiency increased the number of terminal end buds, epithelial elongation and cell proliferation in the mammary gland of the female rat offspring and these effects were associated with higher susceptibility to DMBA-induced mammary tumors (increased incidence and higher grade tumors). On the other hand, paternal selenium supplementation did not influence any of these parameters. These results highlight the importance of father's nutrition including selenium status as a relevant factor affecting daughter's breast cancer risk and paternal preconception as a potential developmental stage to start disease preventive strategies.

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Selenium (Se) status varies worldwide as a result of natural variation of Se content in soils, dietary pattern, and the presence of SNPs. Further, Se status in Brazilians and its relationship between genetic variation and Se biomarkers is unknown. This work investigated the association between SNPs in glutathione peroxidase genes and biomarkers of Se status in healthy Brazilians. The study was conducted in 116 healthy adults in São Paulo, Brazil. Plasma and erythrocyte Se were measured by HGFAAS. Erythrocyte GPx (eGPx) activity was measured spectrometrically in a biochemical analyzer. Genotypes were determined by real-time PCR using Taqman(®) Assays. eGPx activity was higher in females compared with males. Lower erythrocyte Se concentrations were found in heterozygous GC carriers for GPX1 rs8179169. eGPx activity was higher in females with the common genotypes, except for rs8179169. GC carriers for rs8179169 had lower erythrocyte Se in both genders, and only male carriers of the variant alleles of both rs1050450 and rs1800668 had higher eGPx activity. In conclusion, the genotype for SNPs in GPX1 and gender affected biomarkers of Se status in this pilot study with healthy Brazilians.

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Selenoproteins play important roles in antioxidant mechanisms, and are thus hypothesised to have some involvement in the pathology of certain types of dementia. Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are both thought to involve impaired biological activity of certain selenoproteins. Previously, supplementation with a selenium-rich Brazil nut (Bertholletia excelsa) has shown potential in reducing cognitive decline in MCI patients, and could prove to be a safe and effective nutritional approach early in the disease process to slow decline. Here, we have conducted a pilot study that examined the effects of a range of single nucleotide polymorphisms (SNPs) in genes encoding the selenoproteins glutathione peroxidase (GPX1) and selenoprotein P (SEPP) in response to selenium supplementation via dietary Brazil nuts, including selenium status, oxidative stress parameters and GPX1 and SEPP gene expression. Our data suggest that GPX1 Pro198Leu rs1050450 genotypes may differentially affect the selenium status and GPx activity. Moreover, rs7579 and rs3877899 SNPs in SEPP gene, as well as GPX1 rs1050450 genotypes can influence the expression of GPX1 and SEPP mRNA in response to Brazil nuts intake. This small study gives cause for larger investigations into the role of these SNPs in both the selenium status and response to selenium dietary intake, especially in chronic degenerative conditions like MCI and AD.

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OBJECTIVE: The Brazilian Amazon region has selenium (Se)-rich soil, which is associated with higher Se levels in populations fed locally grown produce. Brazil nuts are a major source of dietary Se and are included with meals offered to children enrolled in public preschool in Macapá. The aim of this study was to examine Se intake and status of these children. METHODS: The Macapá group consisted of 41 children from a public preschool who received 15 to 30 g of Brazil nuts 3 d/wk. The control group included 88 children from the nearby city of Belém who did not receive Brazil nut-enriched meals. In both groups, school meals comprised ≥90% of the children's total food consumption. Selenium was assessed using hydride generation quartz tube atomic absorption spectroscopy in plasma, erythrocytes, nails, hair and urine. Dietary intakes (macronutrients and Se) were evaluated using the duplicate-portion method. RESULTS: Both groups received inadequate intakes of energy and macronutrients. Selenium intake was excessive in both groups (155.30 and 44.40 µg/d, in Macapá and Belém, respectively). Intake was potentially toxic in Macapá on days when Brazil nuts were added to meals. Although biomarkers of Se exposure exceeded reference levels in the Macapá group, no clinical symptoms of Se overload (selenosis) were observed. CONCLUSIONS: The inclusion of Brazil nuts in school meals provided to children with already high dietary Se intakes increased Se levels and may result in an increased risk for toxicity. As selenosis is associated with some chronic diseases, we recommend continued monitoring of Se intake and status in this population.

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Studies have shown that there are inverse relationships between nut consumption and the reduction of cardiovascular risk. This study tested the hypothesis that daily consumption of Brazilian nuts would have a positive effect upon selenium (Se) status, erythrocyte glutathione peroxidase activity, lipid profile, and atherogenic risk in severely obese women...

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Studies have shown that there are inverse relationships between nut consumption and the reduction of cardiovascular risk. This study tested the hypothesis that daily consumption of Brazilian nuts would have a positive effect upon selenium (Se) status, erythrocyte glutathione peroxidase activity, lipid profile, and atherogenic risk in severely obese women. Thirty-seven severely obese women each consumed 1 Brazilian nut a day (290 µg of Se a day) for 8 weeks. Blood Se concentrations, total erythrocyte glutathione peroxidase activity, lipid profile, and Castelli I and II indexes were evaluated before and after the nuts consumption. All the patients were Se deficient at baseline; this deficiency was remedied by the consumption of the Brazilian nut (P < .0001). The intake of Brazilian nuts promoted a significant increase in high-density lipoprotein cholesterol concentrations (P < .00001), which then resulted in a significant improvement of the Castelli I (P < .0002) and II (P < .0004) indexes. This study shows that obese people who implement daily consumption of Brazilian nuts can improve both Se status and lipid profile, especially high-density lipoprotein cholesterol levels, thereby reducing cardiovascular risks.

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BACKGROUND: Large amounts of reactive oxygen species are produced in hemodialysis (HD) patients, and, at higher concentrations, reactive oxygen species are thought to be involved in the pathogenesis of cardiovascular disease. It has been proposed that selenium (Se) may exert an antiatherogenic influence by reducing oxidative stress. The richest known food source of Se is the Brazil nut (Bertholletia excelsa, family Lecythidaceae), found in the Amazon region. OBJECTIVE: The objective of this work was to determine if Se plasma levels in HD patients submitted to a program of supplementation during 3 months with 1 Brazil nut by day could be sustained after 12 months. METHODS: A total of 21 HD patients (54.2 ± 15.2 years old; average time on dialysis, 82.3 ± 51.6 months; body mass index, 24.4 ± 3.8 kg/m(2)) from the RenalCor Clinic in Rio de Janeiro, Brazil, were followed up 12 months after the supplementation study ended. The Se plasma levels were determined by atomic absorption spectrophotometry with hydride generation. RESULTS: The Se Plasma levels (17.3 ± 19.9 µg/L) were below the normal range (60 to 120 µg/L) before nut supplementation, and after 3 months of supplementation, the levels increased to 106.8 ± 50.3 µg/L (P < .0001). Twelve months after supplementation, the plasma Se levels decreased to 31.9 ± 14.8 µg/L (P < .0001). CONCLUSIONS: The data showed that these patients were Se deficient and that the consumption of Brazil nut was effective to increase the Se parameters of nutritional status. Se levels 12 months after the supplementation period were not as low as presupplementation levels but yet significantly lower, and we needed to motivate patients to adopt different dietary intake patterns.

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The present investigation is the first part of an initiative to prepare a regional map of the natural abundance of selenium in various areas of Brazil, based on the analysis of bean and soil samples. Continuous-flow hydride generation electrothermal atomic absorption spectrometry (HG-ET AAS) with in situ trapping on an iridium-coated graphite tube has been chosen because of the high sensitivity and relative simplicity. The microwave-assisted acid digestion for bean and soil samples was tested for complete recovery of inorganic and organic selenium compounds (selenomethionine). The reduction of Se(VI) to Se(IV) was optimized in order to guarantee that there is no back-oxidation, which is of importance when digested samples are not analyzed immediately after the reduction step. The limits of detection and quantification of the method were 30 ng L(-1) Se and 101 ng L(-1) Se, respectively, corresponding to about 3 ng g(-1) and 10 ng g(-1), respectively, in the solid samples, considering a typical dilution factor of 100 for the digestion process. The results obtained for two certified food reference materials (CRM), soybean and rice, and for a soil and sediment CRM confirmed the validity of the investigated method. The selenium content found in a number of selected bean samples varied between 5.5±0.4 ng g(-1) and 1726±55 ng g(-1), and that in soil samples varied between 113±6.5 ng g(-1) and 1692±21 ng g(-1).

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Patients with chronic kidney disease (CKD) often have abnormal levels ofplasma minerals. Among some factors that may account for an abnormalmineral metabolism in this group is the low or high dietary intake. However,the mechanism of trace-element disturbances has not been thoroughlyestablished. The purpose of this study was to evaluate the concentrations ofeleven trace elements (As, Br, Co, Cr, Cs, Fe, Rb, Se, Th, U and Zn) in the dietof non-dialyzed CKD patients. While Fe, Co, Cr, Br, Rb, Se and Zn are elementsplaying a role in nutrition, As, Cs, Th and U are toxicologically importanttrace elements. These elements were determined using Instrumental NeutronActivation Analysis (INAA) on samples of total diets consumed by typicalnon-dialyzed CKD patients in Brazil. Each subject?s food consumption wascalculated by using an individual 24h-consumption record and the dietswere prepared according to a modified duplicate portion method based onthe analysis of 39 diet samples. In this group, Br, Co, Fe, Se and Zn intakeswere lower and there was a positive correlation with protein intake. Theintakes of toxic elements were within recommended levels. The patient?s dietspresented low concentrations of important trace elements, which can causesome alterations in the metabolism. The supplementation with a determinedtrace element may be indicated when its depletion is documented in bodycompartments, and when there is evidence of the positive effects of this elementon the life quality of CKD patients.

Pacientes con enfermedad renal crónica (ERC)pueden presentar niveles anormales deminerales. Uno de los factores que puedecontribuir para este metabolismo anómalo es ladieta. Entretanto, los mecanismos de esasanormalidades no están completamentecomprendidos. El objetivo de este estudio fueevaluar las concentraciones de once elementostrazos (As, Br, Co, Cr, Cs, Fe, Rb, Se, Th, U y Zn)en la dieta de pacientes con ERC no dializados.Los minerales como Fe, Co, Cr, Br, Rb, Se y Zndesempeñan funciones nutricionalesimportantes, al contrario de As, Cs, Th y U queson tóxicos. Esos elementos fueron determinadosen 39 muestras de dietas obtenidas del consumoalimentar de 24 horas relatado por los pacientescon ERC y el m??todo analítico utilizado fueAnálisis Instrumental por Activación deNeutrones (INAA). Las concentraciones de Br, Co,Fe, Se y Zn eran bajos y hubo correlación positivacon el consumo de proteínas. La ingestión deelementos tóxicos estaba dentro de lo permitido.La dieta de los pacientes presentó bajasconcentraciones de elementos trazos importanteslo cual podría causar alteraciones metabólicasimportantes que exigirían suplemento en casoque los niveles sanguíneos alterados fuesenconfirmados. Los elementos tóxicos no estabanen concentraciones elevadas

Pacientes com doença renal crônica (DRC)podem apresentar níveis anormais de minerais.Um dos fatores que pode contribuir para essemetabolismo anormal é a dieta. Entretanto, osmecanismos para essas anormalidades não sãocompletamente entendidos. O objetivo desseestudo foi avaliar as concentrações de onzeelementos traço (As, Br, Co, Cr, Cs, Fe, Rb, Se,Th, U e Zn) na dieta de pacientes com DRC nãodialisados. Os minerais como Fe, Co, Cr, Br, Rb,Se e Zn são elementos com importantes papéisna nutrição. Em contrapartida As, Cs, Th e Usão tóxicos. Esses elementos foram determinadosem 39 amostras de dietas obtidas do consumoalimentar de 24h relatado pelos pacientes renaiscrônicos, e o método utilizado para verificaçãodos minerais foi pela Análise Instrumental deAtivação de Nêutrons (INAA). Os níveis de Br,Co, Fe, Se e Zn foram baixos e houve correlaçãopositiva com o consumo protéico. A ingestão deelementos tóxicos estava dentro dasrecomendações. A dieta dos pacientes apresentoubaixas concentrações de importantes elementostraço, o que poderia causar algumas alteraçõesno metabolismo desses nos pacientes renais,sendo a suplementação necessária se os níveissangüíneos alterados fossem confirmados. Oselementos tóxicos não estavam em elevadasconcentrações.

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Essa revisão relata os aspectos etiológicos da resistência à insulina, bem como a participação do zinco nesse processo. O zinco participa de vias metabólicas que envolvem a síntese de proteínas, metabolismo de carboidratos, de lipídeos e de ácidos nucléicos. Esse mineral tem sido relacionado com a interação entre hormônios e seus receptores, e com melhoras no estímulo pós-receptor. Estudos in vitro apontam que a insulina pode se ligar com o zinco, melhorando a solubilidade deste hormônio nas células beta do pâncreas, e, ainda, pode aumentar a capacidade de ligação da insulina ao seu receptor. Na obesidade e resistência à insulina, têm sido detectadas alterações na concentração e na distribuição de zinco nos tecidos, bem como melhora da sensibilidade à insulina após a suplementação com esse mineral. Portanto, o papel metabólico do zinco na síndrome de resistência insulínica deve ser mais pesquisado, tendo em vista que esse mineral pode contribuir no controle das alterações metabólicas comumente presentes em pacientes obesos.

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This review reports the etiological aspects of insulin resistance as well as the participation of zinc in this process. Zinc participates in the metabolic pathways involving protein synthesis, and the metabolism of carbohydrate, lipid and nucleic acid. This element has been associated with the interaction between hormones and their receptors and to the improvement in the post-receptor stimulus. In vitro studies show that insulin may form a complex with zinc improving the solubility of this hormone in the pancreatic beta cells and also increasing the binding ability of insulin to its receptor. Regarding obesity and insulin resistance, alterations in zinc concentration and distribution in tissues, as well as improvement in sensitivity to insulin after supplementation with this element, have been detected. Thus, the metabolic role of zinc in the insulin resistance syndrome should be further investigated having in mind that this element may contribute to the control of the usual metabolic alterations present in obese patients.

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OBJECTIVE: The aim of the present study was to determine the erythrocyte CAI and CAII concentrations in nondialyzed chronic kidney disease patients, and observe the relationship with acidosis, zinc, anemia, and iron supplementation. METHODS: Erythrocyte CA concentrations were measured in nondialyzed patients (n = 38) using enzyme-linked immunosorbent assays (ELISA). The zinc concentration was determined by atomic absorption spectrophotometer. RESULTS AND CONCLUSIONS: The CA levels were observed to be increased in the patients. The mean erythrocyte zinc concentration was also high and the levels of zinc in plasma were baseline values. Correlation was found between CAI and erythrocytes Zn (r = 0.46; P = 0.003), but there was no correlation with ferritin or pH and bicarbonate. The CA levels did not change after iron supplementation, but the zinc erythrocyte levels were reduced. It is concluded that the CA erythrocyte concentration in CKD patients is increased but this cannot be explained by iron deficiency or acidosis.

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OBJECTIVE: The purpose of this study was to assess the zinc and iron status in patients with chronic renal failure (CRF) who were not receiving dialysis. DESIGN: Cross-sectional study. SETTING: Outclinic patients of the Nephrology Division at Federal University of São Paulo. PATIENTS: This study was performed on 29 stable patients with CRF who were not receiving dialysis. MAIN OUTCOME MEASURE: The parameters for determining iron and zinc status were transferrin saturation, zinc protoporphyrin, serum ferritin, hematocrit, serum iron, total iron binding capacity, erythrocyte, and plasma zinc levels (measured by atomic absorption spectrophotometry). RESULTS: The serum ferritin level was reduced to 85.5 +/- 67.1 ng/mL and the zinc protoporphyrin level was high (68 +/- 32.9 micromol/mol heme), serum transferrin saturation was 19.9% +/- 7.85%, mean serum iron level was 66.6 +/- 26.3 microg/dL, and mean total iron binding capacity was 336 +/- 45.7 microg/dL. Absolute iron deficiency was found in 34.5% of the patients. Zinc level in erythrocytes was high (50.0 +/- 7.2 microg/g hemoglobin), whereas plasma zinc was at a borderline level (74 +/- 17.7 microg/dL) when compared with normal values. There were significant correlations among plasma zinc and serum iron and transferrin saturation, zinc erythrocyte, and parameters of iron. CONCLUSION: These results show that absolute iron deficiency can occur in patients who are not receiving dialysis and that there is an abnormal distribution of zinc levels in these patients. Moreover, a possible relationship between iron deficiency and zinc distribution was observed.

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