营养性锌缺乏症在发展中地区广泛流行是由以下两个原因共同引起的:锌摄入不足;摄入过多限制锌吸收的物质,如肌醇六磷酸、草酸盐,有些病例中还有泥土。吃泥土或“异食癖”在某些社区的儿童中很常见。泥土可以有效地与锌结合,导致锌的生物利用度大幅下降。据估计,发展中国家约有 20 亿人患有不同程度的锌缺乏症。儿童与老年人危险更高。[22]Oldewage-Theron WH, Samuel FO, Venter CS. Zinc deficiency among the elderly attending a care centre in Sharpeville, South Africa. J Hum Nutr Diet. 2008;21:566-574.http://www.ncbi.nlm.nih.gov/pubmed/19017101?tool=bestpractice.com[23]Fischer Walker C, Black RE. Zinc and the risk for infectious disease. Annu Rev Nutr. 2004;24:255-275.http://www.ncbi.nlm.nih.gov/pubmed/15189121?tool=bestpractice.com[24]Schneider JM, Fujii ML, Lamp CL, et al. The prevalence of low serum zinc and copper levels and dietary habits associated with serum zinc and copper in 12- to 36-month-old children from low-income families at risk for iron deficiency. J Am Diet Assoc. 2007;107:1924-1929.http://www.ncbi.nlm.nih.gov/pubmed/17964312?tool=bestpractice.com
美国和其他发达国家的锌缺乏症患病率较不清楚。由于大量摄入肉类和强化谷物,锌缺乏症在健康的青少年和成人中较为少见。然而,已有记录表明美国的许多亚群中高发锌缺乏症,包括:营养不良的婴儿、[20]Hambidge KM, Krebs NF. Zinc deficiency: a special challenge. J Nutr. 2007;137:1101-1105.http://jn.nutrition.org/content/137/4/1101.fullhttp://www.ncbi.nlm.nih.gov/pubmed/17374687?tool=bestpractice.com慢性肠胃疾病患者、[1]Singhal N, Alam S, Sherwani R, et al. Serum zinc levels in celiac disease. Indian Pediatr. 2008;45:319-321.http://www.ncbi.nlm.nih.gov/pubmed/18451454?tool=bestpractice.com[4]Goh J, O'Morain CA. Review article: nutrition and adult inflammatory bowel disease. Aliment Pharmacol Ther. 2003;17:307-320.http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2003.01482.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/12562443?tool=bestpractice.com[5]Ojuawo A, Keith L. The serum concentrations of zinc, copper and selenium in children with inflammatory bowel disease. Cent Afr J Med. 2002;48:116-119.http://www.ncbi.nlm.nih.gov/pubmed/14562534?tool=bestpractice.com肝病、[6]Narkewicz MR, Krebs N, Karrer F, et al. Correction of hypozincemia following liver transplantation in children is associated with reduced urinary zinc loss. Hepatology. 1999;29:830-833.http://www.ncbi.nlm.nih.gov/pubmed/10051486?tool=bestpractice.com[7]Stamoulis I, Kouraklis G, Theocharis S. Zinc and the liver: an active interaction. Dig Dis Sci. 2007;52:1595-1612.http://www.ncbi.nlm.nih.gov/pubmed/17415640?tool=bestpractice.com糖尿病、[8]Chausmer AB. Zinc, insulin and diabetes. J Am Coll Nutr. 1998;17:109-115.http://www.ncbi.nlm.nih.gov/pubmed/9550453?tool=bestpractice.com[9]Zheng Y, Li XK, Wang Y, et al. The role of zinc, copper and iron in the pathogenesis of diabetes and diabetic complications: therapeutic effects by chelators. Hemoglobin. 2008;32:135-145.http://www.ncbi.nlm.nih.gov/pubmed/18274991?tool=bestpractice.com镰状细胞病、[14]Prasad AS. Zinc deficiency in patients with sickle cell disease. Am J Clin Nutr. 2002;75:181-182.http://ajcn.nutrition.org/content/75/2/181.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11815307?tool=bestpractice.com[11]Bao B, Prasad AS, Beck FW, et al. Zinc supplementation decreases oxidative stress, incidence of infection, and generation of inflammatory cytokines in sickle cell disease patients. Transl Res. 2008;152:67-80.http://www.ncbi.nlm.nih.gov/pubmed/18674741?tool=bestpractice.com肾脏疾病、[17]Perrone L, Gialanella G, Giordano V, et al. Impaired zinc metabolic status in children affected by idiopathic nephrotic syndrome. Eur J Pediatr. 1990;149:438-440.http://www.ncbi.nlm.nih.gov/pubmed/2332016?tool=bestpractice.com[12]Kalantar-Zadeh K, Kopple JD. Trace elements and vitamins in maintenance dialysis patients. Adv Ren Replace Ther. 2003;10:170-182.http://www.ncbi.nlm.nih.gov/pubmed/14708071?tool=bestpractice.com[13]Mahajan SK. Zinc in kidney disease. J Am Coll Nutr. 1989;8:296-304.http://www.ncbi.nlm.nih.gov/pubmed/2674256?tool=bestpractice.com酗酒者、[18]Kang YJ, Zhou Z. Zinc prevention and treatment of alcoholic liver disease. Mol Aspects Med. 2005;26:391-404.http://www.ncbi.nlm.nih.gov/pubmed/16099027?tool=bestpractice.com[19]Rico H. Alcohol and bone disease. Alcohol Alcohol. 1990;25:345-352.http://www.ncbi.nlm.nih.gov/pubmed/2222569?tool=bestpractice.com艾滋病患者[15]Koch J, Neal EA, Schlott MJ, et al. Zinc levels and infections in hospitalized patients with AIDS. Nutrition. 1996;12:515-518.http://www.ncbi.nlm.nih.gov/pubmed/8878145?tool=bestpractice.com[16]Kupka R, Fawzi W. Zinc nutrition and HIV infection. Nutr Rev. 2002;60:69-79.http://www.ncbi.nlm.nih.gov/pubmed/11908743?tool=bestpractice.com、老年人。[25]Meunier N, O'Connor JM, Maiani G, et al. Importance of zinc in the elderly: the ZENITH study. Eur J Clin Nutr. 2005;59(Suppl 2):S1-S4.http://www.ncbi.nlm.nih.gov/pubmed/16254574?tool=bestpractice.com[26]Prasad AS, Beck FW, Bao B, et al. Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress. Am J Clin Nutr. 2007;85:837-844.http://ajcn.nutrition.org/content/85/3/837.fullhttp://www.ncbi.nlm.nih.gov/pubmed/17344507?tool=bestpractice.com
肠病性肢端皮炎较为罕见,在全世界的发病率小于 50 万分之一。[27]Ackland ML, Michalczyk A. Zinc deficiency and its inherited disorders - a review. Genes Nutr. 2006;1:41-49.http://www.ncbi.nlm.nih.gov/pubmed/18850219?tool=bestpractice.com