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Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient.

OBJECTIVE: Critical illness is associated with the generation of oxygen free radicals and low endogenous antioxidant capacity leading to a condition of oxidative stress. We investigated whether supplementing critically ill patients with antioxidants, trace elements, and vitamins improves their survival. METHODS: We searched four bibliographic databases from 1980 to 2003 and included studies that were randomized, reported clinically important endpoints in critically ill patients, and compared various trace elements and vitamins to placebo. RESULTS: Eleven articles met the inclusion criteria. When the results of all the trials were aggregated, overall antioxidants were associated with a significant reduction in mortality [Risk Ratio (RR) 0.65, 95% confidence intervals (CI) 0.44-0.97, p=0.03] but had no effect on infectious complications. Studies that utilized a single trace element were associated with a significant reduction in mortality [RR 0.52, 95% CI 0.27-0.98, p=0.04] whereas combined antioxidants had no effect. Studies using parenteral antioxidants were associated with a significant reduction in mortality [RR 0.56, 95% CI 0.34-0,92, p=0.02] whereas studies of enteral antioxidants were not. Selenium supplementation (alone and in combination with other antioxidants) may be associated with a reduction in mortality [RR 0.59, 95% CI 0.32-1.08, p=0.09] while nonselenium antioxidants had no effect on mortality. CONCLUSIONS: Trace elements and vitamins that support antioxidant function, particularly high-dose parenteral selenium either alone or in combination with other antioxidants, are safe and may be associated with a reduction in mortality in critically ill patients.

Antioxidants↗

Uptake of trace elements and PAHs by fruit and vegetables from contaminated soils.

The aims of this study were to investigate the uptake of seven trace elements and five PAHs in crop plants in order to establish advice regarding consumption of fruit and vegetables grown in soils contaminated by trace elements and PAHs. In a field experiment, vegetables were grown in two contaminated soils and in a reference soil, whereas fruits were collected from uncontaminated and contaminated private gardens. The results showed elevated levels of several trace elements and PAHs in the vegetables from contaminated soil. Bioconcentration factors (BCF values), based on dry weight, were below 1, except for those of Cd in lettuce and carrot with peel from uncontaminated soil. In most cases, BCF values were decreasing with increasing concentrations in soil. From the heavily contaminated soil, BCF values for Pb in lettuce, potato, and carrot with peel were 0.001, 0.002, and 0.05, respectively, and those for benzo[a]pyrene were 0.004, 0.002, and 0.002, respectively. For most metals in most vegetables, linear regression showed good correlation between soil and crop concentrations. For PAHs, such good correlation was generally not found. The contents of contaminants in fruits were generally low and no correlation with the level of contamination in the soils was found.

Biological Availability↗

Dietary intake of essential minor and trace elements from Asian diets.

In view of the limited data available from the Asian region on the daily intake of nutritionally essential trace elements, a study was taken up, as part of a coordinated research project of the International Atomic Energy Agency, to estimate the daily dietary intake and organ content of some selected trace elements of importance in radiation protection, and also in nutrition. Nine Asian countries--Bangladesh, China, India, Indonesia, Japan, South Korea, Pakistan, Philippines, and Vietnam--which represented more than 50% of the world's population, participated in this study. Analysis of about 700 diet samples was carried out for four minor (calcium, potassium, magnesium, and sodium) and eight trace (chromium, cobalt, copper, iron, iodine, manganese, selenium, and zinc) elements using nuclear and other sensitive analytical methods employing neutron activation analysis (NAA), inductively coupled plasma mass spectrometry (ICP-MS), inductively coupled plasma atomic emission spectrometry (ICP-AES), and atomic absorption spectrometry (AAS) techniques. These samples consisted of the total cooked diet, market basket, duplicate diets, and 225 staple foods. Emphasis was placed on the quality assurance and harmonization of the sampling techniques to ensure quality data. Significant inter- and intra-country variations in daily dietary intake of various trace elements were observed. The maximum inter-country variation was observed for iodine intake (factor of more than 45), being highest for Japan and lowest for Pakistan. For iron, an important trace element, the variation between the intakes was by a factor of four being lowest for Vietnam and highest for Pakistan.

Adult↗

Effect of feeding a mineral-vitamin supplement before calving on the calving performance of a trace element deficient dairy herd.

A split-herd, randomised mineral-vitamin supplementation experiment was carried out in a large, trace element deficient dairy herd over two years. Ten weeks before the herd's mean calving date, 147 Holstein-Friesian cows were fed grass silage on to which 50 g per head of a mineral-vitamin supplement (3000 mg copper, 500 mg iodine, 45 mg selenium and 80 mg cobalt per kg of supplement as specified) was sprinkled twice daily and 147 cows were fed the silage alone until calving. The supplement had no effect on the incidence of abortion (1.4 per cent), dystocia (2.3 per cent), fetal maldisposition (7.3 per cent), perinatal mortality (6.0 per cent) or retained fetal membranes (4.0 per cent), but it significantly increased the concentrations of trace elements in the blood and tissues of dead perinatal calves from 10 supplemented dams compared with those from eight unsupplemented dams. It also significantly increased the concentrations of trace elements in the blood of the cows and newborn calves in the supplemented group.

Animal Feed↗

Trace elements incorporated into the culture medium of Mycobacterium tuberculosis promote the presence of tuberculoprotein C in the preparation of purified protein derivatives.

Two purified protein derivatives (PPDs) were prepared from Mycobacterium tuberculosis, H37Ra. One of the PPDs was prepared from the culture filtrate of organisms grown on Proskauer-Beck medium to which trace elements had been added. The other PPD was prepared from the culture filtrate of organisms grown on the same medium but without trace elements, and was used as the control. Comparative skin reactions in sensitized rabbits showed that the PPD prepared from organisms grown in the presence of trace elements was less potent than the control. Since it has long been recognized that of the many tuberculoproteins present in PPD, the C protein (a 44 to 66 kDa protein) was always the least potent fraction when tested in equivalent concentrations in both serological and skin test assays, the possibility existed that the PPD obtained from organisms grown in trace element medium had more of the C protein complex than the control. Comparative studies of these two PPDs in terms of their chemical composition, skin test responses, and electrophoretic profiles obtained by SDS-polyacrylamide gel electrophoresis provide support for this assumption.

Animals↗

Trace element concentrations and bioindicator responses in tree swallows from northwestern Minnesota.

Extremely high concentrations of cadmium (3.5 microg/g dry wgt.) and elevated concentrations of chromium (>10 microg/g dry wgt.) and mercury (1.6 microg/g dry wgt.) were reported in waterbird tissues at Agassiz National Wildlife Refuge in northwestern Minnesota in 1994. Tree swallows (Tachycineta bicolor) were studied during 1998-2001 at three drainages into the Refuge, two pools on the Refuge, and at a nearby reference location to document whether high levels of contaminants were still present, and if so to quantify the source and severity of the contamination. Trace elements were measured in tree swallow eggs, livers, and diet. Reproductive success and bioindicator responses were monitored. In 2000, water was drawn down on Agassiz Pool, one of the main pools on the Refuge. This presented an opportunity to evaluate the response of trace element concentrations in the diet and tissues of tree swallows after reflooding. High concentrations of trace elements were not detected in swallow tissues, nor were there differences among locations. Less than 20% of swallow samples had detectable concentrations of cadmium or chromium. Mercury concentrations were low and averaged <0.25 microg/g dry wgt. in swallow tissues. Trace elements, including mercury, did not increase in tree swallows following the 2000 drawdown at Agassiz Pool. Hatching success and survival of nestlings to 12 days-of-age for tree swallows on the Refuge were similar to the national average and consistent with background trace element concentrations. Bioindicator measurements were within the normal ranges as well.

Animals↗

[Trace elements of bone tumors].

Due to activation analysis involving the use of neutrons from a nuclear reactor, the concentrations of 11 trace elements: scandium, iron, cobalt, mercury, rubidium, selenium, silver, antimony, chrome, zinc and terbium in intact bone and skeletal tumors were measured. 76 specimens of bioptates and resected material of operations for bone tumors and 10 specimens of normal bone tissue obtained in autopsies of cases of sudden death were examined. The concentrations of trace elements and their dispersion patterns in tumor tissue were found to be significantly higher than those in normal bone tissue. Also, the concentrations of some trace elements in tumor differed significantly from those in normal tissue; moreover, they were found to depend on the type and histogenesis of the neoplasm.

Adolescent↗

[Assay of trace elements and heavy metals in different growth stages of Ganoderma lucidum].

The trace elements and heavy metals in the different growth stages of Ganoderma lucidum were analyzed by ICP-MS, AFS and AAS. The fermented mycelia, fruiting bodies and spore contained all kinds of detected trace elements and heavy metals, the contents of which were higher in spore. The content of Se was same in different growth stages. Ganoderma lucidum had the ability of bio-enrichment of Ge.

Fruit↗

Kinetics and effects of trace elements and electron complexes on 2-keto-4-methylthiobutyric acid-dependent biosynthesis of ethylene in soil.

AIMS: 2-Keto-4-methylthiobutyric acid (KMBA) is an established intermediate in microbial biosynthesis of ethylene from methionine. This study demonstrates the kinetics and effects of trace elements and electron complexes on substrate (KMBA)-derived C2H4 biosynthesis in soil. METHODS AND RESULTS: We have previously reported KMBA-dependent C2H4 production in soil. We studied the kinetics and effects of various trace elements and electron complexes on KMBA-derived C2H4 biosynthesis in soil by gas chromatography. Kinetic analysis revealed that ethylene forming enzyme (EFE) reaction was linear (R2 = 0.9448) when velocity of reaction (V) was plotted against substrate [S] over the range from 2.5 to 10 mmol l(-1) and thus followed a first order reaction. Application of three linear transformations of the Michaelis-Menten equation indicated high affinity of EFE for the substrate because Km values ranged between 5.4 and 6.67 mmol l(-1) and Vmax of reaction was between 22.4 and 35.7 nmol kg(-1) soil 120 cm(-1). Most of the trace elements exhibited positive effects on KMBA-dependent C2H4 production in soil. Maximum stimulatory effect on C2H4 biosynthesis was observed in response to Co(II) application, while Fe(III) inhibited the biotransformation of KMBA into C2H4. Contrarily, most of the tested electron complexes inhibited KMBA-derived C2H4 biosynthesis in the soil. However, lower concentrations (1.0 mmol l(-1)) of mannitol and hydroquinone were stimulatory to C2H4 production in soil compared with controls (substrate only). CONCLUSIONS: The results revealed that both kind and concentration of trace elements and electron complexes affected the substrate-dependent production of C2H4 in soil with different degrees of efficacy. SIGNIFICANCE AND IMPACT OF THE STUDY: The C2H4 in the root environment could be physiologically active even at low concentrations, so knowledge regarding various factors which regulate C2H4 biosynthesis in soil could be of significance for plant growth and development.

Edetic Acid↗

Trace elements and inflammatory response: implications for nutritional support.

The acute-phase response to injury or infection is associated with alteration in dynamics of many trace elements, particularly iron, zinc and copper. The fall in serum iron and zinc, and rise in serum copper, are brought about by changes in the concentration of specific tissue proteins controlled by cytokines, especially interleukin 1, tumor necrosis factor, and interleukin 6. These are generally believed to be beneficial aspects of the early acute phase response. One difficulty associated with these changes is that assessment of status for these elements is particularly difficult, since plasma concentration may bear little relationship to tissue status. Simultaneous assessment of the acute-phase response, for example, serum C-reactive protein, together with trace elements and monitoring changes in concentrations, may, however, permit interpretation of trace element requirements. Suggestions are made for the requirements for these and other essential elements during enteral or intravenous nutrition, together with proposed methods of interpreting laboratory tests.

Acute Disease↗

Impact on crops, plants and soils of metal trace elements transfer and flux, after spreading of fertilizers and biosolids.

In France, the yearly production of sludge from wastewater treatment plants is 900,000 metric tons dry matter and 60% of this is reused for land application. Today, the sustainability of this pathway is open to question. Among the different arguments cited are the levels of metal trace elements and the risks of accumulation in soils. With the ultimate aim of agronomic sludge recycling, the transfer of metal trace elements has been studied using vegetation containers planted with rye-grass under controlled conditions of temperature and humidity. Samples of a domestic sludge, an industrial sludge and a fertilizer have been mixed with the soil. By monitoring the growth of the rye-grass, we have been able to observe that the addition of sludge increases production of plant matter. It appears that the roots absorb higher quantities of metal trace elements and form a barrier to their transfer to the above ground parts of the rye-grass. For the group of metal trace elements studied, no significant differences have been observed between the rye-grass grown on soil alone and that on soils amended with fertilizer or urban sludge. For the majority of the vegetation containers studied, there has been no significant modification in the soil metal distribution over time, as a result of the addition of urban sludge, and no significant difference between fertilizers and sludges.

Biological Availability↗

[Relationship of serum trace elements to lung cancer and its clinical application].

The levels of serum trace elements Cu, Zn, Fe, Mn and Ca were measured by PE3030 atomic absorption spectrophotometer in 300 patients with lung cancer, 50 with nonmalignant pulmonary diseases and 100 healthy subjects. In addition, these trace elements were also measured in 60 cases with lung cancer (40 remitted, 20 non-remitted) before and after treatment. Results showed that the concentrations of serum Cu, Mn and Cu/Zn ratio were significantly higher (P < 0.01) but Zn, Ca were significantly lower (P < 0.05-0.01) in lung cancer and nonmalignant pulmonary diseases than in healthy controls. Within the three groups there has no difference among profession, area and age discovered. In the remitted patients with lung cancer, the levels of serum Cu and Cu/Zn ratio were significantly lower (P < 0.01) but Zn, Ca were significantly higher (P < 0.01) after treatment. In the non-remitted group, only Cu/Zn ratio was significantly higher (P < 0.01) after treatment. Multivariable logistic regression analysis showed that the Odds Ratio (OR) of serum Ca was 0.9950 with 95% Confidence interval (CI) 0.9910-0.9990, and the OR of Cu/Zn was 7.9914 with 95% CI 3.4310-18.6134. It was suggested that Ca might play a protective vole while Cu/Zn ratio a risk factor for lung cancer. Results also showed that if the threshold of Cu/Zn ratio set at 1.10 in the healthy control group, the positive rate of Cu/Zn ratio was 68% which might be important in diagnosis and to assessing the prognosis of lung cancer.

Adult↗

[Vitamins and trace elements in the elderly (author's transl)].

A review of published research data on the requirement, intake, and signs of deficiency of vitamins and trace elements in old age is presented. It particularly deals with the problem of a general indication for vitamins and trace element supplements - the mean components of geriatric preparations. Special emphasis is laid on the question if these substances exhibit a specific effect on the alterations of physical and psychic capacity typically accompanying the growing old. It could be shown that in several groups of the elderly diminished vitamin levels are common and/or vitamin and trace element intake does not reach daily recommended allowances. But it still remains unclear if these findings have to be considered as disease symptoms.

Aged↗

[Relations between trace elements in drinking water and elderly residents' cognitive function].

The relationship between trace element levels in drinking water and cognitive function was studied for elderly residents in rural areas in China. Cognitive function was measured by a Chinese translation of the Community Screening Interview for Dementia (CSI "D"). The trace elements fluoride, calcium, selenium, aluminum, iron, zinc, cadmium, lead and arsenic contents of drinking water were determined using Chinese. National Standard Methods. A mixed effects model was used to evaluate the effect of each of the elements on cognitive function while adjusting for age, sex, and education level. Several of the elements examined had a significant effect on cognitive function when they were examined in a univariate context. However, after adjusting for other elements many of these results were not significant. There was a significant quadratic effect for calcium and a significant zinc-cadmium interaction. Cognitive function increased with calcium level to a certain point, and then decreased as calcium continued to increase. Zinc showed a positive relationship with cognitive function at low cadmium levels, but a negative relationship at high cadmium levels.

Aged↗

Trace elements and chronic liver diseases.

The relationships between chronic liver diseases and trace element (TE) contents are debated. Particularly, no defined data are available about the TE levels in viral liver disease patients with or without malnutrition. In this study we evaluated blood and plasma levels of various trace elements in patients with HCV-related chronic liver disease, at different stages of liver damage (8 patients with chronic hepatitis and 32 with liver cirrhosis) with or without malnutrition. We also studied 10 healthy volunteers as control group. We found that cirrhotic subjects had a significant decrease of blood levels of Zn and Se, independently on the nutritional status, whereas plasma levels of Fe were significantly reduced only in malnourished cirrhotic patients. Our data indicate that liver impairment is the main cause of the blood decrease of Se and Zn levels in patients with non alcoholic liver disease, whereas the malnutrition affects Fe levels only.

Adolescent↗

Regional brain trace-element studies in Alzheimer's disease.

Alzheimer's disease (AD) brain trace-element imbalances in the amygdala, hippocampus and nucleus basalis of Meynert (nbM) are found in most cases to be consistent with those previously reported in samples derived principally from AD cerebral cortex (Ehmann et al., 1986). The elevation of mercury in AD nbM, as compared to age-matched controls, is the largest trace-element imbalance observed to date in AD brain. In addition to the general confirmation of imbalances for Cs, Hg, N, Na, P, and Rb noted previously in cerebral cortex samples, imbalances for Fe, K, Sc, and Zn were observed in two regions and one region also exhibited imbalances for both Co and Se. Persistent imbalances for the univalent cations Na, K, Rb and Cs support arguments for a membrane abnormality in AD. The data presented here also provide the first comprehensive simultaneous multi-element determinations in both control and AD nbM.

Alzheimer Disease↗

Effects of thiuram, disulfiram and a trace element mixture on the incidence of tibial dyschondroplasia in chickens.

Two experiments were conducted to determine the effect of dietary addition of 30 ppm of thiuram or disulfiram on the development of tibial dyschondroplasia (a large mass of cartilage in the proximal end of the tibia) in chicks in the presence and absence of trace element supplementation: B, Ni, Al, Sr, Br, V, Si, Sn, Cr, F, Mo, Li, Mn, Zn, Fe, Cu and I. In two experiments, the incidence and severity of tibial dyschondroplasia were lower in chicks fed the diet containing the trace element supplement than in those fed the basal diet. Adding thiuram or disulfiram to the diet caused a significantly higher incidence and severity of tibial dyschondroplasia in chicks regardless of the presence or absence of the trace element supplement. In a third experiment not involving thiuram or disulfiram the addition of trace elements had no significant effect on tibial dyschondroplasia. Adding thiuram or disulfiram to the diet in a fourth experiment lowered the absorption of 47Ca from the gastrointestinal tract but did not influence the biological half-life of 47Ca in the chick.

Absorption↗

Prediction of trace element mobility in contaminated soils by sequential extraction.

The modified three-step sequential extraction procedure proposed by the Community Bureau of Reference (or Bureau Communautaire de Reference, BCR) was used to predict trace element mobility in soils affected by an accidental spill comprising arsenopyrite- and heavy metal-enriched sludge particles and acid waste waters. The procedure was used to obtain the distribution of both the major (Al, Ca, Fe, Mg, and Mn) and trace elements (As, Bi, Cd, Cu, Pb, Tl, and Zn) in 13 soils of contrasting properties with various levels of contamination and in the sludge itself. The distributions of the major elements enabled us to confirm the main soil fractions solubilized in each of the three steps, and, in turn, to detect the presence of pyritic sludge particles by the high Fe extractability obtained in the third step. Cadmium was identified as being the most mobile of the elements, having the highest extractability in the first step, followed by Zn and Cu, Lead, Tl, Bi, and As were shown to be poorly mobile or nonmobile. In the case of some of the trace elements, the residual fractions decreased at higher levels of contamination, which was attributed to the anthropogenic contributions to the polluted samples. Comparison with soil-plant transfer factors, calculated in plants growing in the affected area, indicated that a relative sequence of trace element mobility was well predicted from data of the first step.

Accidents↗