Nutritional assessment and serum zinc and copper concentration in children with malignancy

الملخص EN

Background: malnutrition in childhood cancer is a common, serious problem.

Cancer patients usually have inadequate energy and protein intakes, increased metabolic rate and metabolic abnormalities which are exacerbated by multimodal therapy for malignant diseases including surgery, chemotherapy and radiation therapy.

Aims : to assess nutritional status, serum zinc and copper concentrations in children suffering from cancer, and their relation to the stage of illness and chemotherapy.

Methods : Twenty children with cancer were studied at diagnosis and 3 months after therapy.

Twenty normal matched children were involved as a control group.

Each individual was subjected to thorough clinical examination and anthropometric measurements including Body mass index (BMI) and mid arm Circumferences (MAC).Serum levels of zinc and copper were assessed by atomic absorption spectrophotometer.

Results : the body weight and BMI were significantly lower in the patients groups both at diagnosis and 3 months after therapy compared to the control group without significant difference regarding height or MAC.

Children below 5th percentile for the body weight and BMI were more frequent 3 months after therapy.

According to Welcome classification, at diagnosis 30% (6 out of 20 children )were underweight this percentage increased significantly 3 months after chemotherapy to be 45% (9 out of 20 children) and each patients' groups had significant higher prevalence of under nutrition compared to the controls (10%) .

According to Water low classification, each of patients' groups had significant higher prevalence of under nutrition (25% at diagnosis &30% 3 months after therapy) compared to the controls (0%).

Serum zinc concentration in children with malignancy was significantly lower than that of the control group and significantly increased after 3 months of therapy while serum copper concentration and Copper / zinc ratio (CZR) were significantly higher than that of the control group and significantly decreased after 3 months of therapy.

Conclusions : malnutrition is one of the major problems in cancer patients, and become advanced with therapy unless good nutritional support is delivered .Serum zinc level is higher, serum copper level and copper / zinc ratio (CZR) are lower in children with malignancy compared to healthy controls .With treatment and remission ,serum zinc increases while serum copper and CZR become decreased.