SERUM ZINC AND PROTEIN-LEVELS - LACK OF A CORRELATION IN HOSPITALIZED-PATIENTS WITH AIDS

Abnormally low serum zinc levels are associated with advanced states o f malnutrition. Zinc levels are thought to parallel serum albumin, and repletion of zinc has reportedly led to increased albumin. We examine d the correlation between zinc deficiency and serum proteins in hospit alized patients with AIDS. Over 500 inpatient consultations were perfo rmed by our Gastroenterology-Nutrition Consult Service from May 1992 t o June 1994. We reviewed the medical records from all 228 AIDS patient s in whom a serum zinc level was measured (by atomic absorption spectr ophotometry). The correlation between serum zinc, albumin, prealbumin, and transferrin drawn on the same hospital day was analyzed by linear regression. The patients were stratified by the level of albumin, gro up A albumin < 2.0 g/dL, group B albumin 2.0-2.9 g/dL, and group C alb umin > 3.0 g/dL, to allow comparison of the incidence of diarrhea and mean zinc level by chi square. Thirty-four patients had more than one serum zinc and albumin determination; the change over time was compare d by linear regression. Serum zinc and albumin, prealbumin, and transf errin levels did not correlate strongly (r(2) less than or equal to 0. 01). Furthermore, changes in zinc over time did not correlate with par allel changes in serum albumin (r(2) less than or equal to 0.01). In p atients grouped by albumin, the proportion of patients with diarrhea d id not differ significantly. The mean zinc levels were also not statis tically significantly different. Serum zinc levels do not strongly cor relate with serum proteins in hospitalized patients with AIDS. Serial measures of zinc over time also do not correlate strongly with changes in albumin. The incidence of diarrhea was not significantly different in patients with hypoalbuminemia or hypozincemia when compared with p atients with near normal albumin or zinc. The relationship between zin c and serum proteins in AIDS patients is not linear. Zinc deficiency s hould be assessed in patients independent of the serum albumin.