TRACE MINERAL BALANCE IN ACUTE DIARRHEA OF INFANTS - ASSOCIATION TO ETIOLOGIC AGENTS AND LACTOSE CONTENT OF FORMULA

We studied zinc and copper losses during dehydrating acute diarrhea re quiring hospitalization, in relation to etiological agents and lactose content of formula, in previously healthy infants. We analyzed 39 mal e infants, 2-10 mo of age, infected with rotavirus(Rt, n=21) or entero pathogenic E.coli (EPEC, n=18). Metabolic balance studies were carried out during the initial 48 h (Period 1) and on days 6 and 7 after admi ssion (Period 2). Ail patients were offered oral rehydration solution (Na 90 mEq/L); refeeding began within 4 h of admission. The infants we re randomly assigned to a cow's milk based formula (F I) or to the sam e formula with previous lactose digestion (F I). Fecal Zn losses were greater than intake and Zn balance was not significantly different in Rt and EPEC infected infants fed any formula, during PI; apparent mean zinc absorption was over 76% in all the groups during P 2. Zn retenti ons were, during P1: Rt, FI -53+/- 39.2, Rt, F II -43+/- 42.1; EPEC, F I -27+/- 21.6, and EPEC, F II -39+/- 56.5 mu g/kg/d. Fecal Cu losses decreased from P1 to P2 (p<0.01). Cu retentions remained negative duri ng P 1 and P2. No differences attributable to the diarrheal agents wer e observed in plasma Zn and Cu levels, but plasma Zn increased from P 1 to P 2 among infants infected with rotavirus and fed lactose formula We conclude that the considerable Zn and Cu losses for infants with a cute diarrhea due to rotavirus and treated with ORS solution and early refeeding, are not different from those of infants infected with ente ropathogenic E.coli and treated similarly. Copper balances remain nega tive during recovery from diarrhea. The lactose content of the formula influences plasma zinc and plasma copper levels of infants with acute diarrhea due to rotavirus. (C) 1998 Elsevier Science Inc.