zink (LH Indholdsside)

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    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Definition</h2>
<ul>
    <li>
    Totalkoncentration af&nbsp;Zn i plasma, m&aring;lt i &micro;mol/L</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>Zn, Zink-ion, Zn<sup>2+</sup></li>
</ul>
<h2>Indikationer<a href=" " data-type="journal-reference" data-value="Stiles LI, Ferrao K, Mehta KJ, Role of zinc in health and disease. Clin Exp Med 2024;24: 38" data-value-piped="Stiles LI, Ferrao K, Mehta KJ|Role of zinc in health and disease.|Clin Exp Med|2024|24|38|38367035" data-url="reference-link" data-pubmedid="38367035" title="Stiles LI, Ferrao K, Mehta KJ, Role of zinc in health and disease. Clin Exp Med 2024;24: 38"><sup>1</sup></a></h2>
<h3>Mistanke om zinkmangel</h3>
<ul>
    <li>Personer med d&aring;rlige eller s&aelig;rpr&aelig;gede kostvaner, eller malnutrition. Marginal zinkmangel kan ses blandt &aelig;ldre, veganere/vegetarer, personer med kronisk sygdom<a href=" " data-type="journal-reference" data-value="Wang T, Masedunskas A, Willett WC, Fontana L, Vegetarian and vegan diets: benefits and drawbacks. Eur Heart J 2023;44: 3423-3439" data-value-piped="Wang T, Masedunskas A, Willett WC, Fontana L|Vegetarian and vegan diets: benefits and drawbacks.|Eur Heart J|2023|44|3423-3439|37450568" data-url="reference-link" data-pubmedid="37450568" title="Wang T, Masedunskas A, Willett WC, Fontana L, Vegetarian and vegan diets: benefits and drawbacks. Eur Heart J 2023;44: 3423-3439"><sup>2</sup></a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Bakaloudi DR, Halloran A, Rippin HL, Oikonomidou AC, Dardavesis TI, Williams J, Wickramasinghe K, Breda J, Chourdakis M, Intake and adequacy of the vegan diet. A systematic review of the evidence. Clin Nutr 2021;40: 3503-3521" data-value-piped="Bakaloudi DR, Halloran A, Rippin HL, Oikonomidou AC, Dardavesis TI, Williams J, Wickramasinghe K, Breda J, Chourdakis M|Intake and adequacy of the vegan diet. A systematic review of the evidence.|Clin Nutr|2021|40|3503-3521|33341313" data-url="reference-link" data-pubmedid="33341313" title="Bakaloudi DR, Halloran A, Rippin HL, Oikonomidou AC, Dardavesis TI, Williams J, Wickramasinghe K, Breda J, Chourdakis M, Intake and adequacy of the vegan diet. A systematic review of the evidence. Clin Nutr 2021;40: 3503-3521"><sup>3</sup></a>&nbsp;&nbsp;</li>
    <li>Lettere zinkmangel kan ses hos b&oslash;rn. Et studie har vist, at n&aelig;sten 1/3 af 1 - 3 &aring;rige raske b&oslash;rn havde lettere zinkmangel<a href=" " data-type="journal-reference" data-value="Vreugdenhil M, Akkermans MD, van der Merwe LF, van Elburg RM, van Goudoever JB, Brus F, Prevalence of Zinc Deficiency in Healthy 1-3-Year-Old Children from Three Western European Countries. Nutrients 2021;13: " data-value-piped="Vreugdenhil M, Akkermans MD, van der Merwe LF, van Elburg RM, van Goudoever JB, Brus F|Prevalence of Zinc Deficiency in Healthy 1-3-Year-Old Children from Three Western European Countries.|Nutrients|2021|13||34835970" data-url="reference-link" data-pubmedid="34835970" title="Vreugdenhil M, Akkermans MD, van der Merwe LF, van Elburg RM, van Goudoever JB, Brus F, Prevalence of Zinc Deficiency in Healthy 1-3-Year-Old Children from Three Western European Countries. Nutrients 2021;13: "><sup>4</sup></a></li>
    <li>Mangeartede og ofte diffuse symptomer, afh&aelig;ngige af alder og k&oslash;n, samt varigheden og sv&aelig;rhedsgraden af mangeltilstanden, f.eks.:
    <ul>
        <li>Reduceret v&aelig;kst, herunder sen k&oslash;nsmodning</li>
        <li>Langsom s&aring;rheling</li>
        <li>H&aring;rtab, diarre og hudaffektioner (acrodermatitis enteropathica)</li>
        <li>Anoreksi og reduceret smagssans</li>
        <li>Tr&aelig;thed</li>
        <li>Hyppige infektioner</li>
        <li>HIV</li>
        <li>Leversygdomme</li>
        <li>Polycystisjk ovariesyndrom med forh&oslash;jet &oslash;strogenniveau</li>
    </ul>
    </li>
</ul>
<h3>Mistanke om zinkforgiftning</h3>
<ul>
    <li>Symptomer er kvalme, diarre og andre abdominale symptomer</li>
    <li>Mulig eksposition for zinkoxid-dampe: Metalarbejdere med kulderystelser, hoste, hovedpine og spytfl&aring;d ("metalfeber")</li>
    <li>Mulig eksposition for zink-forurenet dialyseudstyr: Nyrepatienter med feber, kvalme, opkastninger, neurologiske symptomer og eventuelt an&aelig;mi</li>
    <li>Mulig eksposition for zink-forurenede f&oslash;devarer osv.: Patienter med uforklarlige abdominalsmerter, diarr&eacute; og opkastninger</li>
</ul>
<h3>Andre</h3>
<ul>
    <li>Arvelig zinkmangel ved acrodermatitis enteropathica</li>
    <li>Kontrol af patienter i behandling med penicillamin</li>
    <li>Kontrol af patienter som ern&aelig;res parenteralt i l&aelig;ngerevarende perioder</li>
    <li>Monitorering af patienter i behandling med zink, f.eks. ved&nbsp;<a href="~/link.aspx?_id=313DC3D9E392403FB022A7E75CB8FD63&amp;_z=z">Wilsons sygdom</a></li>
</ul>
<h2>Fortolkninger<a href="https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/" data-type="other-reference" data-value="National Institutes of Health: Zinc - Fact Sheet for Health Professionals, 2020" data-url="https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/" title="National Institutes of Health: Zinc - Fact Sheet for Health Professionals, 2020"><sup>5</sup></a></h2>
<ul>
    <li>Resultatet skal vurderes sammen med&nbsp;<a href="~/link.aspx?_id=F115F1A4BE8648D5B5D0AB79A07629DD&amp;_z=z">P-Albumin</a>, da 80 % af plasmazink er bundet til albumin</li>
</ul>
<h3>Forh&oslash;jede v&aelig;rdier</h3>
<ul>
    <li>Forgiftning med zink, kan udredes sammen med specialister f.eks. arbejdsmedicinere</li>
    <li>Kan af og til ses ved&nbsp;<a href="~/link.aspx?_id=4698F177B4D3453E9A18F1D171C474ED&amp;_z=z">porfyri</a></li>
</ul>
<h3>Lave v&aelig;rdier</h3>
<ul>
    <li>Malnutrition, herunder ogs&aring; parenteral ern&aelig;ring uden zinktilskud</li>
    <li>Malabsorption, herunder ved&nbsp;<a href="~/link.aspx?_id=1BAE2D7A6CED46B48FF6925A54396822&amp;_z=z">kronisk diarr&eacute;</a>,&nbsp;<a href="~/link.aspx?_id=6F049EF2DEE24D36BF754C81BA2AF16F&amp;_z=z">laktoseintolerans</a>,&nbsp;<a href="~/link.aspx?_id=935A845E8C8643229D937C40DCE2A30F&amp;_z=z">c&oslash;liaki</a>, inflammatoriske tarmsygdomme (pr&aelig;valens op mod 50 %)<sup><a href="EditorPage.aspx?da=core&amp;id=%7B9300AA75-9075-46A1-B112-E59F5B515222%7D&amp;ed=FIELD2715190503&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H2715190567&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Zupo R, Sila A, Castellana F, Bringiotti R, Curlo M, De Pergola G, De Nucci S, Giannelli G, Mastronardi M, Sardone R, Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Nutrients 2022;14: " data-value-piped="Zupo R, Sila A, Castellana F, Bringiotti R, Curlo M, De Pergola G, De Nucci S, Giannelli G, Mastronardi M, Sardone R|Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.|Nutrients|2022|14||36235709" data-url="reference-link" data-pubmedid="36235709" title="Zupo R, Sila A, Castellana F, Bringiotti R, Curlo M, De Pergola G, De Nucci S, Giannelli G, Mastronardi M, Sardone R, Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Nutrients 2022;14: "><sup>6</sup></a></sup>&nbsp;og&nbsp;<a href="~/link.aspx?_id=4AF69BE2DC654560A3C10662691E6436&amp;_z=z">cystisk fibrose</a>, samt efter tarmresektioner<a href=" " data-type="journal-reference" data-value="Zupo R, Sila A, Castellana F, Bringiotti R, Curlo M, De Pergola G, De Nucci S, Giannelli G, Mastronardi M, Sardone R, Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Nutrients 2022;14: " data-value-piped="Zupo R, Sila A, Castellana F, Bringiotti R, Curlo M, De Pergola G, De Nucci S, Giannelli G, Mastronardi M, Sardone R|Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.|Nutrients|2022|14||36235709" data-url="reference-link" data-pubmedid="36235709" title="Zupo R, Sila A, Castellana F, Bringiotti R, Curlo M, De Pergola G, De Nucci S, Giannelli G, Mastronardi M, Sardone R, Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Nutrients 2022;14: "><sup>6</sup></a>&nbsp;og gastric bypass</li>
    <li>Maligne sygdomme</li>
    <li>Akutte eller kroniske inflammatoriske sygdomme,&nbsp;fordi zink omfordeles fra blodet til leveren som en del af den akutte fase-respons</li>
    <li>Kroniske leversygdomme, herunder is&aelig;r alkoholbetingede sygdomme</li>
    <li>D&aring;rligt reguleret diabetes</li>
    <li>Behandling med thiazider</li>
    <li>Behandling med kortikosteroider eller ACTH</li>
    <li>Kongenit acrodermatitis enteropathica</li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)</h2>
<ul>
    <li>H&aelig;molyse giver falsk forh&oslash;jede v&aelig;rdier, da zink-koncentrationen i erytrocytter er omkring 10 gange h&oslash;jere end i plasma</li>
    <li>Brug af forkerte r&oslash;r til pr&oslash;vetagningen</li>
    <li>Betydelig d&oslash;gnvariation, lavest om morgenen</li>
    <li>Samtidig inflammation, da zink falder ved akutfase-respons</li>
</ul>
<h2>Fysiologi og biokemi<a href=" " data-type="journal-reference" data-value="Padoan F, Piccoli E, Pietrobelli A, Moreno LA, Piacentini G, Pecoraro L, The Role of Zinc in Developed Countries in Pediatric Patients: A 360-Degree View. Biomolecules 2024;14: " data-value-piped="Padoan F, Piccoli E, Pietrobelli A, Moreno LA, Piacentini G, Pecoraro L|The Role of Zinc in Developed Countries in Pediatric Patients: A 360-Degree View.|Biomolecules|2024|14||38927121" data-url="reference-link" data-pubmedid="38927121" title="Padoan F, Piccoli E, Pietrobelli A, Moreno LA, Piacentini G, Pecoraro L, The Role of Zinc in Developed Countries in Pediatric Patients: A 360-Degree View. Biomolecules 2024;14: "><sup>7</sup></a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7B9300AA75-9075-46A1-B112-E59F5B515222%7D&amp;ed=FIELD1052208823&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H1052208887&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Stiles LI, Ferrao K, Mehta KJ, Role of zinc in health and disease. Clin Exp Med 2024;24: 38" data-value-piped="Stiles LI, Ferrao K, Mehta KJ|Role of zinc in health and disease.|Clin Exp Med|2024|24|38|38367035" data-url="reference-link" data-pubmedid="38367035" title="Stiles LI, Ferrao K, Mehta KJ, Role of zinc in health and disease. Clin Exp Med 2024;24: 38"><sup>1</sup></a></h2>
<ul>
    <li>Metallet transporteres i blodet bundet til albumin (60-70 %) og alfa<sub>2</sub>-makroglobulin (30-40 %), samt i mindre grad til transferrin og frie aminosyrer</li>
    <li>Anbefalet dagligt indtag er ca 10 mg/dag</li>
    <li>Zink spiller en rolle for funktionen af en lang r&aelig;kke enzymer overalt i kroppen, og er det n&aelig;st mest almindelige metal efter jern</li>
    <li>Zink findes is&aelig;r i hjernen, muskler, knogler og lever, og i de h&oslash;jeste koncentrationer i prostata</li>
    <li>Zink har&nbsp;anti-inflammatorisk virkning ved at p&aring;virke Nuclear Factor-kappa (NF-&kappa;B) aktiviteten og begr&aelig;nser histamin frigivelsen</li>
    <li>Zink spiller en rolle for et effektivt immunforsvar og har desuden antioxiderende virkning</li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>
    Zink kan ikke tages i praksis grundet begr&aelig;nset pr&aelig;analytiske holdbarhed (skal v&aelig;re afpipetteret inden 2 timer efter pr&oslash;vetagning)
    </li>
    <li>
    V&aelig;rdierne er h&oslash;jst om morgenen. Pr&oslash;ven b&oslash;r ikke tages i timerne efter et m&aring;ltid, da v&aelig;rdierne kan bliver 10-20 % lavere
    </li>
    <li>Veneblod i s&aelig;rlige lithium- eller natriumheparin-r&oslash;r til spormetaller</li>
    <li>Plasma skal afpipetteres i s&aelig;rlige zink-fri r&oslash;r indenfor 2 timer</li>
    <li>Holdbarheden er 2-3 d&oslash;gn ved stuetemperatur og op til 1 uge ved 4<sup>o</sup>C</li>
    <li>Tidligere blev faste anbefalet for at minimere variation, men forskellen mellem fastende og ikke-fastende pr&oslash;ver er lille. De andre pr&aelig;analytiske faktorer er vigtigere</li>
</ul>
<h2>Referenceintervaller</h2>
<ul>
    <li>Ikke fastende: Alle: 10-19 &micro;mol/L</li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>Fastende&nbsp;NPU18020    </li>
    <li>NPU03768</li>
</ul>
<h3>Navne</h3>
<ul>
    <li><strong>Kort helterm</strong>
    <ul>
        <li>P(fPt)&mdash;Zink; stofk. = ? &micro;mol/l</li>
        <li>P&mdash;Zink; stofk. = ? &micro;mol/l</li>
    </ul>
    </li>
    <li><strong>Brugsnavn</strong>
    <ul>
        <li>Zink;P(fPt)</li>
        <li>Zink;P</li>
    </ul>
    </li>
</ul>]]></HtmlField>
      <HtmlField Name="Resume"><![CDATA[<h2>Resum&eacute;<a href=" " data-type="journal-reference" data-value="Stiles LI, Ferrao K, Mehta KJ, Role of zinc in health and disease. Clin Exp Med 2024;24: 38" data-value-piped="Stiles LI, Ferrao K, Mehta KJ|Role of zinc in health and disease.|Clin Exp Med|2024|24|38|38367035" data-url="reference-link" data-pubmedid="38367035" title="Stiles LI, Ferrao K, Mehta KJ, Role of zinc in health and disease. Clin Exp Med 2024;24: 38"><sup>1</sup></a></h2>
<ul>
    <li>M&aring;ling af zink (Zn)&nbsp;er relevant ved mistanke om
    <ul>
        <li>Zinkforgiftning: Opst&aring;r fortrinsvis ved eksponerede erhvervsgrupper eller som f&oslash;lge af overdrevet indtag af zinkholdige l&aelig;gemidler eller vitamintilskud. Der ses kvalme, opkast, svimmelhed, hovedpine, hoste og abdominalia</li>
        <li>Zink-mangel: Ses som f&oslash;lge af malabsorption, malnutrition, langvarig parenteral ern&aelig;ring, l&aelig;ngerevarende&nbsp;<a href="~/link.aspx?_id=C080DD40EC4E4DAEAEDF4AC362930D12&amp;_z=z">alkoholoverforbrug</a>, behandling med glukokorticoid eller D-penicillamin. Det viser sig ved v&aelig;ksth&aelig;mning, hypogonadisme hos m&aelig;nd, hepatosplenomegali, hudforandringer (acrodermatitis entheropatica), forsinket s&aring;rheling, tr&aelig;thed og anoreksi</li>
    </ul>
    </li>
</ul>]]></HtmlField>
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