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Advancing Knowledge of Zinc in Health and Disease

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Dear Colleagues,

Zinc is necessary for a broad range of essential functions, spanning the numerous biological pathways that determine normal growth, metabolic, immune, and neurological functions. The risk of both communicable diseases (e.g., common infections) and noncommunicable diseases (e.g., cardiovascular disease, type 2 diabetes) depends on zinc nutriture. The purpose of this Special Issue is to advance knowledge of zinc in health and disease, with a focus on studies linking basic research on the mechanisms of zinc action and zinc homeostasis with a broader understanding of zinc's roles in health and disease outcomes. This connection is needed to increase precision in recommendations for zinc intake, while considering strategies to increase zinc bioavailability and to optimize health-promoting dietary patterns involving zinc, with an aim of improved health outcomes.

Dr. Andrew G. Hall
Dr. Janet King
Guest Editors

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19 pages, 5997 KB

Open AccessArticle

Zinc as a Biomarker of Nutritional Status and Clinical Burden in Recessive Dystrophic Epidermolysis Bullosa: Implications for Preventive Monitoring

by Lucía Quintana-Castanedo, Rocío Maseda, Silvia Sánchez-Ramón, Nora Butta, Marta Molero-Luis, María G. Crespo, Antonio Buño, Sara Herráiz-Gil, Carlos León, Alberto Varas, Lidia M. Fernández-Sevilla, Pilar Zuluaga, Raúl de Lucas, Marcela del Río, Ángeles Vicente, María J. Escámez and Rosa Sacedón

Nutrients 2026, 18(2), 232; https://doi.org/10.3390/nu18020232 - 12 Jan 2026

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Abstract

Background/Objectives: Recessive dystrophic epidermolysis bullosa (RDEB) is a severe congenital genodermatosis characterized by skin and mucosa fragility, chronic inflammation, recurrent infections and high nutritional demands due to increased metabolism and epithelial barrier-related losses, placing patients at risk of zinc deficiency. We aimed to investigate the clinical relevance and biochemical determinants of zinc deficiency as a potentially modifiable contributor to disease burden in RDEB. Methods: In this cross-sectional study (n = 84), serum zinc levels were analyzed in association with sex, age, disease severity, percentage of body surface area (BSA) affected, inflammatory markers, infection burden, and common clinical complications including anemia and growth impairment. Results: Zinc deficiency, defined as levels below 670 µg/L, was identified in 35% of patients and became more frequent after age 5 and during adulthood, particularly among those with more severe disease. Deficiency was strongly associated with anemia, inflammation, infection burden, growth impairment, and extensive skin involvement. A revised cutoff of 780 µg/L is proposed, showing improved diagnostic performance for identifying patients at risk of systemic complications, and offering a more suitable threshold for starting preventive supplementation. Multivariate logistic modeling confirmed that low serum zinc independently predicted anemia risk, alongside transferrin saturation and C- reactive protein levels. Serum albumin was identified as the strongest determinant of zinc levels, partially mediating the effects of inflammation and skin involvement. Conclusions: These findings identify serum zinc as a clinically relevant marker of nutritional status and complication burden in RDEB. While no causal or therapeutic effects can be inferred from this cross-sectional study, the strong and biologically plausible associations observed suggest a rationale for systematic monitoring and correction of zinc deficiency as part of comprehensive supportive care, and warrant prospective studies to assess clinical benefit. Full article

(This article belongs to the Special Issue Advancing Knowledge of Zinc in Health and Disease)

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14 pages, 561 KB

Open AccessArticle

Maternal and Infant Determinants of Zinc Status and Zinc’s Association with Anthropometry in 3-Month-Old Bangladeshi Infants

by Ximing Ge, Katherine K. Stephenson, Lee S.-F. Wu, Sarah Baker, Hasmot Ali, Saijuddin Shaikh, Keith P. West, Jr., Parul Christian and Kerry J. Schulze

Nutrients 2025, 17(21), 3393; https://doi.org/10.3390/nu17213393 - 29 Oct 2025

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Abstract

Background/Objectives: Zinc deficiency remains a public health concern in South Asia but is rarely studied through gestation to infancy. Methods: We identified maternal and infant factors related to plasma zinc of 3 mo old Bangladeshi infants (n = 317) in the context of a trial of a daily antenatal to 3 mo postpartum multiple micronutrient supplementation (MMS) with 15 vitamins and minerals, including 12 mg zinc, versus iron–folic acid (IFA). Factors explored included maternal age, parity, and plasma zinc in early (pre-supplementation) and late pregnancy, at 3 months postpartum, and in milk; cord blood zinc (n = 83); birth outcomes; and infant feeding and biomarkers. Consequently, infant zinc was explored with 3 mo anthropometry and growth rates. Results: Mean ± SD infant plasma zinc was 15.63 ± 6.65 µmol/L, with 10.1% deficiency (<9.9 µmol/L). In adjusted analyses, infant zinc was positively associated with maternal age [20–30 years +0.11 µmol/L (p = 0.018) and ≥30 years +0.28 µmol/L (p = 0.003) relative to <20 years], maternal early pregnancy zinc (+0.01 µmol/L per 1 µmol/L maternal zinc, p = 0.011), and infant ferritin (+0.001 µmol/L per 1 µg/L, p = 0.007); conversely, infant zinc was −0.13 µmol/L lower (p = 0.013) with maternal parity ≥2 versus 0–1 and with partial versus exclusive breastfeeding (−0.15 µmol/L, p = 0.038). Relationships with MMS, maternal later pregnancy, postpartum, milk, and cord blood zinc were absent. Length-for-age (+0.02 per µmol/L, p = 0.047) but not weight-for-length Z-scores at 3 months were associated with infant zinc. Conclusions: Thus, infant zinc was associated with pre- but not post-MMS maternal zinc, age and parity, feeding style, and infant iron status. Infant length but not weight was associated with plasma zinc. Full article

(This article belongs to the Special Issue Advancing Knowledge of Zinc in Health and Disease)

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