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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Toppari, Jorma / Turan, Serap Demircioglu

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Volume 32, Issue 10


Zinc deficiency in Japanese children with idiopathic short stature

Kei Yoshida / Tatsuhiko Urakami / Remi Kuwabara / Ichiro Morioka
Published Online: 2019-08-24 | DOI: https://doi.org/10.1515/jpem-2019-0129


Background and methods

We investigated the frequency of zinc deficiency in Japanese children with idiopathic short stature, and evaluated whether serum zinc levels correlated with background factors, including age and standard deviation scores (SDSs) for height and serum insulin-like growth factor (IGF)-1 levels. The study subjects consisted of 89 Japanese children.


The mean serum zinc level was 79 ± 12 (49–108) μg/dL. Of all the children, 48.3% had a low zinc level, in the 60–80 μg/dL range, and 6.7% had zinc deficiency with a zinc level below 60 μg/dL. The majority with a low zinc level and zinc deficiency were asymptomatic other than for short stature. We found no significant correlations of serum zinc with age, or the SDSs for height and serum IGF-1 levels, in either the entire subject population or those with a zinc level below 80 μg/dL.


We found a low zinc level to be common in Japanese children with idiopathic short stature, whereas actual zinc deficiency was rare. However, other as yet unknown mechanisms not associated with the growth hormone (GH)-IGF-1 axis could be involved in growth retardation in idiopathic short stature.

Keywords: children; idiopathic short stature; insulin-like growth factor-1 (IGF-1); Japanese; serum zinc level; zinc deficiency


  • 1.

    Nishi T. Zinc levels in plasma, erythrocyte and leukocyte in healthy children and adults. Hiroshima J Med Sci 1980;29: 7–13.PubMedGoogle Scholar

  • 2.

    Prasad AS. Discovery and importance of human nutrition. Federal Proc 1984;43:2829–34.Google Scholar

  • 3.

    Hambidge KM, Silverman A. Pica with rapid improvement after dietary zinc supplementation. Arch Dis Child 1973;48:567–8.CrossrefPubMedGoogle Scholar

  • 4.

    Prasad AS. Clinical manifestations of zinc deficiency. Ann Rev Nutr 1985;5:341–63.CrossrefGoogle Scholar

  • 5.

    Laitinen R, Vouri E, Dahlstrom S, Akerblom HK. Zinc, copper, and growth status in children and adolescents. Pediatr Res 1988;23:323–6.Google Scholar

  • 6.

    Hurley LS. Zinc deficiency in the developing rat. Am J Clin Nutr 1969;22:1332–9.PubMedCrossrefGoogle Scholar

  • 7.

    Underwood EJ. Trace elements in human and animal nutrition, 4th ed. New York, NY: Academic Press, 1997:196–233.Google Scholar

  • 8.

    Prasad AS, Tenn N, Miale AJ, Farid Z. Biochemical studies on dwarfism, hypogonadism, and anemia. Arch Interns Med 1963;111:407–28.CrossrefGoogle Scholar

  • 9.

    Prasad AS. Clinical, endocrinological and biochemical effects of zinc deficiency. Clin Endocrinol Metab 1985;14:567–89.PubMedCrossrefGoogle Scholar

  • 10.

    İmamoğlu S, Bereket A, Turan S, Taga Y, Haklar G. Effect of zinc supplementation on growth hormone secretion, IGF-1, IGFBP-3, somatomedin generation, alkaline phosphatase, osteocalcin and growth in prepubertal children with idiopathic short stature. J Pediatr Endocrinol Metab 2005;18:69–74.PubMedGoogle Scholar

  • 11.

    Isojima T, Kato N, Ito Y, Kanzaki S, Murata M. Growth standard charts for Japanese children with mean and standard deviation (SD) values based on the year 2000 national survey. Clin Pediatr Endocrinol 2016;25:71–6.CrossrefPubMedGoogle Scholar

  • 12.

    Isojima T, Shimatsu A, Yokoya S, Chihara K, Tanaka T, et al. Standardized centile curves and references intervals of serum insulin-like growth factor-1 (IGF-1) levels in a normal Japanese population using the LMS method. Endocr J 2012;59:771–80.CrossrefGoogle Scholar

  • 13.

    Kodama H, Itakura H, Omori K, Sasaki M, Santo K, et al. Clinical guideline for zinc deficiency. J Japan Soc Clin Nutr 2016;38:104–48 [in Japanese].Google Scholar

  • 14.

    Kaji M, Gotoh M, Takagi Y, Masuda H, Kimura Y, et al. Studies to determine the usefulness of zinc clearance test to diagnose marginal zinc deficiency and effects of oral zinc supplementation for short children. J Am Coll Nutr 1998;17:388–91.CrossrefPubMedGoogle Scholar

  • 15.

    Yagisawa H, Syouno T, Syouji H, Obinata K, Shimizu T. Studies of serum zinc levels in children with growth retardation and short stature. JSPGHAN 2012;26:156 [in Japanese].Google Scholar

  • 16.

    Murphy EW, Willis BW, Watt BK. Provisional tables on the zinc content of foods. J Am Diet Assoc 1975;66:345–55.PubMedGoogle Scholar

  • 17.

    Greger JL, Sciscoe BS. Zinc nutriture of elderly participants in an urban feeding program. J Am Diet Assoc 1977;70:37–41.Google Scholar

  • 18.

    Recommended Dietary Allowances. Report of the Food and Nutrition Board, Nutritional Research Council, 8th ed. Washington, DC: National Academy of Science, 1974.Google Scholar

  • 19.

    Kurasawa R, Kubori S. Zinc Deficiency and its clinical features in the cases found in Kitamimaki, a rural area in Japan. Biomed Res Trace Elements 2006;17:91–3.Google Scholar

  • 20.

    Cesur Y, Yordam N, Dogan M. Serum insulin-like growth favtor-1 and insulin-like growth factor biding protein-3 levels in children with zinc deficiency and the effect of zinc supplementation on these parameters. J Pediatr Endocrinol Metab 2009;22:1137–43.Google Scholar

  • 21.

    Hamza RT, Hamed AI, Sallam MT. Effect of zinc supplementation on growth hormone insulin growth factor axis in short Egyptian children with zinc deficiency. Italian J Pediatr 2012;38:21.CrossrefWeb of ScienceGoogle Scholar

  • 22.

    Nishi Y. Zinc and growth. J Am Coll Nutr 1996;15:340–4.CrossrefPubMedGoogle Scholar

  • 23.

    Nishi Y, Hatano S, Aihara K, Fujie A, Kihara M. Transient partial growth hormone deficiency due to zinc deficiency. J Am Coll Nutr 1989;8:93–7.CrossrefPubMedGoogle Scholar

  • 24.

    Nakamura T, Nishiyama S, Futagoshi-Sugihara Y, Matsuda I, Higashi A. Mild to moderate zinc deficiency in short children: effect of zinc supplementation on linear growth velocity. J Pediatr 1993;123:65–9.CrossrefPubMedGoogle Scholar

  • 25.

    Penny ME, Marin RM, Duran A, Peerson JM, Lanata CF, et al. Randomized controlled trial of the effect of daily supplementation with zinc or multiple micronutrients on the morbidity, growth, and micronutrient status of young Peruvian children. Am J Clin Nutr 2004;79:457–65.PubMedCrossrefGoogle Scholar

  • 26.

    Brown KH, Peerson JM, Rivera J, Allen LH. Effect of supplemental zinc on the growth and serum zinc concentrations of prepubertal children: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2014;58:183–7.Google Scholar

  • 27.

    Solomons NW. Zinc and copper. In: Shils ME, Young VR, editors. Modern nutrition in health and disease, 7th ed. Philadelphia: Lea & Febiger, 1988:238.Google Scholar

  • 28.

    McCall KA, Huang CC, Fierke CA. Function and mechanism of zinc metalloenzymes. J Nutr 2000;130:1446S–73S.Google Scholar

  • 29.

    Kurtogu S, Patiroglu TE, Karakas SE. Effect of growth hormone on epiphyseal growth plates in zinc deficiency. Tokai J Exp Clin Med 1987;12:325–9.PubMedGoogle Scholar

About the article

Corresponding author: Tatsuhiko Urakami, MD, Department of Pediatrics and Child Health, Nihon University School of Medicine, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, Japan, Phone: +81-3-3293-1711, Fax: +81-3-3292-2880

Received: 2019-03-21

Accepted: 2019-07-05

Published Online: 2019-08-24

Published in Print: 2019-10-25

Author contributions: K.Y. and U.T. designed the study; K. Y. and R. K. collected clinical samples; K.Y. performed the statistical analysis and drafted the manuscript; T.U. and I. M. critically revised the manuscript. All authors read and approved the final manuscript.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 32, Issue 10, Pages 1083–1087, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2019-0129.

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