Could Urinary Copper/Zinc Ratio Be a Newer Tool to Replace 24-Hour Urinary Copper Excretion for Diagnosing Wilson Disease in Children?

IF 1.3 Q3 PEDIATRICS
Fahmida Begum, Khan Lamia Nahid, Tahmina Jesmin, Md Wahiduzzaman Mazumder, Md Rukunuzzaman
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Abstract

Purpose: Although the 24-hours urinary copper excretion is useful for the diagnosis of Wilson disease (WD), there are practical difficulties in the accurate and timed collection of urine samples. The purpose of this study was to verify if the spot morning urinary Copper/ Zinc (Cu/Zn) ratio could be used as a replacement parameter of 24-hours urinary copper excretion in the diagnosis of WD.

Methods: A cross-sectional study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from June 2019 to May 2021 on 67 children over three years of age who presented with liver disease. Twenty-seven children who fulfilled the inclusion criteria for WD were categorized into the test group, and the remaining forty children were considered to have non-Wilsonian liver disease and were categorized into the control group. Along with other laboratory investigations, spot morning urinary samples were estimated for the urinary Cu/Zn ratio in all patients and were compared to the 24-hour urinary copper excretion. The diagnostic value of the Cu/Zn ratio was then analyzed.

Results: Correlation of spot morning urinary Cu/Zn ratio with 24-hours urinary copper excretion was found to be significant (r=0.60). The area under ROC curve with 95% confidence interval of morning urinary Cu/Zn ratio measured using 24-hours urine sample was 0.84 (standard error, 0.05; p<0.001).

Conclusion: Spot morning urinary Cu/Zn ratio seems to be a promising parameter for the replacement of 24-hours urinary copper excretion in the diagnosis of WD.

尿铜/锌比值能否成为替代 24 小时尿铜排泄量诊断儿童威尔逊病的新工具?
目的:虽然24小时尿铜排泄量有助于诊断威尔逊病(WD),但在准确和定时收集尿样方面存在实际困难。本研究的目的是验证定点晨尿铜/锌(Cu/Zn)比值是否可作为 24 小时尿铜排泄量的替代参数,用于诊断威尔森氏病:2019年6月至2021年5月,孟加拉国达卡班加班杜-谢赫-穆吉布医科大学(BSMMU)小儿胃肠病学和营养学系对67名三岁以上肝病患儿进行了横断面研究。符合WD纳入标准的27名儿童被归入试验组,其余40名儿童被认为患有非Wilson肝病,被归入对照组。在进行其他实验室检查的同时,对所有患者的晨尿定点样本进行尿铜/锌比值估算,并与24小时尿铜排泄量进行比较。然后分析了铜/锌比值的诊断价值:结果:晨尿铜/锌比值与 24 小时尿铜排泄量的相关性显著(r=0.60)。使用 24 小时尿样测量的晨尿铜/锌比值的 ROC 曲线下面积(95% 置信区间)为 0.84(标准误差为 0.05;p 结论:晨尿铜/锌比值与 24 小时尿铜排泄量之间存在明显的相关性:在诊断 WD 时,晨尿铜/锌比值似乎是替代 24 小时尿铜排泄量的一个有前途的参数。
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来源期刊
CiteScore
3.90
自引率
0.00%
发文量
43
期刊介绍: Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.
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