1. INDICATIONS OF ZINC DEFICIENCY FOR LITHUANIAN POPULATION AND ITS GEOMEDICAL CONTROL Marija Jakubėnienė*, Gediminas Žukauskas*, Saulius Šliaupa** * Institute of Forensic Medicine of Mykolas Romeris University ** Institute of Geology and Geography Vilnius, Lithuania Vilnius, Lithuania SCIENTIFIC NETWORKING AND THE GLOBAL HEALTH SUPERCOURSE FOR THE PREVENTION OF THREAT FROM MAN MADE AND NATURAL DISASTERS August 8-10, 2005, Kaunas, Lithuania

2. Worrying health and social problems Increased general morbidity and mortality in Lithuania Increased general morbidity and mortality in Lithuania The biggest suicide rate among European countries (44.5/100 000 inhabitants) The biggest suicide rate among European countries (44.5/100 000 inhabitants) Nearly epidemic status with tuberculosis (86/100 000) Nearly epidemic status with tuberculosis (86/100 000) High level of alcohol delirium High level of alcohol delirium Increased number of alopecia among young people Increased number of alopecia among young people

3. ESSENTIALITY OF ZINC FOR HUMAN Zinc functions as a required cofactor for over 200 metalloenzymes; Zinc functions as a required cofactor for over 200 metalloenzymes; Zinc is an essential component of the endogenous storage forms of pancreatic insulin; Zinc is an essential component of the endogenous storage forms of pancreatic insulin; Zinc play a very important role in RNA and DNA metabolism; Zinc play a very important role in RNA and DNA metabolism; Zinc is essential for immune system, growth and sex hormones; Zinc is essential for immune system, growth and sex hormones; Zinc is involved in the pathophysiology and therapy of depression. Zinc is involved in the pathophysiology and therapy of depression.

4. BIOLOGICAL IMPORTANCE OF ZINC FOR LIVING ORGANIZMS (HISTORY OF DISCAVERIES) J.Raulin (1869) – essentiality of zinc in the nutrition of Aspergillus Niger; J.Raulin (1869) – essentiality of zinc in the nutrition of Aspergillus Niger; V.Birckner (1919) – first indication of a function for zinc in the higher animals; V.Birckner (1919) – first indication of a function for zinc in the higher animals; A.Sommer, C.Lipman (1928) – the essentiality of zinc for the higher form of plant life; A.Sommer, C.Lipman (1928) – the essentiality of zinc for the higher form of plant life; W.Todd (1934) – first evidence that zinc is a dietary essential for the rat; W.Todd (1934) – first evidence that zinc is a dietary essential for the rat; W.Tucker, W.Salmon (1955) – zinc cures and prevents parakeratozis in pigs; W.Tucker, W.Salmon (1955) – zinc cures and prevents parakeratozis in pigs; B. O’Dell (1960) – zinc requirements for growth, feathering, and skeletal development in poultry; B. O’Dell (1960) – zinc requirements for growth, feathering, and skeletal development in poultry; A.Prasad (1961) – the relation of the occurrence of dwarfism and hypogonadism in boys in parts of the Middle East. A.Prasad (1961) – the relation of the occurrence of dwarfism and hypogonadism in boys in parts of the Middle East.

5. CLINICAL MANIFESTATUIONS IN MILD TO MODERATE CASES OF ZINC DEFICIENCY Oligospermia Slight weight loss Delayed wound healing Taste abnormalitiesAbnormal dark adaption

6. CLINICAL MANIFESTATUIONS IN SEVERE CASES OF ZINC DEFICIENCY Bullous-pustular dermatitis Infections Hypogonadism in males Emotional disorders (depression, paranoia) Depletion of immunity Alopecia Alcoholism

7. Other symptoms of Zinc deficiency (Each person manifests different symptoms) Hypo-hyper-tension Diabetes Obesity Acne Infertility Thyroid disorders Pfeiffer C.C., 1978 Jensen B., 1983 Zn deficiency may lead to expressed Fe, Cu, Cd, Pb accumulations, essentially on the background of alcohol abuse. They are functional antagonists to Zn.

8. Zn deficiency symptoms result from Nutritional factors Excessive alcohol use Liver diseases Malabsorption syndromes Renal disease Sickle cell disease

9. Nutritional factors: Consumption of cereal proteins containing high levels of fibers known as phylates; Consumption of cereal proteins containing high levels of fibers known as phylates; Geochemical characteristics of soil (decreased level of zinc in cultures grown in the regions with depleted content of zinc in soil). Geochemical characteristics of soil (decreased level of zinc in cultures grown in the regions with depleted content of zinc in soil). 20% of the world’s people suffer from zinc deficient diet (the report of International Zinc Nutrition Consultative Group, 2004) 20% of the world’s people suffer from zinc deficient diet (the report of International Zinc Nutrition Consultative Group, 2004)

10. Zn content in soil of Lithuania Different filtering window

11. Rates of suicides in different regions of Lithuania Three anomalies excluded

12. Rates of suicides in different regions of Lithuania (three anomalies excluded) Zn in soil

13. The rates of suicides in different regions of Lithuania (average rate for four years:1999, 2001, 2002, 2003). Average rate of suicides for 45 regions – 57.6/100 000 Average rate in regions with low zinc content in soil – 63.2/100 000 Average rate in regions with highest zinc abundance in soil – 51.2/100 000

14. Concentration of ZN in the soil (top and bottom), circum-Baltic area Lithuania (after Reimann et al., 2003)

15. Comparison of the average Zn content in soil with rates of suicides in Nordic and Baltic countries Estonia FinlandLatvia Lithuania NorwaySweden

16. Concentration of zinc in various biomedia of patients with alopecia accordingly to the age Zinc in blood plasma of persons from control group

17. ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (1)

18. ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (2)

19. ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (3) Zinc serum concentration in patients with hepatitis and liver cirrhosis n=33 n=22

20. ZN DEFICIENCY AND EXCESSIVE ALCOHOL USE (4) Alcohol use Liver diseases Zn deficiency

21. Emotional disorder Excessive alcohol use Zn deficiency Nutritional factors Behavior disorder Personality disorder Anxiety disorder Depressive disorder Suicides

22. What are criteria for zinc deficiency status for human? Necessity to have normal ranges of this element for specific population; Necessity to have normal ranges of this element for specific population; Depleted concentration of element in blood compartments, selected tissues and body fluids; Depleted concentration of element in blood compartments, selected tissues and body fluids; Knowledge about interaction of zinc in organism with another elements; Knowledge about interaction of zinc in organism with another elements; The influence on health status of such geofactors as gravity and magnetic field, sub-soil lithologies, relief, some other landscape feature, drinking water and soil chemistry. The influence on health status of such geofactors as gravity and magnetic field, sub-soil lithologies, relief, some other landscape feature, drinking water and soil chemistry.

23. FUTURE INVESTIGATIONS: 1. Monitoring of elements in biological specimens for Lithuanian people and establishment of normal ranges; 2. Participation in comparative investigation of elements in biological specimens for different populations; 3. Investigation of the influence of geofactors on health status of different population.

24. Thank you very much for your attention !!!