Sex Difference Between Trace Elements and Pulmonary Functions in Children


It has been defined that deficiency of trace elements plays an important role in the progression of asthma. However, the relationship between blood zinc (Zn), selenium (Se), and magnesium (Mg) and pulmonary functions in children remains to be clarified. A cross-sectional study was conducted in Wuxi, China, and a total of 202 healthy children were recruited. The forced vital capacity volume (FVC) and forced expiratory volume in the 1 s (FEV1) were measured. Blood samples were collected, and the levels of blood zinc, selenium, and magnesium were measured by inductively coupled plasma mass spectrometry (ICP-MS). Meanwhile, the concentrations of serum total IgE was also determined. The associations between trace elements and pulmonary functions were analyzed by multiple linear regression models. After stratified by sex, there was a positive association between blood Zn and pulmonary functions in boys. In addition, blood Zn was also negatively associated with serum total IgE concentrations in boys, but not in girls after adjusting for potential confounders. Our findings indicated that zinc deficiency was significantly related to children’s pulmonary functions and that screening of trace elements may be a potential solution to decrease the risks of asthma in children.

This is a preview of subscription content, access via your institution.


  1. 1.

    Bousquet J, Jeffery PK, Busse WW, Johnson M, Vignola AM (2000) Asthma. From bronchoconstriction to airways inflammation and remodeling. Am J Respir Crit Care Med 161(5):1720–1745.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Kocyigit A, Armutcu F, Gurel A, Ermis B (2004) Alterations in plasma essential trace elements selenium, manganese, zinc, copper, and iron concentrations and the possible role of these elements on oxidative status in patients with childhood asthma. Biol Trace Elem Res 97(1):31–41.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Ataee P, Najafi M, Gharagozlou M, Aflatounian M, Mahmoudi M, Khodadad A, Farahmand F, Motamed F, Fallahi GH, Kalantari N, Soheili H, Modarresi V, Modarresi MS, Rezaei N (2014) Effect of supplementary zinc on body mass index, pulmonary function and hospitalization in children with cystic fibrosis. Turk J Pediatr 56(2):127–132

    PubMed  Google Scholar 

  4. 4.

    Zhou X, Hong J (2018) Pediatric asthma management in China: current and future challenges. Paediatr Drugs 20(2):105–110.

    Article  PubMed  Google Scholar 

  5. 5.

    Ariaee N, Farid R, Shabestari F, Shabestari M, Jabbari Azad F (2016) Trace elements status in sera of patients with allergic asthma. Rep Biochem Mol Biol 5(1):20–25

    CAS  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Zhou CC, Gao ZY, He YQ, Wu MQ, Chen F, Wang J, Liu JX, Yan CH (2019) Effects of lead, mercury, aluminium and manganese co-exposure on the serum BDNF concentration of pre-school children in Taizhou, China. Chemosphere 217:158–165.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Cao J, Gao Z, Yan J, Li M, Su J, Xu J, Yan CH (2016) Evaluation of trace elements and their relationship with growth and development of young children. Biol Trace Elem Res 171(2):270–274.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Zalewski PD (2006) Zinc metabolism in the airway: basic mechanisms and drug targets. Curr Opin Pharmacol 6(3):237–243.

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Taylor CG, Bray TM (1991) Effect of hyperoxia on oxygen free radical defense enzymes in the lung of zinc-deficient rats. J Nutr 121(4):460–466.

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Morgan CI, Ledford JR, Zhou P, Page K (2011) Zinc supplementation alters airway inflammation and airway hyperresponsiveness to a common allergen. J Inflamm (Lond) 8:36.

    CAS  Article  Google Scholar 

  11. 11.

    Baiz N, Chastang J, Ibanez G, Annesi-Maesano I, Group EM-CCS (2017) Prenatal exposure to selenium may protect against wheezing in children by the age of 3. Immun Inflamm Dis 5(1):37–44.

    CAS  Article  Google Scholar 

  12. 12.

    Swaminathan R (2003) Magnesium metabolism and its disorders. Clin Biochem Rev 24(2):47–66

    CAS  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Xie C, Li X, Zhu J, Wu J, Geng S, Zhong C (2019) Magnesium isoglycyrrhizinate suppresses LPS-induced inflammation and oxidative stress through inhibiting NF-kappaB and MAPK pathways in RAW264.7 cells. Bioorg Med Chem 27(3):516–524.

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    AbdulWahab A, Zeidan A, Avades T, Chandra P, Soliman A (2018) Serum zinc level in asthmatic and non-asthmatic school children. Children (Basel) 5(3).

  15. 15.

    Ciarallo L, Brousseau D, Reinert S (2000) Higher-dose intravenous magnesium therapy for children with moderate to severe acute asthma. Arch Pediatr Adolesc Med 154(10):979–983

    CAS  Article  Google Scholar 

  16. 16.

    Allam MF, Lucane RA (2004) Selenium supplementation for asthma. Cochrane Database Syst Rev 2:CD003538.

    Article  Google Scholar 

  17. 17.

    Zervas E, Papatheodorou G, Psathakis K, Panagou P, Georgatou N, Loukides S (2003) Reduced intracellular Mg concentrations in patients with acute asthma. Chest 123(1):113–118.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Singh AK, Gaur S, Kumar R (2008) A randomized controlled trial of intravenous magnesium sulphate as an adjunct to standard therapy in acute severe asthma. Iran J Allergy Asthma Immunol 7 (4):221-229. doi:07.04/ijaai.221229

  19. 19.

    Shaikh MN, Malapati BR, Gokani R, Patel B, Chatriwala M (2016) Serum magnesium and vitamin D levels as indicators of asthma severity. Pulm Med 2016:1643717.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Pan Z, Guo Y, Xiang H, Hui Y, Ju H, Xu S, Li L (2019) Effects of lead, mercury, and cadmium co-exposure on children’s pulmonary function. Biol Trace Elem Res:1–6.

  21. 21.

    Kadrabova J, Mad'aric A, Podivinsky F, Gazdik F, Ginter F (1996) Plasma zinc, copper and copper/zinc ratio in intrinsic asthma. J Trace Elem Med Biol 10(1):50–53

    CAS  Article  Google Scholar 

  22. 22.

    Biltagi MA, Baset AA, Bassiouny M, Kasrawi MA, Attia M (2009) Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study. Acta Paediatr 98(4):737–742.

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Wu W, Bromberg PA, Samet JM (2013) Zinc ions as effectors of environmental oxidative lung injury. Free Radic Biol Med 65:57–69.

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Prasad AS (2007) Zinc: mechanisms of host defense. J Nutr 137(5):1345–1349.

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Wang IJ, Karmaus WJJ, Yang CC (2017) Lead exposure, IgE, and the risk of asthma in children. J Expo Sci Environ Epidemiol 27(5):478–483.

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Seo HM, Kim YH, Lee JH, Kim JS, Park YM, Lee JY (2017) Serum zinc status and its association with allergic sensitization: the Fifth Korea National Health and Nutrition Examination Survey. Sci Rep 7(1):12637.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Mao S, Wu L, Shi W (2018) Association between trace elements levels and asthma susceptibility. Respir Med 145:110–119.

    Article  PubMed  Google Scholar 

  28. 28.

    Flatt A, Pearce N, Thomson CD, Sears MR, Robinson MF, Beasley R (1990) Reduced selenium in asthmatic subjects in New Zealand. Thorax 45(2):95–99.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  29. 29.

    Razi CH, Akelma AZ, Akin O, Kocak M, Ozdemir O, Celik A, Kislal FM (2012) Hair zinc and selenium levels in children with recurrent wheezing. Pediatr Pulmonol 47(12):1185–1191.

    Article  PubMed  Google Scholar 

  30. 30.

    Hashimoto Y, Nishimura Y, Maeda H, Yokoyama M (2000) Assessment of magnesium status in patients with bronchial asthma. J Asthma 37(6):489–496

    CAS  Article  Google Scholar 

  31. 31.

    Britton J, Pavord I, Richards K, Wisniewski A, Knox A, Lewis S, Tattersfield A, Weiss S (1994) Dietary magnesium, lung function, wheezing, and airway hyperreactivity in a random adult population sample. Lancet 344(8919):357–362.

    CAS  Article  PubMed  Google Scholar 

  32. 32.

    Okayama H, Aikawa T, Okayama M, Sasaki H, Mue S, Takishima T (1987) Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma. JAMA 257(8):1076–1078

    CAS  Article  Google Scholar 

  33. 33.

    Burney P, Potts J, Makowska J, Kowalski M, Phillips J, Gnatiuc L, Shaheen S, Joos G, Van Cauwenberge P, van Zele T, Verbruggen K, van Durme Y, Derudder I, Wohrl S, Godnic-Cvar J, Salameh B, Skadhauge L, Thomsen G, Zuberbier T, Bergmann KC, Heinzerling L, Renz H, Al-Fakhri N, Kosche B, Hildenberg A, Papadopoulos NG, Xepapadaki P, Zannikos K, Gjomarkaj M, Bruno A, Pace E, Bonini S, Bresciani M, Gramiccioni C, Fokkens W, Weersink EJ, Carlsen KH, Bakkeheim E, Loureiro C, Villanueva CM, Sanjuas C, Zock JP, Lundback B, Janson C (2008) A case-control study of the relation between plasma selenium and asthma in European populations: a GAL2EN project. Allergy 63(7):865–871.

    CAS  Article  PubMed  Google Scholar 

  34. 34.

    Garcia-Larsen V, Chinn S, Arts IC, Amigo H, Rona RJ (2007) Atopy, wheeze and bronchial responsiveness in young Chilean adults. Do dietary antioxidants matter? Allergy 62(6):714–715.

    CAS  Article  PubMed  Google Scholar 

Download references


This study was supported by the Medical Innovation Team of Jiangsu Province (Grant No. CXTDB 2017016), The Major Program of Wuxi health and Family Planning Commission (z201606), Wuxi Medical Talents (Grant No. QNRC071), The Youth project of Wuxi health and Family Panning Commission (Q201837), and The general Program of Nanjing Medical University (2016NJMU119).

Author information



Corresponding author

Correspondence to Ling Li.

Ethics declarations

The study was approved by the Ethics Committee of Wuxi Children’s Hospital, and the written informed consents were acquired from children’s parents.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material


(DOCX 19 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Pan, Z., Zhang, X., Hui, Y. et al. Sex Difference Between Trace Elements and Pulmonary Functions in Children. Biol Trace Elem Res 197, 405–410 (2020).

Download citation


  • Zinc
  • Selenium
  • Magnesium
  • Children
  • Pulmonary function
  • IgE