***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The increments in plasma zinc concentrations after an oral dose of elemental zinc ( 50 mg ) as the sulphate were used to assess the intestinal absorption of the metal in 11 patients with dermatitis herpetiformis ( DH ) before starting a gluten-free diet , 12 patients with newly diagnosed celiac disease ( CD ) , 10 patients known to have CD , and 15 healthy volunteers . The areas under the plasma zinc increment curve plotted against time were determined for 3 ( AUC3 ) and 6 ( AUC6 ) h. The AUC3 in healthy volunteers was 401 + /- 48 mumol 1(-1 ) 3 h ( mean + /- SD ) ; it was reduced in newly diagnosed CD 187 + /- 76 mumol 1(-1 ) 3 h ( p less than 0.001 ) , and in dermatitis herpetiformis 206 + /- 87 mumol 1(-1 ) 3 h ( p less than 0.01 ) ; but it was normal in the known CD 396 + /- 204 mumol 1(-1 ) 3 h , the wide variation reflecting the variable compliance with a previously instituted gluten-free diet . The AUC6 was similarly affected , healthy volunteers 700 + /- 111 mumol 1(-1 ) 6 h , new CD 380 + /- 169 mumol 1(-1 ) 6 h ( p less than 0.01 ) ; dermatitis herpetiformis 471 + /- 107 mumol 1(-1 ) 6 h ( p less than 0.01 ) ; known CD 725 + /- 380 mumol 1(-1 ) 6 h. The AUC3 was more consistently abnormal than conventional tests of small intestinal function . In a prospect i ve study the AUC3 and AUC6 improved and reflected compliance with a gluten-free diet Studies of  zinc  status in insulin-dependent diabetes mellitus ( IDDM ) have shown contradictory results . Zinc is essential for many enzymes involved in the human metabolism and may play a role in the bio synthesis and storage of insulin in the B-cell . We therefore prospect ively followed 26 patients ( 14 males and 12 females ) with newly diagnosed IDDM in order to determine the plasma zinc variation at the time of diagnosis and after 1 , 3 , 6 , 12 and 24 months . Seventy-two healthy persons ( 36 males and 36 females ) served as controls . Only minor differences in plasma zinc were demonstrated during the first 2 years of IDDM . A sex difference was found in healthy controls but only after 24 months in the diabetics . Quantitative changes of the B-cell function , development of insulin antibodies , age , body weight and serum albumin did not correlate with the course of plasma zinc Two main diabetic groups were investigated , viz , one consisting of 19 diabetic children with newly diagnosed insulin-dependent diabetes mellitus ( IDDM ) ( median age 10 years ) where a prospect i ve study was made , and one where a retrospective examination was performed of 73 patients ( median age 14 years ) with a mean duration of IDDM of 7 years ; 83 healthy school children ( median age 13 years ) served as controls . In both groups of diabetic children more zinc was excreted in the urine than in the controls . At onset of IDDM , serum and blood clot zinc concentrations were reduced with a gradual increase towards normal within 1 month of insulin therapy . The zinc concentrations in hair did not differ from those of the controls . No correlation were found between zinc levels in serum , blood clots , urine and hair on one h and and the concentrations of albumin and glucose in serum and urine on the other Disturbances of zinc homeostasis have been observed in several diseases , including diabetes mellitus . To further characterize the association between zinc and diabetes , we recruited 75 patients with type 1 or type 2 diabetes and 75 nondiabetic sex-/age-matched control subjects in order to analyze differences concerning human zinc transporter 8 ( hZnT-8 ) expression , single nucleotide polymorphisms ( SNPs ) in the genes of hZnT-8 as well as metallothionein 1A and serum/intracellular zinc . Furthermore , we investigated the relation between insulin and zinc homeostasis in type 2 diabetic subjects and consoli date d our results by in vitro analysis of the effect of insulin on cellular zinc status and by analysis of the modulation of insulin signal transduction by intracellular zinc homeostasis . Concerning the expression of hZnT-8 and the SNPs analyzed , we did not observe any differences between diabetic and control subjects . Serum zinc was significantly lower in diabetic patients compared to controls , and intracellular zinc showed the same tendency . Interestingly , type 2 diabetes patients treated with insulin displayed lower serum zinc compared to those not injecting insulin . In vitro analyses showed that insulin leads to an increase in intracellular zinc and that insulin signaling was enhanced by elevated intracellular zinc concentrations . In conclusion , we show that type 1 and type 2 diabetic patients suffer from zinc deficiency , and our results indicate that zinc supplementation may qualify as a potential treatment adjunct in type 2 diabetes by promoting insulin signaling , especially in zinc-deficient subjects Rheumatoid arthritis ( RA ) is a chronic autoimmune inflammatory disease , which mainly involves the joints . RA is prevalent worldwide with increasing prevalence in elderly people . The mechanism of RA pathogenesis is still undefined , and it is interplaying between genetic susceptibility and environmental factors . Although risk factors for RA are not fully established , various studies have focused on the role of trace elements in association with RA . Trace elements act as co-factors for most of the enzymes , and their deficiency is associated with many untoward effects on human health . The homeostatic alterations in the metabolism of trace elements may partly be due to inflammatory response in RA . The objective of the present study was to determine the serum concentrations and correlation of zinc , copper , and iron in RA patients and healthy controls . The study comprised of 61 RA patients and 61 age- and sex-related healthy individuals of Pakistani population .  Serum levels of Zn , Cu , and Fe were measured in all the participants by atomic absorption spectrophotometer .  Serum Zn and Fe were significantly reduced in the RA patients than those in the healthy controls . Serum Cu concentrations were found elevated in the RA patients . Correlation studies of trace elements determine that there was negative correlation between Zn and Cu in the RA patients and no correlation in the control group . It is very important to explore the deficiency of essential trace metals in biological sample s of the RA patients in different population s which may be helpful for diagnosis and supplementary management of rheumatoid arthritis patients The urinary excretion of zinc in individuals with insulin-dependent diabetes mellitus ( IDDM ) is approximately doubled . In the absence of a compensatory mechanism , this hyperzincuria should induce a deficient or marginal Zn status . We examined parameters of Zn status in plasma and in blood cells with respect to urinary Zn losses and Zn supplementation . We measured Zn levels in the urine , plasma , and erythrocytes of 14 IDDM subjects and 15 nondiabetics who kept dietary records for 3 consecutive days . Subsequently , six IDDM subjects and seven nondiabetics were supplemented with 50 mg Zn daily for 28 days . We measured the above parameters , as well as mononuclear leukocyte Zn ( MNL-Zn ) and the plasma subfraction of albumin-bound Zn ( alb-Zn ) . The total plasma Zn-binding capacity was also assessed . Plasma copper and erythrocyte Cu were monitored as indicators of potential Zn toxicity . Individuals with IDDM displayed the expected hyperzincuria , but had normal blood Zn parameters . Zincuria increased by a similar amount in both groups during supplementation , as did the MNL-Zn content . However , erythrocyte Zn ( e-Zn ) was refractory , so a trend toward lower e-Zn among IDDM subjects persisted during Zn supplementation . Hemoglobin A1c ( HbA1c ) increased markedly in the Zn-supplemented IDDM group . Despite their chronic hyperzincuria , individuals with IDDM appear not to be Zn-deficient . Large-dose Zn supplementation increases MNL-Zn and induces an undesirable elevation of HbA1c in all individuals . This is especially disconcerting for those with IDDM , and may reflect an exacerbation of a chronic " Zn diabetes . " These data suggest a potential for toxicity from large-dose Zn supplementation 
    Output:
    
The data presented in our work , although very heterogeneous in the manner of collecting and investigating sample s , have proved to be extremely consistent in witnessing a deficiency of zinc in serum and plasma of  patients  compared to controls