McClain C J, Stuart M A, Vivian B, McClain M, Talwalker R, Snelling L, Humphries L
Department of Medicine, University of Kentucky Medical Center, Lexington 40536-0084.
J Am Coll Nutr. 1992 Dec;11(6):694-700. doi: 10.1080/07315724.1992.10718269.
Reduced food consumption is a major manifestation of zinc (Zn) deficiency. Many manifestations of Zn deficiency are complications of anorexia nervosa and bulimia nervosa. We evaluated serum and 24-hour urinary Zn values in 12 healthy volunteers and 33 eating disorder patients before and after hospitalization which included either Zn supplementation (75 mg Zn/day) or placebo. Bulimics had depressed serum Zn concentrations (p < 0.025). Admission urinary Zn was lower in bulimics (258 +/- 44 micrograms/day), and significantly depressed in anorexics (196 +/- 36 micrograms/day, p < 0.005) vs controls (376 +/- 45 micrograms/day). During hospitalization, serum Zn concentrations increased in all supplemented patients vs no change with placebo. Urinary Zn excretion increased in supplemented bulimics (p < 0.001) and placebo (p < 0.05). Urinary Zn excretion markedly increased in supplemented anorexics (179 +/- 65 to 1052 +/- 242 micrograms/day); however, placebo values fell or remained unacceptably low (admission 208 +/- 48 micrograms/day; discharge 160 +/- 17 micrograms/day). By dietary history, controls consumed the Recommended Dietary Allowance (RDA) for Zn (11.95 +/- 1.25 mg/day); anorexics 6.46 +/- 1.14 mg/day; and bulimics 8.93 +/- 1.29 mg/day. We suggest that Zn deficiency may act as a "sustaining" factor for abnormal eating behavior in certain eating disorder patients.
食物摄入量减少是锌（Zn）缺乏的主要表现。锌缺乏的许多表现都是神经性厌食症和神经性贪食症的并发症。我们评估了12名健康志愿者和33名饮食失调患者在住院前后的血清和24小时尿锌值，住院期间这些患者接受了补锌（75毫克锌/天）或安慰剂治疗。贪食症患者的血清锌浓度降低（p < 0.025）。贪食症患者入院时尿锌较低（258±44微克/天），与对照组（376±45微克/天）相比，神经性厌食症患者的尿锌显著降低（196±36微克/天，p < 0.005）。住院期间，所有接受补锌治疗的患者血清锌浓度均升高，而接受安慰剂治疗的患者则无变化。接受补锌治疗的贪食症患者尿锌排泄增加（p < 0.001），接受安慰剂治疗的患者尿锌排泄也增加（p < 0.05）。接受补锌治疗的神经性厌食症患者尿锌排泄显著增加（从179±65微克/天增至1052±242微克/天）；然而，接受安慰剂治疗的患者尿锌值下降或仍低至不可接受的水平（入院时208±48微克/天；出院时160±17微克/天）。根据饮食史，对照组摄入的锌量达到推荐膳食摄入量（RDA）（11.95±1.25毫克/天）；神经性厌食症患者为6.46±1.14毫克/天；神经性贪食症患者为8.93±1.29毫克/天。我们认为，锌缺乏可能是某些饮食失调患者异常饮食行为的一个“持续存在”的因素。
