Bovio G, Piazza V, Ronchi A, Montagna G, Semeraro L, Galli F, Efficace E, Picardi L, Villa G, Segagni S, Minoia C
Metabolic-Nutritional Unit, Palliative Care Unit, Salvatore Maugeri Foundation, IRCCS Rehabilitation Institute of Pavia, Pavia, Italy.
Minerva Gastroenterol Dietol. 2007 Dec;53(4):329-36.
Trace elements are involved in many metabolic processes. They circulate prevalently bound to protein. In literature few studies deal with metal metabolism in adult patients with proteinuria, so we decided to further investigate metal metabolism in proteinuric patients.
We studied 27 patients (14 male, 13 female), mean age 61.6+/-17 years with different degrees of renal function, serum albumin and proteinuria. Metal concentrations of copper (Cu), zinc (Zn) and aluminum (Al) were measured in serum and urine. No patient had environmental exposure to these metals.
The serum Zn level was below the normal range in 11 patients. The serum Cu level was reduced in 5 patients. The Al serum level was elevated in 4 patients. Six patients had reduced and 6 patients had elevated Zn excretion. The urinary Cu excretion was elevated in 6 patients. The urinary Al excretion was elevated in 1 patient. Trace metal concentrations were related neither to renal function nor to total serum protein or albumin levels. Serum zinc was directly correlated with proteinuria and urinary zinc and negatively correlated with testosterone levels in both sexes.
Adult patients with proteinuria have several modification of trace metal concentration in serum and urine. Serum concentration of metals did not depend on renal function or serum protein levels. Urinary Zn excretion was directly related to proteinuria and serum Zn levels. A negative correlation between serum Zn levels and testosterone was found in both sexes. Renal failure reduced urinary excretion of Cu and Al.
微量元素参与许多代谢过程。它们主要以与蛋白质结合的形式循环。文献中很少有研究涉及成年蛋白尿患者的金属代谢,因此我们决定进一步研究蛋白尿患者的金属代谢。
我们研究了27例患者(14例男性,13例女性),平均年龄61.6±17岁,具有不同程度的肾功能、血清白蛋白和蛋白尿。测定了血清和尿液中铜(Cu)、锌(Zn)和铝(Al)的金属浓度。没有患者有这些金属的环境暴露。
11例患者的血清锌水平低于正常范围。5例患者的血清铜水平降低。4例患者的血清铝水平升高。6例患者的锌排泄减少,6例患者的锌排泄增加。6例患者的尿铜排泄增加。1例患者的尿铝排泄增加。微量元素浓度与肾功能、总血清蛋白或白蛋白水平均无关。血清锌与蛋白尿、尿锌直接相关,与两性的睾酮水平呈负相关。
成年蛋白尿患者血清和尿液中的微量元素浓度有多种改变。血清金属浓度不依赖于肾功能或血清蛋白水平。尿锌排泄与蛋白尿和血清锌水平直接相关。两性血清锌水平与睾酮之间均存在负相关。肾衰竭减少了铜和铝的尿排泄。