Ghayour-Mobarhan Majid, Taylor Andrew, Kazemi-Bajestani Seyyed Mohammad Reza, Lanham-New Susan, Lamb David J, Vaidya Nandita, Livingstone Callum, Wang Tim, Ferns Gordon A A
Centre for Clinical Science & Measurement, School of Biomedical & Molecular Science, University of Surrey, Guildford, Surrey, United Kingdom.
Clin Lab. 2008;54(9-10):321-9.
Aspects of trace element status have previously been investigated as possible contributory factors to atherosclerosis. In this present study a more comprehensive approach has been taken, looking at the relationship between dietary macro- and micronutrient intake, serum concentrations of zinc and copper, and markers of inflammation in dyslipidaemic patients with or without established coronary artery disease (CAD) and healthy controls, so that a clearer understanding of the potential relationship between copper and zinc status and coronary disease may be ascertained.
Dyslipidaemic patients (n = 238) were recruited from the local General Hospital in Guildford, UK. Fifty-five of these patients had established CAD. Control subjects (n = 135) were recruited from among employees at the local University and Hospital. A validated food frequency questionnaire was used for estimating the dietary intake of zinc and copper.
Serum copper, copper/caeruloplasmin ratio, zinc/copper ratio, and C-reactive protein (CRP) were significantly different in the patient groups compared to controls [serum copper: 17.20 +/- 0.2 v 15.91 +/- 0.29 micromol/L, p < 0.001; copper/caeruloplasmin ratio: 111.37 +/- 2.18 v 100.63 +/- 2.93 micromol/g, p < 0.01; zinc/copper ratio: 0.85 +/- 0.01 v 0.90 +/- 0.01, p < 0.05; and CRP: 1.25 (0.42-3.26) v 0.58 (0.17-1.42) mg/L, p < 0.001]. Dietary protein, total fat, starch, fibre, monounsaturated fat, zinc, and zinc/copper ratio were also significantly higher in the patients compared to controls. Patients with established CAD had significantly higher serum CRP (p < 0.05) and lower serum zinc (p < 0.01) and zinc/copper ratio (p < 0.01) compared to both patients without CAD and healthy controls.
Significant differences in copper and zinc status, dietary intake and markers of inflammation were observed in patients with dyslipidaemia, with or without established CAD, compared with control subjects. Differences in serum CRP, copper and caeruloplasmin may be related to a heightened state of inflammation. The imbalance in zinc/copper metabolism may either contribute to the CAD risk or be a consequence of an acute phase response.
微量元素状态的相关方面此前已被作为动脉粥样硬化可能的促成因素进行研究。在本研究中，我们采用了一种更全面的方法，研究血脂异常患者（无论有无已确诊的冠状动脉疾病（CAD））及健康对照者的膳食常量和微量营养素摄入量、血清锌和铜浓度与炎症标志物之间的关系，以便更清楚地确定铜和锌状态与冠状动脉疾病之间的潜在关系。
从英国吉尔福德当地综合医院招募血脂异常患者（n = 238）。其中55例患者已确诊CAD。对照受试者（n = 135）从当地大学和医院的员工中招募。使用经过验证的食物频率问卷来估计锌和铜的膳食摄入量。
与对照组相比，患者组的血清铜、铜/铜蓝蛋白比值、锌/铜比值和C反应蛋白（CRP）有显著差异[血清铜：17.20±0.2对15.91±0.29微摩尔/升，p < 0.001；铜/铜蓝蛋白比值：111.37±2.18对100.63±2.93微摩尔/克，p < 0.01；锌/铜比值：0.85±0.01对0.90±0.01，p < 0.05；CRP：1.25（0.42 - 3.26）对0.58（0.17 - 1.42）毫克/升，p < 0.001]。与对照组相比，患者的膳食蛋白质、总脂肪、淀粉、纤维、单不饱和脂肪、锌和锌/铜比值也显著更高。与无CAD的患者和健康对照者相比，已确诊CAD的患者血清CRP显著更高（p < 0.05），血清锌显著更低（p < 0.01），锌/铜比值显著更低（p < 0.01）。
与对照受试者相比，血脂异常患者（无论有无已确诊的CAD）在铜和锌状态、膳食摄入量及炎症标志物方面存在显著差异。血清CRP、铜和铜蓝蛋白的差异可能与炎症状态增强有关。锌/铜代谢失衡可能促成CAD风险，也可能是急性期反应的结果。
