Reina de la Torre Maria Luisa, Navarro-Alarcón Miguel, del Moral Loreto Martí, López-G de la Serrana Herminia, Palomares-Bayo Magdalena, Oliveras López María Jesús, Blanca Herrera Rosa María, Agil Ahmad
Department of Nutrition and Food Chemistry, School of Pharmacy, University of Granada, 18071, Granada, Spain.
Biol Trace Elem Res. 2014 May;158(2):129-35. doi: 10.1007/s12011-014-9921-y. Epub 2014 Mar 2.
The objective of this study was to analyze serum Zn and Cu concentrations and Cu/Zn ratios in 116 hemodialysis patients (HPs) over a 2-year longitudinal study at four time points (6-month intervals). The relation exerted on these values by 26 biochemical and nutritional indexes, the age and drug consumption of the patients, and the etiology of their disease were also evaluated. A healthy control group (n = 50) was also studied. Mean serum Zn concentrations were lower (p = 0.009) and the Cu/Zn ratios higher (p = 0.009) in HPs than in controls. Serum Cu levels in HP did not differ to those of controls. At all four sampling times, the mean serum Zn levels and Cu/Zn ratios were lower and higher, respectively, in HPs than in the controls. There was a significant reduction in serum Zn levels and an increase in Cu concentrations and Cu/Zn ratios in HPs from the second to the fourth sampling. Serum Zn levels of the HPs diminish with age older than 50 years. Serum Cu levels were significantly higher in patients consuming antihypercalcemic or anti-infarction drugs, whereas serum Cu levels and Cu/Zn ratios were significantly lower in those treated with diuretics. Diminished Zn levels were negatively correlated with low-density lipoprotein (LDL) cholesterol in HPs; however, enhanced Cu/Zn ratios were positively correlated with total cholesterol and LDL cholesterol. Both findings indicate an increased cardiovascular risk. We conclude that this study contributes the first evidence of a correlation between marked dyslipidemia and worsened Cu/Zn ratios in HPs, implying an increased risk of diseases associated with elevated oxidative stress, inflammation, and depressed immune function, such as cardiovascular diseases.
本研究的目的是在一项为期2年的纵向研究中，于4个时间点（间隔6个月）分析116例血液透析患者（HPs）的血清锌和铜浓度以及铜/锌比值。还评估了26项生化和营养指标、患者的年龄和药物消耗以及疾病病因对这些值的影响。同时研究了一个健康对照组（n = 50）。与对照组相比，HPs的平均血清锌浓度较低（p = 0.009），铜/锌比值较高（p = 0.009）。HPs的血清铜水平与对照组无差异。在所有4个采样时间点，HPs的平均血清锌水平均低于对照组，铜/锌比值均高于对照组。从第二次到第四次采样，HPs的血清锌水平显著降低，铜浓度和铜/锌比值升高。年龄大于50岁的HPs血清锌水平随年龄增长而降低。服用抗高钙血症或抗梗死药物的患者血清铜水平显著较高，而使用利尿剂治疗的患者血清铜水平和铜/锌比值显著较低。HPs中锌水平降低与低密度脂蛋白（LDL）胆固醇呈负相关；然而，铜/锌比值升高与总胆固醇和LDL胆固醇呈正相关。这两个发现均表明心血管风险增加。我们得出结论，本研究首次提供了证据，证明HPs中明显的血脂异常与恶化的铜/锌比值之间存在相关性，这意味着与氧化应激升高、炎症和免疫功能低下相关的疾病风险增加，如心血管疾病。
