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缺铁性贫血患者的血清锌水平及其与缺铁性贫血症状的关联。

Serum zinc levels in patients with iron deficiency anemia and its association with symptoms of iron deficiency anemia.

作者信息

Kelkitli Engin, Ozturk Nurinnisa, Aslan Nevin Alayvaz, Kilic-Baygutalp Nurcan, Bayraktutan Zafer, Kurt Nezahat, Bakan Nuri, Bakan Ebubekir

机构信息

Department of Hematology, Ondokuz Mayıs University Medical School, Samsun, Turkey.

Department of Biochemistry, Ataturk University Medical School, Erzurum, Turkey.

出版信息

Ann Hematol. 2016 Apr;95(5):751-6. doi: 10.1007/s00277-016-2628-8. Epub 2016 Mar 2.

Abstract

Iron deficiency anemia (IDA) is a major public health problem especially in underdeveloped and developing countries. Zinc is the co-factor of several enzymes and plays a role in iron metabolism, so zinc deficiency is associated with IDA. In this study, it was aimed to investigate the relationship of symptoms of IDA and zinc deficiency in adult IDA patients. The study included 43 IDA patients and 43 healthy control subjects. All patients were asked to provide a detailed history and were subjected to a physical examination. The hematological parameters evaluated included hemoglobin (Hb); hematocrit (Ht); red blood cell (erythrocyte) count (RBC); and red cell indices mean corpuscular volume (MCV), mean corpuscular hemoglobin (МСН), mean corpuscular hemoglobin concentration (МСНС), and red cell distribution width (RDW). Anemia was defined according to the criteria defined by the World Health Organization (WHO). Serum zinc levels were measured in the flame unit of atomic absorption spectrophotometer. Symptoms attributed to iron deficiency or depletion, defined as fatigue, cardiopulmonary symptoms, mental manifestations, epithelial manifestations, and neuromuscular symptoms, were also recorded and categorized. Serum zinc levels were lower in anemic patients (103.51 ± 34.64 μ/dL) than in the control subjects (256.92 ± 88.54 μ/dL; <0.001). Patients with zinc level <99 μ/dL had significantly more frequent mental manifestations (p < 0.001), cardiopulmonary symptoms (p = 0.004), restless leg syndrome (p = 0.016), and epithelial manifestations (p < 0.001) than patients with zinc level > 100 μ/dL. When the serum zinc level was compared with pica, no statistically significant correlation was found (p = 0.742). Zinc is a trace element that functions in several processes in the body, and zinc deficiency aggravates IDA symptoms. Measurement of zinc levels and supplementation if necessary should be considered for IDA patients.

摘要

缺铁性贫血(IDA)是一个重大的公共卫生问题,尤其在欠发达国家和发展中国家。锌是多种酶的辅助因子,在铁代谢中发挥作用,因此锌缺乏与缺铁性贫血相关。本研究旨在调查成年缺铁性贫血患者中缺铁性贫血症状与锌缺乏之间的关系。该研究纳入了43例缺铁性贫血患者和43例健康对照者。所有患者均被要求提供详细病史并接受体格检查。评估的血液学参数包括血红蛋白(Hb)、血细胞比容(Ht)、红细胞计数(RBC)以及红细胞指数平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)和红细胞分布宽度(RDW)。贫血根据世界卫生组织(WHO)定义的标准来界定。血清锌水平采用原子吸收分光光度计火焰法进行测定。还记录并分类了归因于缺铁或铁耗竭的症状,定义为疲劳、心肺症状、精神表现、上皮表现和神经肌肉症状。贫血患者的血清锌水平(103.51±34.64μ/dL)低于对照组(256.92±88.54μ/dL;P<0.001)。锌水平<99μ/dL的患者比锌水平>100μ/dL的患者出现精神表现(P<0.001)、心肺症状(P=0.004)、不宁腿综合征(P=0.016)和上皮表现(P<0.001)的频率显著更高。当将血清锌水平与异食癖进行比较时,未发现统计学上的显著相关性(P=0.742)。锌是一种在人体多个过程中发挥作用的微量元素,锌缺乏会加重缺铁性贫血症状。对于缺铁性贫血患者,应考虑检测锌水平并在必要时进行补充。

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