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铁与锰、锌、铬和硒的相互作用与缺铁的预防和治疗相关。

Interactions of iron with manganese, zinc, chromium, and selenium as related to prophylaxis and treatment of iron deficiency.

作者信息

Bjørklund Geir, Aaseth Jan, Skalny Anatoly V, Suliburska Joanna, Skalnaya Margarita G, Nikonorov Alexandr A, Tinkov Alexey A

机构信息

Council for Nutritional and Environmental Medicine, Mo i Rana, Norway.

Department of Public Health, Hedmark University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.

出版信息

J Trace Elem Med Biol. 2017 May;41:41-53. doi: 10.1016/j.jtemb.2017.02.005. Epub 2017 Feb 12.

Abstract

Iron (Fe) deficiency is considered as the most common nutritional deficiency. Iron deficiency is usually associated with low Fe intake, blood loss, diseases, poor absorption, gastrointestinal parasites, or increased physiological demands as in pregnancy. Nutritional Fe deficiency is usually treated with Fe tablets, sometimes with Fe-containing multimineral tablets. Trace element interactions may have a significant impact on Fe status. Existing data demonstrate a tight interaction between manganese (Mn) and Fe, especially in Fe-deficient state. The influence of Mn on Fe homeostasis may be mediated through its influence on Fe absorption, circulating transporters like transferrin, and regulatory proteins. The existing data demonstrate that the influence of zinc (Zn) on Fe status may be related to their competition for metal transporters. Moreover, Zn may be involved in regulation of hepcidin production. At the same time, human data on the interplay between Fe and Zn especially in terms of Fe-deficiency and supplementation are contradictory, demonstrating both positive and negative influence of Zn on Fe status. Numerous data also demonstrate the possibility of competition between Fe and chromium (Cr) for transferrin binding. At the same time, human data on the interaction between these metals are contradictory. Therefore, while managing hypoferremia and Fe-deficiency anemia, it is recommended to assess the level of other trace elements in parallel with indices of Fe homeostasis. It is supposed that simultaneous correction of trace element status in Fe deficiency may help to decrease possible antagonistic or increase synergistic interactions.

摘要

缺铁被认为是最常见的营养缺乏症。缺铁通常与铁摄入量低、失血、疾病、吸收不良、胃肠道寄生虫感染或怀孕等生理需求增加有关。营养性缺铁通常用铁剂治疗,有时也用含铁的多矿物质片治疗。微量元素之间的相互作用可能对铁状态产生重大影响。现有数据表明锰(Mn)与铁之间存在紧密的相互作用,尤其是在缺铁状态下。锰对铁稳态的影响可能通过其对铁吸收、循环转运蛋白(如转铁蛋白)和调节蛋白的影响来介导。现有数据表明锌(Zn)对铁状态的影响可能与其对金属转运蛋白的竞争有关。此外,锌可能参与铁调素生成的调节。同时,关于铁和锌之间相互作用的人体数据,尤其是在缺铁和补充铁方面的数据相互矛盾,表明锌对铁状态既有正面影响也有负面影响。大量数据还表明铁和铬(Cr)之间存在竞争转铁蛋白结合的可能性。同时,关于这些金属之间相互作用的人体数据相互矛盾。因此,在处理低铁血症和缺铁性贫血时,建议在评估铁稳态指标的同时,并行评估其他微量元素的水平。据推测,同时纠正缺铁状态下的微量元素状况可能有助于减少可能的拮抗作用或增强协同作用。

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