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降压治疗联合改良饮食或补锌对高血压患者生化参数和矿物质状况的影响。

Effect of hypotensive therapy combined with modified diet or zinc supplementation on biochemical parameters and mineral status in hypertensive patients.

机构信息

Instytut Żywienia Człowieka i Dietetyki, Uniwersytet Przyrodniczy w Poznaniu (Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences), ul. Wojska Polskiego 31, 60-624 Poznań, Poland.

Zakład Edukacji i Leczenia Otyłości oraz Zaburzeń Metabolicznych, Uniwersytet Medyczny w Poznaniu (Department of Education and Obesity Treatment and Metabolic Disorders, University of Medical Sciences, Poznan, Poland), ul. Szamarzewskiego 82/84, 60-569 Poznan, Poland.

出版信息

J Trace Elem Med Biol. 2018 May;47:140-148. doi: 10.1016/j.jtemb.2018.02.016. Epub 2018 Feb 18.

Abstract

BACKGROUND

Hypotensive therapy leads to a number of trace elements metabolism disturbances. Zinc balance is frequently affected by antihypertensive treatment.

AIM

To evaluate the effect of a hypotensive treatment, modified diet and zinc supplementation on mineral status and selected biochemical parameters in newly diagnosed hypertensive patients on monotherapy.

METHODS

In the first stage, arterial hypertension in ninety-eight human subjects was diagnosed. In the second stage, antihypertensive monopharmacotherapy was implemented. In the third stage, patients were randomized into three groups and continued antihypertensive monotherapy: group D received an optimal-mineral-content diet, group S received zinc supplementation, and group C had no changes in diet or zinc supplementation. Iron, zinc, and copper concentrations in serum, erythrocytes, urine, and hair were determined. Lipids, glucose, ceruloplasmin, ferritin, albumin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α), nitric oxide (NO), superoxide dismutase (SOD) and catalase (CAT) were assayed in serum.

RESULTS

Antihypertensive monotherapy decreased zinc concentration in serum and erythrocytes and increased the level of zinc in urine, decreased CAT and SOD activity, TNF-α concentration in serum, and increased the level of NO in the serum. Zinc supply led to an increase in zinc concentration in serum, erythrocytes, and hair (in group S only). In the groups with higher zinc intake, decreased glucose concentration in the serum was observed. Significant correlation was seen between the zinc and glucose serum concentrations.

CONCLUSION

Hypotensive drugs disturb zinc status in newly diagnosed hypertensive patients. Antihypertensive monotherapy combined with increased zinc supply in the diet or supplementation favorably modify zinc homeostasis and regulate glucose status without blood pressure affecting in patients with hypertension.

摘要

背景

降压治疗会导致多种微量元素代谢紊乱。锌平衡经常受到降压治疗的影响。

目的

评估降压治疗、饮食改良和补锌对单一疗法治疗的新诊断高血压患者矿物质状态和某些生化参数的影响。

方法

在第一阶段,诊断了 98 例人类高血压患者。在第二阶段,实施了降压单一药物治疗。在第三阶段,患者被随机分为三组并继续接受降压单一药物治疗:组 D 接受最佳矿物质含量饮食,组 S 接受锌补充,组 C 则不改变饮食或锌补充。测定血清、红细胞、尿液和头发中铁、锌和铜的浓度。测定血清中的脂质、葡萄糖、铜蓝蛋白、铁蛋白、白蛋白、C 反应蛋白 (CRP)、肿瘤坏死因子-α (TNF-α)、一氧化氮 (NO)、超氧化物歧化酶 (SOD) 和过氧化氢酶 (CAT)。

结果

降压单一药物治疗降低了血清和红细胞中的锌浓度,增加了尿液中的锌水平,降低了 CAT 和 SOD 活性、血清中的 TNF-α 浓度,增加了血清中的 NO 水平。锌供应导致血清、红细胞和头发中的锌浓度增加(仅在组 S 中)。在锌摄入量较高的组中,观察到血清中葡萄糖浓度降低。血清锌浓度与葡萄糖浓度之间存在显著相关性。

结论

降压药物会扰乱新诊断的高血压患者的锌状态。降压单一药物治疗联合饮食中增加锌供应或补充可有利地改善锌平衡并调节葡萄糖状态,而不会影响高血压患者的血压。

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