Dolev E, Deuster P A, Solomon B, Trostmann U H, Wartofsky L, Burman K D
Department of Military Medicine, Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, MD 20814-4799.
Metabolism. 1988 Jan;37(1):61-7. doi: 10.1016/0026-0495(88)90030-3.
Magnesium (Mg) and zinc (Zn) status was assessed in subjects to evaluate the effects of thyroid diseases on Mg and Zn metabolism. Plasma and red blood cell (RBC) concentration and peripheral blood mononuclear cell (MNC) content of Mg and Zn, and 24-hour urinary excretion of Mg, Zn, creatinine (Cr), calcium (Ca), sodium (Na), and potassium (K) were measured in 11 thyrotoxic, 29 hypothyroid, and 25 euthyroid control subjects. Serum albumin, alpha 2-macroglobulin, and the binding of Zn to albumin were also determined. Plasma and RBC Mg concentrations were low in half of the hyperthyroid subjects, but mean values were not significantly different from controls. Urinary excretion and clearance of Mg were lower in hypothyroid subjects, but differences were removed when expressed relative to Cr excretion and clearance. Similar patterns were noted for urinary Ca, Na, and K, suggesting that their reduced excretion reflects alterations in renal hemodynamics. Plasma Zn was lower in hypothyroid subjects and correlated with serum albumin; MNC Zn and urinary Zn were also low. Plasma Zn concentration was normal and serum albumin significantly lower in the hyperthyroid group than in the control group. Further, RBC Zn content was significantly lower in hyperthyroid subjects, and inversely related to plasma thyroxine concentration. The hyperthyroid group also excreted significantly greater amounts of Zn than controls, indicative of a catabolic process. This increased urinary loss may reflect a shift in the distribution of plasma Zn between ultrafilterable and Zn-albumin complexes. In summary, this study provides evidence for marked alterations in Zn homeostasis in persons with thyroid disease. Whether the observations indicate deficiency states and have clinical implications will require further investigation.
对受试者的镁（Mg）和锌（Zn）状态进行评估，以评价甲状腺疾病对镁和锌代谢的影响。测定了11例甲状腺功能亢进、29例甲状腺功能减退和25例甲状腺功能正常的对照受试者的血浆和红细胞（RBC）中镁和锌的浓度、外周血单核细胞（MNC）中镁和锌的含量，以及24小时尿中镁、锌、肌酐（Cr）、钙（Ca）、钠（Na）和钾（K）的排泄量。还测定了血清白蛋白、α2-巨球蛋白以及锌与白蛋白的结合情况。一半的甲状腺功能亢进受试者血浆和红细胞镁浓度较低，但平均值与对照组无显著差异。甲状腺功能减退受试者尿镁排泄量和清除率较低，但相对于肌酐排泄量和清除率表达时差异消失。尿钙、钠和钾也有类似模式，表明其排泄减少反映了肾血流动力学的改变。甲状腺功能减退受试者血浆锌较低，且与血清白蛋白相关；MNC锌和尿锌也较低。甲状腺功能亢进组血浆锌浓度正常，但血清白蛋白显著低于对照组。此外，甲状腺功能亢进受试者红细胞锌含量显著较低，且与血浆甲状腺素浓度呈负相关。甲状腺功能亢进组尿锌排泄量也显著高于对照组，表明存在分解代谢过程。这种尿锌丢失增加可能反映了血浆锌在可超滤部分和锌-白蛋白复合物之间分布的改变。总之，本研究为甲状腺疾病患者锌稳态的显著改变提供了证据。这些观察结果是否表明锌缺乏状态及其临床意义尚需进一步研究。
