Hajji Marwa, Khedher Rania, Mrad Mehdi, Bassem Hammami Mohamed, Rafrafi Nawel, Chouchi Salma, Feki Moncef, Bahlous Afef, Zouaghi Karim, Fellah Hayet
University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia.
Rabta University Hospital, Laboratory of Biochemistry, Tunis, Tunisia.
J Med Biochem. 2021 Mar 12;40(2):193-198. doi: 10.5937/jomb0-26698.
Zinc (Zn) deficiency is a common condition and could contribute to poor outcomes in hemodialysis (HD) patients. The aim of this study was to evaluate the effects of Zn supplementation on serum copper (Cu) to Zn and C-reactive protein (CRP) to albumin ratios (CAR) in HD patients.
Seventy-seven HD patients were enrolled in a multicentre simple-blind randomized clinical trial. Only 37 HD patients completed the study; they were randomly divided into two groups and supplemented with zinc sulphate (n=17) or placebo (n=20) for two months. Serum Zn and Cu were measured by atomic absorption spectrophotometry. Serum albumin and hypersensitive-CRP were assessed by colorimetric and immunoturbidimetric method, respectively. Determinations were performed before and after supplementation.
After two months of supplementation, serum Zn significantly increased, and Cu to Zn ratio decreased in Zn supplemented group, but remained unchanged in the placebo group. In parallel, serum albumin concentrations significantly increased, and CAR decreased in Zn supplemented group only.
Zn supplementation reduces Cu to Zn and CRP to albumin ratios in HD patients. These changes point towards an improvement in nutritional, oxidative and inflammatory status. The study findings suggest that correcting Zn deficiency reduces poor outcomes in HD patients.
锌（Zn）缺乏是一种常见情况，可能导致血液透析（HD）患者预后不良。本研究的目的是评估补充锌对HD患者血清铜（Cu）与锌的比值以及C反应蛋白（CRP）与白蛋白的比值（CAR）的影响。
77例HD患者参加了一项多中心单盲随机临床试验。只有37例HD患者完成了研究；他们被随机分为两组，分别补充硫酸锌（n = 17）或安慰剂（n = 20），为期两个月。血清锌和铜通过原子吸收分光光度法测定。血清白蛋白和超敏C反应蛋白分别通过比色法和免疫比浊法评估。在补充前后进行测定。
补充两个月后，补充锌组的血清锌显著升高，铜与锌的比值降低，而安慰剂组保持不变。同时，仅补充锌组的血清白蛋白浓度显著升高，CAR降低。
补充锌可降低HD患者铜与锌的比值以及CRP与白蛋白的比值。这些变化表明营养、氧化和炎症状态有所改善。研究结果表明，纠正锌缺乏可减少HD患者的不良预后。
