择期膝关节置换术后全身炎症反应的急性变化与循环硫胺素和镁浓度的关系。

The relation between acute changes in the systemic inflammatory response and circulating thiamine and magnesium concentrations after elective knee arthroplasty.

机构信息

Emergency Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK.

Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, 8-16 Alexandra Parade, Glasgow, G31 2ER, UK.

出版信息

Sci Rep. 2021 May 28;11(1):11271. doi: 10.1038/s41598-021-90591-y.

DOI:10.1038/s41598-021-90591-y

PMID:34050237

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8163855/

Abstract

Thiamine diphosphate (TDP) and magnesium are co-factors for key enzymes in human intermediary metabolism. However, their role in the systemic inflammatory response (SIR) is not clear. Therefore, the aim of the present study was to examine the relation between acute changes in the SIR and thiamine and magnesium dependent enzyme activity in patients undergoing elective knee arthroplasty (a standard reproducible surgical injury in apparently healthy individuals). Patients (n = 35) who underwent elective total knee arthroplasty had venous blood samples collected pre- and post-operatively for 3 days, for measurement of whole blood TDP, serum and erythrocyte magnesium, erythrocyte transketolase activity (ETKA), lactate dehydrogenase (LDH), glucose and lactate concentrations. Pre-operatively, TDP concentrations, erythrocyte magnesium concentrations, ETKA and plasma glucose were within normal limits for all patients. In contrast, 5 patients (14%) had low serum magnesium concentrations (< 0.75 mmol/L). On post-operative day1, both TDP concentrations (p < 0.001) and basal ETKA (p < 0.05) increased and serum magnesium concentrations decreased (p < 0.001). Erythrocyte magnesium concentrations correlated with serum magnesium concentrations (r = 0.338, p < 0.05) and remained constant during SIR. Post-operatively 14 patients (40%) had low serum magnesium concentrations. On day1 serum magnesium concentrations were directly associated with LDH (p < 0.05), WCC (p < 0.05) and neutrophils (p < 0.01). Whole blood TDP and basal ETKA increased while serum magnesium concentrations decreased, indicating increased requirement for thiamine and magnesium dependent enzyme activity during SIR. Therefore, thiamine and magnesium represent potentially modifiable therapeutic targets that may modulate the host inflammatory response. Erythrocyte magnesium concentrations are likely to be reliable measures of status, whereas serum magnesium concentrations and whole blood TDP may not.ClinicalTrials.gov: NCT03554668.

摘要

硫胺素二磷酸（TDP）和镁是人体中间代谢关键酶的辅助因子。然而，它们在全身炎症反应（SIR）中的作用尚不清楚。因此，本研究旨在探讨 SIR 急性变化与接受择期膝关节置换术（在健康个体中是一种标准可重复的手术损伤）患者中硫胺素和镁依赖性酶活性之间的关系。接受择期全膝关节置换术的患者（n=35）在术前和术后 3 天内采集静脉血样，用于测量全血 TDP、血清和红细胞镁、红细胞转酮醇酶活性（ETKA）、乳酸脱氢酶（LDH）、血糖和乳酸浓度。术前，所有患者的 TDP 浓度、红细胞镁浓度、ETKA 和血浆葡萄糖均在正常范围内。相比之下，5 名患者（14%）的血清镁浓度较低（<0.75mmol/L）。术后第 1 天，TDP 浓度（p<0.001）和基础 ETKA（p<0.05）均升高，血清镁浓度降低（p<0.001）。红细胞镁浓度与血清镁浓度相关（r=0.338，p<0.05），在 SIR 期间保持不变。术后 14 名患者（40%）的血清镁浓度较低。第 1 天血清镁浓度与 LDH（p<0.05）、WCC（p<0.05）和中性粒细胞（p<0.01）直接相关。全血 TDP 和基础 ETKA 增加，而血清镁浓度降低，表明 SIR 期间对硫胺素和镁依赖性酶活性的需求增加。因此，硫胺素和镁是潜在可调节的治疗靶点，可能调节宿主炎症反应。红细胞镁浓度可能是可靠的状态指标，而血清镁浓度和全血 TDP 可能不是。ClinicalTrials.gov：NCT03554668。