Department of Nephrology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, Guangdong, People's Republic of China.
Department of Nephrology, Jiangmen Central Hospital, Jiangmen City, Guangdong, People's Republic of China.
Biol Trace Elem Res. 2022 Dec;200(12):4977-4987. doi: 10.1007/s12011-022-03104-x. Epub 2022 Feb 12.
Patients undergoing maintenance hemodialysis (MHD) are at risk of an imbalance of copper and zinc homeostasis. We hypothesized that there is an association between the blood copper-zinc (Cu/Zn) ratio and nutritional status in these patients. For this cross-sectional study, blood samples were collected from patients undergoing MHD at Guangzhou Red Cross Hospital in September 2019. Zinc and copper levels were measured using inductively coupled plasma mass spectrometry. The seven-point subjective global assessment (SGA), nutritional risk screening 2002 (NRS2002), and geriatric nutritional risk index (GNRI) were used to evaluate the overall nutritional status. We enrolled 144 MHD patients (men:women = 78:66), with an average age of 64.33 ± 13.39 years and a median dialysis vintage of 33.50 (16.25-57.50) months. Patients with a higher blood Cu/Zn ratio had lower levels of hemoglobin, blood zinc, serum prealbumin, albumin, and creatinine as well as low SGA and GNRI scores, but higher modified Charlson comorbidity index score, serum C-reactive protein level, interleukin-6 level, blood copper level, and NRS2002 score (all p < 0.05). After adjustment for confounding factors in multivariable models, a high blood Cu/Zn ratio was independently associated with nutritional risk defined by all nutritional parameters (SGA, NRS2002, and GNRI). Prospective studies with larger sample sizes are warranted to confirm these results.
接受维持性血液透析（MHD）的患者存在铜锌平衡失调的风险。我们假设这些患者的血液铜锌（Cu/Zn）比值与营养状况之间存在关联。在这项横断面研究中，我们于 2019 年 9 月采集了广州红十字会医院接受 MHD 的患者的血液样本。使用电感耦合等离子体质谱法测量锌和铜水平。采用七点主观整体评估（SGA）、2002 年营养风险筛查（NRS2002）和老年营养风险指数（GNRI）评估整体营养状况。我们共纳入了 144 名 MHD 患者（男：女=78:66），平均年龄为 64.33±13.39 岁，中位透析龄为 33.50（16.25-57.50）个月。血液 Cu/Zn 比值较高的患者血红蛋白、血锌、血清前白蛋白、白蛋白和肌酐水平较低，SGA 和 GNRI 评分较低，但改良 Charlson 合并症指数评分、血清 C 反应蛋白水平、白细胞介素-6 水平、血铜水平和 NRS2002 评分较高（均 P<0.05）。在校正了多变量模型中的混杂因素后，高血液 Cu/Zn 比值与所有营养参数（SGA、NRS2002 和 GNRI）定义的营养风险独立相关。需要更大样本量的前瞻性研究来证实这些结果。
