Klevay L M
Clin Geriatr Med. 1987 May;3(2):361-72.
Four classes of etiologic agents that cause human illness have been discovered. Sometimes members of two or more classes of agents cooperate to cause illness. Knowledge of etiology is necessary if a disease is to be eradicated. The leading causes of death in the United States have changed dramatically in the last century. Infection has been replaced by chronic illnesses of obscure etiology. Ischemic heart disease is the leading cause of death in middle age and is the major obstacle to becoming old. There are numerous similarities between animals deficient in copper and people with ischemic heart disease. The most important of these similarities are glucose intolerance, hypercholesterolemia, abnormal electrocardiogram, hyperuricemia, and hypertension, as these characteristics are predictive of risk of ischemic heart disease. No other nutritional insult has produced these characteristics in experiments with animals; men fed diets low in copper have been found to have increased cholesterol, decreased glucose tolerance, and abnormal electrocardiograms. The process that results in ischemic heart disease is remarkably similar to that of copper deficiency. Links have been found between copper metabolism and several hypotheses on the origin of ischemic heart disease. Several aspects of the lipid hypothesis can be interpreted in terms of copper metabolism. More features of the etiology, pathogenesis, and pathophysiology of ischemic heart disease can be explained in terms of copper deficiency than can be explained by any other environmental insult.
已发现四类可导致人类疾病的病原体。有时，两类或更多类病原体的成员会协同致病。若要根除一种疾病，病因学知识必不可少。在上个世纪，美国的主要死因发生了巨大变化。感染已被病因不明的慢性疾病所取代。缺血性心脏病是中年人的主要死因，也是长寿的主要障碍。缺铜动物与缺血性心脏病患者之间存在许多相似之处。其中最重要的相似之处是葡萄糖不耐受、高胆固醇血症、心电图异常、高尿酸血症和高血压，因为这些特征可预测缺血性心脏病的风险。在动物实验中，没有其他营养损伤会产生这些特征；人们发现，食用低铜饮食的男性胆固醇升高、葡萄糖耐量降低且心电图异常。导致缺血性心脏病的过程与铜缺乏症的过程非常相似。已发现铜代谢与缺血性心脏病起源的几种假说之间存在联系。脂质假说的几个方面可以从铜代谢的角度进行解释。与任何其他环境损伤相比，缺血性心脏病的病因、发病机制和病理生理学的更多特征可以用铜缺乏来解释。
