Stammler G, Klooker P, Bommer J, Ziegler T, Fiehn W, Manthey J, Ritz E
Blood Purif. 1985;3(4):192-8. doi: 10.1159/000169413.
The response of serum alkaline phosphatase (AP), a zinc-dependent metalloenzyme, to zinc administration via the dialysate (400 micrograms/l) was examined in 14 hypozincemic (less than 30th percentile of dialysis patients) hemodialysis patients and in 14 placebo-treated matched dialysis control patients. Plasma zinc and serum AP were measured three times: prior to, once weekly during (5 weeks), and 2 weeks after addition of zinc to the dialysate. The serum zinc levels remained stable in placebo-treated controls (initial 87.7 +/- 12.5; final 78.6 +/- 8.3 micrograms/dl) and increased in zinc-treated patients (initial 76.4 +/- 8.3; 5th week 96.9 +/- 13.3; 2 weeks after zinc withdrawal 82.3 +/- 12.2 micrograms/dl). There was a slight increase of AP with time in placebo controls (initial 90.2 +/- 26.5; 5th week 100 +/- 29 U/l) and a more pronounced increase in zinc-treated patients (initial 90.8 +/- 19.9; 5th week 113 +/- 20.9 U/l). The difference between the two groups was marginally significant (p less than 0.05; analysis of variance). It is concluded that zinc repletion via dialysate with documented increase of serum zinc levels in initially hypozincemic dialysis patients causes a reversible increase of serum AP. The result is compatible with some tissue zinc deficiency in hypozincemic dialysis patients.
血清碱性磷酸酶（AP）是一种锌依赖性金属酶，研究人员在14名低锌血症（低于透析患者第30百分位数）的血液透析患者以及14名接受安慰剂治疗的匹配透析对照患者中，检测了通过透析液（400微克/升）补充锌后血清碱性磷酸酶的反应。血浆锌和血清AP检测了三次：透析液中添加锌之前、添加锌期间每周一次（共5周）以及添加锌后2周。接受安慰剂治疗的对照组血清锌水平保持稳定（初始值87.7±12.5；最终值78.6±8.3微克/分升），而接受锌治疗的患者血清锌水平升高（初始值76.4±8.3；第5周96.9±13.3；停止补锌2周后82.3±12.2微克/分升）。安慰剂对照组中AP随时间略有升高（初始值90.2±26.5；第5周100±29 U/升），而接受锌治疗的患者升高更为明显（初始值90.8±19.9；第5周113±20.9 U/升）。两组之间的差异具有边际显著性（p<0.05；方差分析）。研究得出结论，在最初低锌血症的透析患者中，通过透析液补充锌并记录到血清锌水平升高，会导致血清AP可逆性升高。该结果与低锌血症透析患者存在某些组织锌缺乏的情况相符。
