Brissot P, Le Treut A, Dien G, Cottencin M, Simon M, Bourel M
Digestion. 1978;17(6):469-78. doi: 10.1159/000198153.
Serum levels of vitamin A, its specific carrier protein retinol-binding protein (RBP), and zinc were determined in 34 cases of idiopathic hemochromatosis, 33 cases of alcoholic cirrhosis, 10 cases of non-alcoholic cirrhosis, and in 35 normal controls. In both alcoholic and non-alcoholic cirrhosis, vitamin A and RBP levels were very significantly reduced, whereas a significantly low zinc was observed only in the alcoholic cirrhosis group. In idiopathic hemochromatosis, vitamin A values were significantly lower compared to normals, whereas serum RBP levels were normal and serum zinc was very close to that of the controls. A significant correlation was found between vitamin A and RBP levels in the entire group of 112 patients. These results, (1) in alcoholic and non-alcoholic cirrhosis, confirm a dramatic vitamin A deficiency and the major role played by decreased RBP, but tend to deemphasize the possible role of zinc deficiency; (2) in idiopathic hemochromatosis, affirm a significant serum vitamin A deficiency supposedly by a different mechanism from that of alcoholic cirrhosis since in idiopathic hemochromatosis plasma RBP levels are normal. The role of this vitamin A disorder should be considered in the interpretation of clinical signs of idiopathic hemochromatosis such as ichthyosis and visual disorders.
测定了34例特发性血色素沉着症患者、33例酒精性肝硬化患者、10例非酒精性肝硬化患者以及35名正常对照者的血清维生素A、其特异性载体蛋白视黄醇结合蛋白（RBP）和锌的水平。在酒精性和非酒精性肝硬化中，维生素A和RBP水平均显著降低，而仅在酒精性肝硬化组中观察到锌水平显著降低。在特发性血色素沉着症中，维生素A值与正常相比显著降低，而血清RBP水平正常，血清锌水平与对照组非常接近。在112例患者的整个群体中，维生素A和RBP水平之间存在显著相关性。这些结果，（1）在酒精性和非酒精性肝硬化中，证实了严重的维生素A缺乏以及RBP降低所起的主要作用，但倾向于淡化锌缺乏可能起的作用；（2）在特发性血色素沉着症中，确认血清维生素A存在显著缺乏，推测其机制与酒精性肝硬化不同，因为在特发性血色素沉着症中血浆RBP水平正常。在解释特发性血色素沉着症的临床体征如鱼鳞病和视觉障碍时，应考虑这种维生素A紊乱的作用。
