Khedun S M, Naicker T, Maharaj B
Department of Experimental and Clinical Pharmacology, University of Natal Medical School, Durban, South Africa.
Cent Afr J Med. 1995 Oct;41(10):312-5.
This study was designed to test the hypothesis that hydrochlorothiazide a diuretic used to treat hypertension depletes body zinc and thereby cause sexual dysfunction. Serum zinc and sexual dysfunction were measured in 39 middle aged hypertensive men who had been taking hydrochlorothiazide in average daily doses of between 25 and 50 mg daily for at least six months, and a control group of 27 unmedicated middle aged normotensive men. The medicated group had a higher incidence of sexual dysfunction (56 pc) as compared to 11 pc in the control group. The use of hydrochlorothiazide did affect serum zinc levels significantly in 20 patients. Sexual dysfunction occurred more often in older and overweight patients (p < 0.004). Three of the normotensive men experienced sexual dysfunction probably related to old age. Twenty two of the 39 on hydrochlorothiazide and experiencing sexual dysfunction were divided into two groups of 11 patients. Bloods were taken from the 27 normotensive and 22 hypertensive men receiving hydrochlorothiazide for the analyses of zinc. Subsequently one group of the patients were supplemented with zinc 500 mg daily for 30 days while the other group was supplemented with magnesium chloride 1 g daily for 30 days. The normotensive men were not treated. After 30 days, bloods were again taken from the three groups of analyses for zinc and magnesium. Serum zinc was significantly decreased (p < 0.05) by hydrochlorothiazide and a non significant decrease in serum magnesium (p = ns) was observed. After supplementation with zinc, the serum zinc levels returned to normal only in eight patients. There was improvement in the symptoms of sexual dysfunction in five patients. Two patients gained weight. Hydrochlorothiazide decreased serum zinc levels (p < 0.05) and was unchanged with magnesium supplementation but the serum magnesium returned to normal values. Improvement of symptoms of sexual dysfunction was positive in one patient. This study shows that low serum zinc levels may be associated with sexual dysfunction but the definitive role of zinc in the pathogenesis of sexual dysfunction will remain controversial.
用于治疗高血压的利尿剂氢氯噻嗪会消耗体内锌元素，进而导致性功能障碍。对39名中年高血压男性和27名未接受药物治疗的中年血压正常男性进行了血清锌含量及性功能障碍情况的检测。39名中年高血压男性平均每日服用25至50毫克氢氯噻嗪，且至少持续服用了六个月。结果显示，用药组性功能障碍的发生率为56%，而对照组为11%。在20名患者中，氢氯噻嗪的使用确实显著影响了血清锌水平。性功能障碍在年龄较大和超重的患者中更为常见（p < 0.004）。3名血压正常的男性出现性功能障碍，可能与年龄有关。39名服用氢氯噻嗪且出现性功能障碍的患者中，22人被分为两组，每组11人。采集了27名血压正常男性和22名服用氢氯噻嗪的高血压男性的血液用于锌分析。随后，一组患者每日补充500毫克锌，持续30天，另一组患者每日补充1克氯化镁，持续30天。血压正常的男性未接受治疗。30天后，再次采集三组血液进行锌和镁的分析。氢氯噻嗪使血清锌显著降低（p < 0.05），血清镁无显著下降（p = 无显著性差异）。补充锌后，仅8名患者的血清锌水平恢复正常。5名患者的性功能障碍症状有所改善。2名患者体重增加。氢氯噻嗪降低了血清锌水平（p < 0.05），补充镁后无变化，但血清镁恢复到了正常水平。1名患者的性功能障碍症状有所改善。本研究表明，血清锌水平低可能与性功能障碍有关，但锌在性功能障碍发病机制中的决定性作用仍存在争议。
