Emenaker N J, DiSilvestro R A, Nahman N S, Percival S
Department of Human Nutrition and Food Management, Ohio State University, Columbus 43210-1295, USA.
Am J Clin Nutr. 1996 Nov;64(5):757-60. doi: 10.1093/ajcn/64.5.757.
Previous work has suggested that kidney hemodialysis patients could be at risk for either moderate copper deficiency or copper toxicity. The present study examined copper-related blood indexes in subjects undergoing hemodialysis treatments with membranes that are not copper-based, in subjects undergoing chronic ambulatory peritoneal dialysis (CAPD), and in control subjects. Both dialysis groups had low plasma copper and ceruloplasmin activities. This occurred despite high plasma interleukin 6 concentrations, a situation that usually elevates plasma ceruloplasmin and copper values. CAPD and hemodialysis subjects had low ratios of ceruloplasmin activity to immunoreactive protein, and low ratios of plasma copper to ceruloplasmin protein. Both are signs of copper deficiency. In contrast, copper-containing erythrocyte superoxide dismutase (SOD) activities were high in hemodialysis subjects and showed a nonsignificant trend toward high values in CAPD subjects. Blood mononuclear cell copper contents were highly variable within each group, and there were no significant differences between groups. In conclusion, ceruloplasmin-related indexes in kidney dialysis patients not dialyzed with copper-based membranes suggested a tendency toward moderate copper deficiency. However, this contention could not be confirmed by erythrocyte SOD activity or mononuclear cell copper measurements.
先前的研究表明,肾脏血液透析患者可能面临中度铜缺乏或铜中毒的风险。本研究检测了使用非铜基膜进行血液透析治疗的患者、进行持续性非卧床腹膜透析(CAPD)的患者以及对照受试者的铜相关血液指标。两个透析组的血浆铜和铜蓝蛋白活性均较低。尽管血浆白细胞介素6浓度较高,但这种情况通常会升高血浆铜蓝蛋白和铜值。CAPD和血液透析受试者的铜蓝蛋白活性与免疫反应性蛋白的比值较低,血浆铜与铜蓝蛋白的比值也较低。这两者都是铜缺乏的迹象。相比之下,血液透析受试者中含铜红细胞超氧化物歧化酶(SOD)活性较高,而CAPD受试者中该活性呈无显著意义的升高趋势。每组中血液单核细胞铜含量变化很大,组间无显著差异。总之,未使用铜基膜进行透析的肾脏透析患者中与铜蓝蛋白相关的指标表明有中度铜缺乏的倾向。然而,红细胞SOD活性或单核细胞铜测量无法证实这一观点。