2型糖尿病患者血清微量元素、血糖及体成分相关性分析

目的了解糖尿病患者与正常人群血清微量元素含量的差异,并探讨微量元素与糖尿病患者血糖、人体成分测量指标之间的关系。方法随机选取72名糖尿病患者作为病例组,64名健康体检者作为对照组。分别测量病例组和对照组的血清锌、硒、锰、镉、铁、铅、铜、镍、钴、锂、铬含量,铜锌比值,比较两组间差异,并与血糖及蛋白质含量、矿物质含量、脂肪含量、瘦体重、腰围、臀围等人体成分指标进行相关性分析。结果2型糖尿病患者血清锌、硒、铬含量显著低于对照组(P<0.05),血清铜含量则显著高于对照组(P<0.05),其他元素差异没有显著性。血清锌与血糖呈微弱负相关,铜与血糖呈正相关(P<0.01)。铜与腰围呈微弱正相关(P<0.01),锰与蛋白质含量、矿物质含量、臀围均呈微弱负相关(P<0.05)。结论纠正2型糖尿病患者体内存在着的微量元素代谢紊乱,对于糖尿病的治疗及预防并发症有重要价值。     

Serum Concentrations of Trace Elements in Patients with Tuberculosis and Its Association with Treatment Outcome

Deficiencies in essential trace elements are associated with impaired immunity in tuberculosis infection. However, the trace element concentrations in the serum of Korean patients with tuberculosis have not yet been investigated. This study aimed to compare the serum trace element concentrations of Korean adult patients with tuberculosis with noninfected controls and to assess the impact of serum trace element concentration on clinical outcome after antituberculosis treatment. The serum concentrations of four trace elements in 141 consecutively recruited patients with tuberculosis and 79 controls were analyzed by inductively coupled plasma-mass spectrometry. Demographic characteristics were also analyzed. Serum cobalt and copper concentrations were significantly higher in patients with tuberculosis compared with controls, while zinc and selenium concentrations were significantly lower (p < 0.01). Moreover, serum selenium and zinc concentrations were positively correlated (ρ = 0.41, p < 0.05). A high serum copper concentration was associated with a worse clinical outcome, as assessed after one month of antituberculosis therapy. Specifically, culture-positive patients had higher serum copper concentrations than culture-negative patients (p < 0.05). Patients with tuberculosis had altered serum trace element concentrations. Further research is needed to elucidate the roles of individual trace elements and to determine their clinical impact on patients with tuberculosis.     

妊娠糖尿病患者血清中硒、锌、铜、钙含量分析

目的:检测妊娠糖尿病(GDM)患者血清中微量元素硒、锌、铜、钙的含量,探讨其与GDM的关系。方法:采用原子分光光度计分别检测78例GDM孕妇和72例正常孕妇血清中硒、锌、铜和钙的含量。结果:GDM组孕妇血清中微量元素硒、锌及钙的含量明显低于正常对照组(P<0.000 1);而铜的含量,GDM组却显著高于正常对照组(P<0.000 1)。结论:微量元素硒、锌、铜、钙在GDM的发生和发展过程中具有重要的作用。GDM组孕妇体内存在微量元素的代谢紊乱,应加强孕妇的饮食指导,适时补充硒、锌、钙等。     

血清微量元素对糖尿病的影响

目的:通过检测糖尿病患者血清中微量元素的含量,探讨微量元素对糖尿病的影响。方法:用原子吸收分光光度法对84例糖尿病患者及50例健康人血清中微量元素锌、铜、铁、钙、镁的含量进行测定分析。结果:糖尿病组血清中锌、铁明显低于对照组,铜高于对照组,经t检验差别有显著意义(P<0.05或P<0.01),而钙、镁两组无差异。Ⅰ型糖尿病患者血清中锌明显低于Ⅱ型糖尿病患者(P<0.01)。结论:本研究结果提示糖尿病患者体内存在锌、铜、铁的代谢紊乱。检测糖尿病患者血清中微量元素的变化对病情估计及治疗有一定的临床意义。     

癌症患者血中微量元素与氧化应激的相关研究

目的 :研究癌症患者血中微量元素变化与氧化应激的相关关系。方法 :测定了 1 1 1例癌症病人和 3 6例健康对照血清中 MDA浓度 (作脂质过氧化指标 ) ,微量元素铜、锌、铁、硒及其转运蛋白铜蓝蛋白、白蛋白和转铁蛋白浓度。测定了抗氧化标志物 XOD、GSH、GSHPx、Vit E、Vit C浓度和总抗氧化力水平。结果 :癌症患者脂质过氧化水平 (以 MDA计 )明显高于对照 (P<0 .0 0 1 ) ,总抗氧化力明显低于对照 (P<0 .0 0 1 )。抗氧化标志物 XOD、GSH、GSHPx、Vit E和Vit C无明显变化。癌症患者血清白蛋白浓度明显降低 (P<0 .0 0 1 ) ,血清铜蓝蛋白浓度明显增高 (P<0 .0 2 ) ,血清转铁蛋白浓度未发现有所改变 (P>0 .2 0 )。同健康对照比较 ,血清铜水平明显增高 (P<0 .0 0 1 ) ,血清硒水平明显降低 (P<0 .0 0 1 ) ,但锌和铁水平无显著变化。癌症患者血中铜和 MDA之间呈明显相关 (r=0 .2 81 ,P=0 .0 0 3 ) ,但健康对照间未发现相关性存在。另外 ,肝癌患者血清铁和 MDA存在相关关系 (r=0 .6 80 ,P=0 .0 0 1 )。结论 :癌症患者氧化应激和某些微量元素呈相关变化 ,然而 ,其变化情况可因癌肿、癌症分期以及癌症患者个体因素的不同而有所差异     

心脏病患者血清铜、锌、锰、铬、硒含量测定的临床意义

作者应用原子吸收光谱法和原子荧光光谱法测定了人血清铜、锌、锰、铬、及全血硒。测定对象分正常对照(40例),冠心病(36例),风湿性心脏瓣膜病(27例),扩张型心肌病(34例)4组。结果表明,正常人平均血铜值1.227±0.213μg/ml,锌1.0±0.149μg/ml,铬8.945±5.464ng/ml,锰12.163±4.21ng/ml,硒0.0625±0.03μg/ml,与文献报道值接近。其余三组心脏病人血铜值(1.448μg/ml,1.740μg/ml、1.746μg/ml)均显著升高(P<<0.001),血锌在冠心病、风心病组降低(P<0.01),铬三组无变化,锰仅在风心病组降低(P<0.01),硒在冠心病组增高(P<0.05),在扩张型心肌病组则显著降低(P<0.0001)。急性心肌梗塞(13例),血铜升高,而锌降低;心衰时血铜显著升高。以上变化对三种心脏病及急性心肌梗塞的诊断与鉴別、判断心脏的功能可能有一定意义。特别是扩张型心肌病呈现出特异性血硒降低,可能是该病的致病因素之一。     

食管癌切除术后血清微量元素及其运载蛋白的应激变化

目的:探讨血清铜、锌、铁及其转运蛋白在食管癌切除术后的变化情况。方法:对9名男性和17名女性食管癌患者手术前后抽取血清进行铜、锌、铁及其转运蛋白测定。结果:血清铜、锌、铁在手术初期呈相似变化,即先增加再降低,呈现不同的应激变化。其中锌和铁变化有显著性差异,而血清铜水平变化均无显著性差异(P>0.05);3种转运蛋白均自手术开始时下降,其中白蛋白和转铁蛋白在整个研究期均下降,且有明显差异;而铜蓝蛋白的变化则相应较慢,至第7天才出现显著增高(P<0.05)。结论:外科手术时机体内微量元素的变化极为复杂,对进行大外科手术治疗的患者给予补充一定量的微量元素益于其疾病恢复。     

The influence of copper, selenium and zinc on the response to the Montenegro skin test in subjects vaccinated against American cutaneous leishmaniasis

We evaluated the relationship between the trace elements copper, zinc and selenium and the response to the Montenegro skin test (MST) in 172 volunteers vaccinated against American cutaneous leishmaniasis. The MST diameter was categorized as negative and in quartiles of positive response, constituting five groups. Trace element serum levels were analyzed by coupled plasma atomic emission spectrometry and hydride generation atomic absorption spectrometry, with study subjects classified into two groups depending on low or high levels of trace elements observed. MST-positive subjects had an MST diameter (mean+/-SD) of 10.35+/-4.64mm, with copper, selenium and zinc serum levels of 1433.7+/-665.7microg/l, 88.6+/-39microg/l and 999.2+/-366microg/l, respectively. The MST diameter was significantly different in the selenium groups only. The selenium levels also differed with the quartiles of the MST diameters of individuals testing positive (P<0.05). Our findings suggest that trace elements, particularly selenium, should be measured in future vaccine trials so that vaccine immunogenicity and response can be assessed and compared between different studies.     

微量元素铜和锌在实验性肝癌中的变化及意义

探讨微量元素铜和锌在二乙基亚硝胺诱发大鼠实验性肝癌中的变化及意义。用原子吸收光谱法观察血清中微量元素铜和锌的含量 :用分析电镜对实验组与对照组肝组织中微量元素铜和锌进行了原位定性定量分析。结果 :与对照组相比 ,实验组中血清铜水平升高 ,血清锌水平降低及血清铜 /锌比值 ( 1 .53)显著高于对照组 ( 0 .78) ( P<0 .0 5) ,实验组肝癌组织中微量元素铜和锌含量明显低于对照组正常肝组织 ( P<0 .0 5)。结论 :微量元素铜和锌的变化与肝癌的发生发展密切相关 ,血清铜 /锌比值升高可作为肝癌的一个重要标志。     

Dosing and monitoring of trace elements in long-term home parenteral nutrition patients

Background: Trace elements (TEs) dosing and monitoring in home parenteral nutrition (PN) patients vary with their underlying conditions. Methods: This retrospective observational study evaluated parenteral TE dosing, serum TE concentrations and monitoring, and dose‐concentration relationships between TE doses and serum TE concentrations in 26 adult and adolescent home PN patients. Results: There was a total of 40,493 PN days. Average parenteral zinc doses of 9.1 mg/d and 7.6 mg/d resulted in the majority of serum zinc concentrations (90%) within normal range in patients with and without short bowel syndrome (SBS), respectively. Selenium at about 70 mcg/d resulted in about 60% of serum selenium concentrations within normal range, with 38% of values below normal in patients with and without SBS alike. Copper at 1 mg/d resulted in 22.5% of serum copper concentrations above the normal range. The majority of serum manganese (94.6%) and chromium (96%) concentrations were elevated. Serum TE concentrations were infrequently monitored. Significant relationships existed between doses and serum concentrations for zinc (P < .0001), manganese (P = .012), and chromium (P < .0001) but not for selenium or copper. Conclusions: TE doses in home PN should be individualized and adjusted based on regular monitoring of TE status. In long‐term home PN patients, higher zinc and selenium doses may be necessary to maintain their normal serum concentrations. Lower copper doses and restrictions of manganese and chromium supplementation may be needed to avoid their accumulation. Relationships between TE doses and serum TE concentrations vary for each TE and underlying clinical conditions.     

血微量元素和性激素水平对精子缺陷的影响

目的:探讨血清微量元素和性激素水平对精子缺陷的影响。方法:检测精子缺陷已婚育龄男性和健康对照者血清钙、镁、铜、锌、铁、铅、性激素,并精液常规分析。结果:精子缺陷组血铅、血镁含量与健康对照组比较,差异有统计学意义(P<0.05)。血钙、锌、铜、铁与健康对照组比较差异无统计学意义(P>0.05),激素水平与健康对照组比较差异无统计学意义(P>0.05),睾酮与雌二醇的比值T/E2(0.109±0.031)低于健康对照组差异有统计学意义(P<0.05)。结论:血液微量元素和性激素与精子形态存在一定的关系,血液中保持合理平衡的微量元素和激素水平对于形成优良精子具有积极作用。     

尿毒症患者血清及头发中微量元素含量变化的临床意义

目的 :检测尿毒症患者血清及头发中铁、锌、铜、钙、镁的含量 ,探讨其临床意义及相关性。方法 :应用原子吸收光谱法。结果 :尿毒症患者血清及头发中铁、锌、钙均较正常对照组明显降低 (P <0 0 1) ,铜较正常对照组显著升高 (P <0 .0 1) ,而镁在两组比较中无明显差别 (P >0 0 5 ) ;正常对照组头发较血清中Fe、Zn、Cu、Ca、Mg含量显著升高 (P <0 0 1) ,且各元素含量存在相关关系 (P <0 0 5、P <0 0 1) ,而尿毒症患者尽管头发中Fe、Zn、Cu、Ca、Mg含量较血清中也明显升高 (P <0 0 1) ,但各元素含量间无相关性 (P >0 0 5 )。结论 :检测尿毒症患者血清Fe、Zn、Cu、Ca、Mg水平对临床了解病情、调整治疗及观察疗效具有重要意义 ,但对于尿毒症患者 ,不能用检测头发Fe、Zn、Cu、Ca、Mg作为临床辅助检查手段来反应血清中同一元素水平。     

微量元素铜锌硒与肺癌的关系探讨

目的 :探讨血清微量元素水平与肺癌之间的关系。方法 :采用 1 80 - 80型原子吸收分光光度计及 UV- 2 1 0 0可见紫外分光光度计测定 31 0例肺癌患者及 48例健康对照者的血清铜、锌、硒水平。结果 :肺癌患者血清锌、硒水平显著低于对照组 ( P<0 .0 0 1 ) ,铜、铜 /锌比值组间无差异 ;但有肿瘤负荷组患者血清铜及铜 /锌比值则高于无肿瘤负荷组 ( P<0 .0 0 1 ) ,血清锌、硒则组间无差异。非条件 Logistic回归分析表明仅锌、硒进入方程 ,且为保护因素。结论 :低锌、低硒可能是肺癌发生的危险因素 ,而血清铜及铜 /锌比值高则可能是肺癌存在的结果。     

乙二胺四乙酸铁钠口服液治疗小儿缺铁性贫血及对血清微量元素的影响

目的:探讨乙二胺四乙酸铁钠(NaFeEDTA)口服液治疗婴幼儿缺铁性贫血的疗效及其对血清微量元素的影响。方法:对101例缺铁性贫血(IDA)患儿给予NaFeEDTA口服液0.5mg·kg-1·d-1,连服8周,治疗前、后分别测定血常规和微量元素,并与正常儿童进行对照。结果:用药8周后93.0%的IDA患儿血红蛋白(Hb)恢复至正常水平(P<0.01);治疗前IDA患儿血清铁、锌、铜均较正常儿童低(P<0.05),治疗8周后血清铁、锌、铜均较治疗前明显升高(P<0.05),血清钙、镁变化不明显。结论:NaFeEDTA口服液治疗婴幼儿IDA临床效果好,可显著升高血清铁、锌、铜水平。     

Iron status influences trace element levels in human blood and serum

Food is the main source of trace elements for the general population. The gastrointestinal absorption of certain trace elements, e.g., cadmium, is strongly influenced by iron (Fe) status. This factor may also be relevant for the bioavailability of other trace elements. Therefore, we investigated relationships between Fe status indicators and trace element concentrations in blood and serum of 234 boys and girls at ages 15 and 17 years. Fe status was measured using serum ferritin (S-Ft), soluble transferrin receptor in serum (sTfR), and the ratio sTfR/S-Ft. The trace elements we investigated were, in blood, cadmium, cobalt, copper, zinc, selenium, rubidium, mercury, and lead, and, in serum, cobalt, copper, zinc, selenium, rubidium, tungsten, mercury, and lead. We found inverse correlations between Fe status and blood cadmium, blood or serum cobalt, or blood copper. There were positive correlations between Fe status and mercury concentrations. Selenium was positively correlated with sTfR. The relationships between Fe status and lead were equivocal. There were fewer correlations for serum than for blood, but the inverse relationships between Fe status and cobalt were equally strong in serum and blood. We found only occasional, and perhaps spurious, correlations with zinc, rubidium, and tungsten. In conclusion, previous indications that cadmium, cobalt, and copper are absorbed by transport mechanisms similar to that of Fe are supported by this study. Strong positive correlations between Fe status and mercury concentrations remain to be explained.     

Determination of trace elements in patients with chronic hepatitis B

Chronic hepatitis B virus (HBV) infection is a major liver disease worldwide and its clinical manifestations are linked to immune response. The purpose of this study was to evaluate the relationship between selenium, copper, and zinc in comparison with transaminase level in chronic HBV patients. Serum samples of the HBV infected patients were obtained from Tooba medical center, Sari, Iran. Sixty patients were enrolled in this study (36 men and 24 women), mean age: 39.6 ± 12.2 years. The concentration of zinc, selenium, copper and transaminases were determined using an autoanalyzer system. Concentrations of selenium (0.273 ± 0.056 μg/dl) and zinc (2.1 ± 0.037) was elevated in patients with low transaminase levels as were significantly different in comparison with patients with high transaminase level (P<0.05). Serum copper concentration was similar in two groups of patients. Elevated levels of transaminase concentrations were independently associated with low zinc and selenium concentrations in chronic HBV patients. It is concluded that serum zinc and selenium levels are associated with less hepatic damage in chronic HBV patients and might have a protective role during liver injury.     

Changes in circulating concentrations of vitamins and trace elements after cessation of nocturnal enteral tube feeding

BACKGROUND: This study aimed to examine whether circulating concentrations of a range of vitamins and trace elements in patients receiving long-term cyclic enteral tube feeding vary during the day, and whether standardised time points for blood sampling are required for assessment of nutrient status. METHODS: Circulating concentrations or activities of water-soluble vitamins (thiamine, riboflavin, and vitamins B6, B12, folate and C), fat-soluble vitamins (A, D, E) and trace elements (iron, zinc, copper and selenium (assessed by glutathione peroxidase activity), were measured at 0,3,6 and 9-12h after cessation of nocturnal feeding (fasting), in eight clinically stable patients receiving cyclic nocturnal enteral nutrition. RESULTS: The circulating concentrations of the nutrients did not change between the fed and fasted state (repeated-measures-ANOVA) except the following: plasma folate increased progressively from 10.9 (SD 4.6)nmol/l in the fed state to 14.0 (SD 4.4)nmol/l at 9-12 h after cessation of feeding (P<0.05); plasma zinc increased progressively throughout the fasting period by 33.5% (8.57, SD 0.68 vs. 11.44, SD 1.85 micromol/l, in fed state vs. 9-12h fast respectively, P<0.05); and total tocopherol/cholesterol ratio decreased by 9.6% during the study period (P<0.02), while gamma-tocopherol increased by 59.2% (P<0.05). For all analytes, the concentrations in blood samples taken at 3 and 6h after cessation of feeding were not significantly different from those at 9-12h. CONCLUSIONS: Although cessation of nocturnal tube feeding had no significant effect on the circulating concentrations of most micronutrients, it increased plasma folate and zinc concentrations, and decreased the tocopherol/cholesterol ratio. The timing for blood sampling should be standardised when the status of these nutrients is assessed in patients receiving cyclic tube feeding.     

严重烧伤病人微量元素的动态变化

目的：了解重度烧伤后血及２４ｈ尿中七种微量元素的变化规律。方法：选择烧伤面积，３０％的病人１０例，动态测定伤后至创面基本愈合时血、２４ｈ尿中锌、铜，铁、钼、硒、铬的浓度，同时选择未烧伤者３９例正常对照组。结果：２４ｈ尿中七种元素排泄量均增加，血锌明显下降，铜、铬、钼水平增加、铁、硒、锰未见明显变化。结论：严重烧伤后微量元素代谢发生较大变化，但是否需要补充及何时补充仍值得探讨。     

血清铜锌硒与卵巢癌关系的研究

对 40例卵巢癌患者进行血清铜、锌、硒及铜 /锌比值测定 ,并以 48例健康成年女性为对照。测定结果进行单因素分析和非条件 Logistic多因素分析。单因素分析结果表明 ,卵巢癌患者血清锌、硒低于正常组 ,铜 /锌比值升高 ,而血清铜无显著差异 ;有负荷患者铜 /锌比值明显高于无负荷患者 ,而血清锌、硒无显著差异。回归多因素分析表明 ,硒、锌是卵巢癌发病的保护因素 ,揭示锌、硒在卵巢癌预防及辅助治疗上均有一定价值。     

Serum iron, zinc, copper, selenium, and bromide concentrations after coronary bypass operation

The effect of surgical trauma on serum trace elements was studied in 10 patients undergoing coronary bypass surgery. After the initial decrease due to the hemodilution during operation serum iron, zinc, copper and selenium remained depressed for the immediate postoperative period. Zinc was still at significantly lower level 2 months after the operation. Low serum iron values were also observed. Changes in trace element concentrations were parallel with changes in the concentrations of their transport and binding proteins in the serum. The multielemental technique also measured nonessential bromide, which returned to initial levels in 7 days. Effects of trauma on metabolism, acute phase reaction with redistribution of zinc and copper and losses via increased urinary excretion explain the above changes. Development of a subclinical deficiency of zinc and possibly iron is suggested by the persistence of low serum levels during recovery after operation.