锌缺乏症的临床、内分泌及生化影响

Ananda S. Prasad
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引用次数: 149

摘要

锌对人体的重要性是在20世纪60年代初认识到的。缺锌的原因包括营养不良、酗酒、吸收不良、大面积烧伤、慢性衰弱性疾病、慢性肾病、某些利尿剂、使用螯合剂,如青霉胺治疗威尔逊病,以及遗传性疾病,如肠病性肢端皮炎和镰状细胞病。锌的需要量在怀孕期间和生长时期增加。缺锌严重病例的临床表现包括大疱性皮炎、脱发、腹泻、情绪障碍、体重减轻、并发感染、男性性腺功能减退,如不治疗可致死性。中度缺锌的特点是青少年发育迟缓和青春期延迟,男性性腺功能减退,皮肤粗糙,食欲不振,精神不振,伤口愈合延迟,味觉异常和黑暗适应异常。在轻度缺锌的人类受试者中,我们观察到少精子症,轻微体重减轻和高氨血症。锌是一种生长因子。由于缺乏维生素a,许多动物和人类的生长受到不利影响。由于蛋白质和DNA的合成以及细胞分裂都需要锌,因此人们认为锌对生长的影响与其对蛋白质合成的影响有关。锌缺乏对人类和实验动物的睾丸功能都有不利影响。锌的这种作用是在末端器官水平,缺锌受试者的下丘脑-垂体轴是完整的。由于锌与细胞分裂密切相关,它的缺乏可能会对睾丸大小产生不利影响,从而影响其功能。在小鼠中,由于锌缺乏,中期II期卵母细胞变性、低单倍体和高单倍体的发生率增加。生理浓度的锌在体外可降低垂体泌乳素的分泌,有人认为这种微量元素可能在体内调节泌乳素的释放。胸腺生成素,一种t细胞成熟所需的激素,也被证明是锌依赖的。锌在各种内分泌器官的生化和激素功能中可能具有多种作用。这方面的进一步研究是非常必要的。
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3 Clinical, endocrinological and biochemical effects of zinc deficiency

The essentiality of zinc for humans was recognized in the early 1960s. The causes of zinc deficiency include malnutrition, alcoholism, malabsorption, extensive burns, chronic debilitating disorders, chronic renal disease, certain diuretics, the use of chelating agents such as penicillamine for Wilson's disease, and genetic disorders such as acrodermatitis enteropathica and sickle cell disease. The requirement of zinc is increased in pregnancy and during the growing age period. The clinical manifestations in severe cases of zinc deficiency included bullous-pustular dermatitis, alopecia, diarrhoea, emotional disorder, weight loss, intercurrent infections, hypogonadism in males and it is fatal if untreated. A moderate deficiency of zinc is characterized by growth retardation and delayed puberty in adolescents, hypogonadism in males, rough skin, poor appetite, mental lethargy, delayed wound healing, taste abnormalities and abnormal dark adaptation. In mild cases of zinc deficiency in human subjects, we have observed oligospermia, slight weight loss and hyperammonaemia.

Zinc is a growth factor. As a result of its deficiency, growth is affected adversely in many animal species and in man. Inasmuch as zinc is needed for protein and DNA synthesis and cell division, it is believed that the growth effect of zinc is related to its effect on protein synthesis.

Testicular functions are affected adversely as a result of zinc deficiency in both humans and experimental animals. This effect of zinc is at the end organ level and the hypothalamic-pituitary axis is intact in zinc-deficient subjects. Inasmuch as zinc is intimately involved in a cell division, its deficiency may adversely affect testicular size and thus its function. In mice, the incidence of degenerate oocytes, and hypohaploidy and hyperhaploidy in metaphase II oocytes were increased due to zinc deficiency.

Zinc at physiological concentrations reduced prolactin secretion from the pituitary in vitro and it has been suggested that this trace element may have a role in the in vivo regulation of prolactin release. Thymopoeitin, a hormone needed for T-cell maturation, has also been shown to be zinc dependent.

It is clear that zinc may have several roles in biochemical and hormonal functions of various endocrine organs. Future research in this area is very much needed.

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