Dietary Zinc Thiab Teeb Meem Calcium Raum Pob Zeb Thaum Hluas
Feb 26, 2022
Gregory E. Tasian, MD, MSc, MSCE,1,2,3,4Michelle E. Ross Ph.D.,4,5ua al
Abstract
Lub hom phiajTxhawm rau txiav txim siab txog kev sib raug zoo ntawm kev noj zaub mov zinc noj thiab qhov tshwm sim calciumraumpob zebthiab tshuaj xyuas kev sib raug zoo ntawm kev noj zaub mov zinc kom tsawg thiab tso zis zinc tso tawm ntawm cov tub ntxhais hluas.
Khoom siv thiab cov txheej txheemTxoj kev tshawb no yog ib txoj kev tshawb nrhiav cov ntaub ntawv pov thawj uas tau ua nyob rau hauv ib qho kev kho mob loj rau menyuam yaus. Peb 24- teev rov qab noj zaub mov thiab cov tshuaj tso zis tso zis tau txais rau 30 tus neeg koom nrog hnub nyoog 12-18 xyoo nrog thawj idiopathic calcium-basedraumpob zebthiab 30 tswj kev noj qab haus huv, sib npaug ntawm hnub nyoog, poj niam txiv neej, haiv neeg, thiab lub hli ntawm kev tso npe kawm. Cov qauv logistic regression tau siv los kwv yees qhov sib txawv ntawm qhov sib txawv (OR) nruab nrab ntawm kev noj zinc txhua hnub thiab qhov xwm txheej calcium.raumpob zeb, kho raunoj zaub movphytate, protein, calcium, sodium, thiab oxalate. Multivariable linear regression tau siv los kwv yees lub koom haum ntawm kev noj haus thiab tso zis zinc, kho cov zis creatinine thiab noj phytate thiab calcium.
Cov txiaj ntsigCov neeg mob tau txais zinc tsawg dua txhua hnub (8.1mg) dua li kev tswj hwm (10mg; p=0.029).
Kev noj zinc txhua hnub ntawm cov tub thiab cov ntxhais nrog calciumpob zebyog 2mg thiab 1.2mg qis dua, feem ntau dua li niaj hnub noj zinc pom zoo los ntawm Lub Tsev Haujlwm Saib Xyuas Tshuaj. Muaj 13 feem pua qis qis ntawm cov pob zeb tshwm sim rau txhua 1mg siab dua cov zinc noj txhua hnub (OR, 0.87; 95 feem pua CI, 0.75-0.99). Muaj kwv yees li ntawm 4.5µg / dL nce hauv cov zis zinc ib 1mg nce hauv zinc noj (p=0.009), nrog rau cov pov thawj tsis muaj zog ntawm cov zis zinc me dua hauv cov kev tswj hwm (kev sib cuam tshuam p{{16). }}.08).
Cov lus xausKev noj zaub mov qis qis qis tau ua rau nws tus kheej cuam tshuam nrog cov xwm txheej calcium nephrolithiasis hauv cov neeg hluas no.
Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791
Cistanche tubulosa tiv thaiv kab mob raum, nyem qhov no kom tau txais cov qauv
Taw qhia
Calcium-basedraumPob zeb qhia txog qhov teeb meem hauv qab ntawm cov ntxhia homeostasis. Kev sib koom ntawm kev noj zaub mov kom tsawg ntawm qee cov zaub mov, xws li calcium, thiabraumCov pob zeb tsim thaum muaj hnub nyoog laus yog tsim tau zoo.1 Txawm li cas los xij, lub luag hauj lwm ntawm cov kab noj hniav, xws li zinc, tsis meej.2 Qhov kev sib raug zoo no tshwj xeeb yog tsis paub meej rau cov menyuam yaus, cov uas tau tshawb fawb me ntsis los txheeb xyuas cov kev pheej hmoo hloov pauv rau nephrolithiasis. Kev nkag siab txog lub luag haujlwm ntawm kev noj zaub mov tsis zoo hauv cov menyuam yaus nephrolithiasis yog qhov tseem ceeb tshwj xeeb vim tias muaj qhov tshwm sim sai ntawm lub raum pob zeb thiab cuam tshuam nrog kev rov ua haujlwm siab thaum menyuam yaus.3, 4 Kev txheeb xyuas kev noj haus ntawmraumCov kab mob pob zeb ntawm cov tub ntxhais hluas tuaj yeem muab kev nkag siab txog vim li cas nephrolithiasis tam sim no tshwm sim thaum yau thiab ua rau cov tswv yim los txo qis kev pheej hmoo ntawm nephrolithiasis mus txog lub neej.
Cov kev sim ua ntej tau pom tias zinc, ib qho tseem ceeb ntawm cov ntxhia, cuam tshuam rau calcium metabolism thiabraumpob zeb tsim, thiab inhibits calcium phosphate (CaP) crystallization. Hauv kev tshawb fawb siv National Health and Nutrition Examination Survey (NHANES), kev noj zaub mov zinc ntau dua ntawm cov neeg laus nrog nephrolithiasis tab sis qis dua ntawm cov neeg laus nrog nephrolithiasis.9 Cov kev tshawb fawb yav dhau los kuaj cov zis zinc hauv cov neeg laus uas muaj thiab tsis muaj nephrolithiasis kuj tau tshaj tawm cov txiaj ntsig sib txawv. .10, 11 Cov kev tshawb fawb ua ntej no yog hla ntu, suav nrog cov neeg laus nkaus xwb, thiab yuav ua rau muaj kev ntxhov siab los ntawm kev noj zaub mov tsis zoo xws li phytate, uas khi zinc hauv plab thiab txo nws cov bioavailability.12
Cov kev tshawb fawb yav tom ntej uas tau siv ntau yam los txheeb xyuas cov kev pheej hmoo ntawm kev noj zaub mov rau cov pob zeb tshwm sim ntawm cov neeg laus, xws li Nurses' Health Study, tsis muaj rau cov menyuam yaus. Peb, yog li ntawd, tau ua ib qho kev tshawb fawb txog kev tswj xyuas qhov sib koom ntawm kev noj zaub mov zinc thiab xwm txheej calcium nephrolithiasis ntawm cov tub ntxhais hluas. Peb xaiv pawg hnub nyoog no vim tias cov tub ntxhais hluas muaj qhov tshwm sim ntau tshaj plawsraumpob zeb thaum yau. Peb lub hom phiaj thib ob yog los tshuaj xyuas qhov sib txawv ntawm kev noj zaub mov zinc kom tsawg thiab tso zis zinc tso tawm ntawm cov neeg mob thiab kev tswj hwm.
Cov ntaub ntawv thiab cov txheej txheem
Peb tau ua txoj kev tshawb fawb txog kev tswj xyuas cov ntaub ntawv nyob rau hauv Children's Hospital of Philadelphia (CHOP) txoj kev kho mob, uas suav nrog cov chaw kho mob thawj thiab tshwj xeeb rau Eastern Pennsylvania thiab New Jersey. Cov neeg koom nrog tau cuv npe txij lub Xya Hli 2014 txog Lub Peb Hlis 2016. Txoj kev tshawb no tau pom zoo los ntawm CHOP Institutional Review Board.
Case txhais
Cov neeg mob sib law liag uas muaj hnub nyoog 12-18 xyoo uas tau muaj txoj hauv kev los yog kev phais tshem tawm thawj zaug uas muaj calciumraumpob zeb tau kuaj xyuas thiab tso npe rau hauv ib lub hlis ntawm kev kuaj mob. Ib qho kev txiav ntawm 50 feem pua rau oxalate thiab phosphate tau siv los faib cov pob zeb xws li calcium oxalate (CaOx) lossis CaP, feem. Cov txheej txheem kawm (24-teev kev noj zaub mov rov qab thiab cov tshuaj urine chemistry) tau ua tiav ua ntej cov neeg mob tau txais kev pom zoo los hloov cov zaub mov kom txo cov pob zeb rov ua dua tshiab.
Tswj txhais
Cov kev tswj hwm tau muab piv txwv los ntawm cov neeg mob hnub nyoog 12-18 xyoo mus ntsib tus menyuam zoo ntawm ob lub tsev kho mob hauv CHOP Primary Care Network. Cov ntaub ntawv kho mob hauv hluav taws xob tau siv los tshuaj xyuas cov sij hawm hauv tsev kho mob thiab txheeb xyuas cov neeg tuaj koom kev tswj hwm. Cov kev tswj tau tsim nyog tau sib npaug 1: 1 rau cov neeg mob raws hnub nyoog (ntxiv rau /- 2 xyoo), poj niam txiv neej, thiab haiv neeg. Kev tswj hwm tau tso npe rau hauv 2 lub hlis ntawm qhov xwm txheej kom txo qis kev hloov pauv raws caij nyoog hauv kev noj zaub mov thiab tso zis chemistry. Kev tswj hwm tau nug txog keeb kwm ntawm nephrolithiasis tab sis tsis tau kuaj pom.
Kev cais tawm
Cov neeg mob ntshav qab zib malignancy, chromosomal anomalies, neurodevelopmental disorders, kub siab, immobility, inflammatory plob tsis so tswj, ureteropelvic hlws ris obstruction, RTA, thiab hyperparathyroidism raug cais tawm. Cov neeg mob uas muaj tus kheej lossis tsev neeg keeb kwm ntawm cystinuria, thawj hyperoxaluria, thiab Dent tus kab mob kuj raug cais tawm. Cov neeg mob noj cov tshuaj diuretics, citrate, topiramate, calcitriol, allopurinol, thiab steroids tsis suav nrog.
Cov txheej txheem kawm
Cov kws tshawb fawb txog kev noj zaub mov tau muab peb 24- teev cov zaub mov rov qab rau cov neeg koom. Kev noj zaub mov rov qab tau tswj hwm hauv xov tooj, pib tam sim tom qab kev kawm rau npe kawm, thiab tau ua tiav 2 hnub ua haujlwm thiab 1 hnub so. Cov ntaub ntawv rov qab tau sau tseg siv Nutrition Data System rau Kev Tshawb Fawb, lub computer-based software application13 uas siv ntau qhov kev sib tham dhau los los ntsuas kev noj zaub mov thiab kwv yees cov khoom noj thiab cov ntxhia hauv cov zaub mov thiab dej haus, thiab tau raug lees paub ntawm cov tub ntxhais hluas.14, 15
Cov neeg tuaj koom tau muab cov zis tso zis tsis muaj pov thawj ntawm kev sau npe uas zinc, pH, calcium, oxalate, citrate, thiab creatinine raug ntsuas. Cov tshuaj urine chemistry tau soj ntsuam los ntawm ARUP thiab CHOP core Laboratories.
Kev txheeb cais
Ib qho piv txwv loj ntawm 30, nrog 15 tus neeg koom hauv txhua pab pawg, muab lub zog ntawm 80 feem pua (nrog rau ob sab =5 feem pua) txhawm rau txheeb xyuas qhov sib txawv ntawm 0.78 mg / hnub hauv kev noj zaub mov zinc ntawm kev kawm pab pawg.9 Peb tau nce kev npaj rau npe rau 60 tus neeg koom nrog rau qhov cuam tshuam ntawm kev noj haus phytate ntawm zinc bioavailability, uas tsis tau txiav txim siab hauv kev tshawb fawb ua ntej.
Paired t-tests lossis rank-sum tests tau siv los sib piv qhov sib txawv tsis tu ncua ntawm pab pawg raws li kev faib cov ntaub ntawv. Conditional logistic regression qauv nrog cov qauv tsis raug, uas suav nrog cov qauv tsim, tau siv los kwv yees kev koom tes ntawm kev noj zaub mov zinc noj txhua hnub (mg) thiab cov xwm txheej calcium pob zeb. Cov qauv raug hloov kho rau txhua hnub noj phytate, sodium, tag nrho cov protein, calcium, thiab oxalate. Peb kuj tau kwv yees qhov kev hloov pauv ntawm qhov tsis sib xws ntawm qhov xwm txheej calcium pob zeb hauv ib chav tsev nce ntxiv hauv qhov sib txawv ntawm qhov sib txawv (IQR) rau kev noj zaub mov noj hauv peb cov qauv kawm. Linear regression tau siv los kwv yees kev sib raug zoo ntawm kev noj zaub mov zinc thiab cov zis zinc, kho cov zis creatinine thiab kev noj haus phytate thiab calcium. Lub sijhawm sib cuam tshuam ntawm kev noj zaub mov zinc thiab cov xwm txheej / kev tswj hwm tau suav nrog los txiav txim siab yog tias kev sib raug zoo ntawm zinc tau txais thiab tso zis zinc sib txawv ntawm qhov xwm txheej thiab kev tswj hwm. Tag nrho cov kev noj qab haus huv rov qab tau suav nrog hauv cov qauv regression. Kev tshuaj xyuas tau ua hauv R v3.2.2 thiab SAS 9.4. Kev ntsuam xyuas yog ob sab, thiab p<0.05 was="" the="" threshold="" for="" statistical="">
Kev soj ntsuam rhiab heev
Matched pairs with solitary extreme dietary intake values were excluded to determine if non-representative meals influenced the results. Second, analyses were restricted to participants with stones containing >50 feem pua CaOx los txiav txim seb qhov kev tshwm sim puas rhiab rau pob zeb muaj pes tsawg leeg.
Cov txiaj ntsig
Kev noj zaub mov kom tsawg thiab tshwm sim calcium-raws li lub raum pob zeb
Peb caug tus neeg koom hauv txhua pab pawg tau cuv npe (Daim duab, Table 1). Txhais tau tias kev noj zinc txhua hnub tau qis dua ntawm cov neeg mob (8.1mg) dua li kev tswj hwm (10mg; p=0.03; Table 2). Qhov nruab nrab txhua hnub phytate tau txais tsawg dua ntawm cov neeg mob tshaj li kev tswj hwm (p<0.001). sodium,="" protein,="" calcium,="" and="" fluid="" intake="" were="" similar.="" oxalate="" intake="" was="" similar="" except="" for="" one="" recall="" for="" a="" control="" participant="" who="" had="" an="" oxalate="" intake="" over="" three="" times="" the="" maximum="" observed="" for="" any="" other="" participant="" in="" either="" group.="" the="" main="" sources="" of="" zinc="" were="" red="" meat,="" zinc-fortified="" cereal,="" and="" pizza.="" most="" phytate="" intakes="" came="" from="" breakfast="" cereals,="" chips,="" seeds,="" and="" nuts.="" controls="" ate="" more="" cereal="" (source="" of="" zinc="" and="" phytate)="" and="" pizza="" (source="" of="" zinc)="" than="">
Muaj kev sib koom ua ke tseem ceeb ntawm cov zinc txhua hnub, phytate, thiab oxalate kom tsawg thiab qhov xwm txheej calcium pob zeb, kho rau sodium, protein, thiab calcium kom tsawg (Table 3a). Kev nce ntxiv ntawm 1mg ntawm zinc tau cuam tshuam nrog 13 feem pua txo qis ntawm qhov xwm txheej calcium pob zeb (OR, 0.87; 95 feem pua CI, 0.75-0.99). Muaj 58 feem pua txo qis ntawm qhov xwm txheej calcium pob zeb rau cov neeg mob ntawm 75 feem pua ntawm zinc tau txais piv rau cov nyob rau ntawm 25 feem pua (OR, 0.42; 95 feem pua CI, 0.{{ 16}}.97), uas yog qhov sib txawv 6mg hauv peb cov qauv kawm. Txhua txhua 423mg siab dua phytate noj txhua hnub, IQR ntawm phytate hauv peb cov qauv kawm, tau txuam nrog 51 feem pua ntawm cov pob zeb qis (OR, 0.49; 95 feem pua CI, 0.{{25 }}.95). Txhua txhua 73mg ntau dua oxalate noj txhua hnub, IQR ntawm oxalate hauv peb cov qauv kawm, tau txuam nrog 30 feem pua ntawm cov pob zeb qis (OR, 0.70; 95 feem pua CI, 0.{{ 33.97). Tsis muaj kev sib koom ua ke tseem ceeb ntawm lwm cov zaub mov lossis cov khoom noj thiab cov pob zeb tshwm sim tau pom.
Zinc tso zis
Zinc tso zis yog 32.5µg/dL thiab 50µg/dL ntawm cov neeg mob thiab kev tswj hwm, tab sis qhov sib txawv no tsis tseem ceeb (p=0.28). Kev kho rau cov zis creatinine thiab kev noj zaub mov phytate thiab calcium, muaj kwv yees li 4.5µg / dL nce hauv cov zis zinc hauv 1mg nce hauv zinc noj (p=0.009). Muaj qee cov pov thawj ntawm kev nce me me ntawm cov zis zinc nyob rau hauv cov ntaub ntawv ntau dua li kev tswj hwm, raws li pom los ntawm qhov kev kwv yees loj me me rau lub sij hawm sib cuam tshuam uas tau nce mus txog qhov tseem ceeb (Table 4). Tsis muaj kev sib koom ua ke tseem ceeb ntawm kev noj zaub mov zinc thiab zis calcium, citrate, lossis oxalate.
Kev soj ntsuam rhiab heev
Tom qab tsis suav nrog cov khub sib tw nrog qhov kev soj ntsuam oxalate sab nraud, qhov loj thiab qhov tseem ceeb ntawm kev sib koom ua ke ntawm qis zinc thiab pob zeb tau nce ntxiv thiab cov koom haum ntawm oxalate thiab phytate tsis muaj qhov tseem ceeb (Table 3b). Xws li tsuas yog 25 tus neeg koom nrog CaOx pob zeb thiab lawv cov khub sib tw tsis tau hloov pauv kev koom tes ntawm zinc thiab pob zeb xwm txheej (LOSSIS, 0.36;
95% CI, 0 13-0.98).
Kev sib tham
Kev nce ntxiv ntawm nephrolithiasis ntawm cov tub ntxhais hluas thiab qhov tsis muaj peev xwm txheeb xyuas qhov tshwm sim no yuav tsum muaj kev nkag siab zoo dua ntawm cov xwm txheej txaus ntshai rau kev tsim kab mob raum pob zeb thaum yau. Txawm hais tias muaj ntau qhov kev sim hauv vitro uas qhia tias zinc inhibits calcium crystallization, txoj kev tshawb no yog, rau peb txoj kev paub, thawj zaug tshuaj xyuas kev sib raug zoo ntawm kev noj zaub mov zinc thiab qhov tshwm sim calcium rau lub raum pob zeb ntawm cov menyuam yaus lossis cov neeg laus. Peb tau pom muaj kev sib raug zoo ntawm kev noj zaub mov ntau dua zinc thiab qis dua ntawm qhov xwm txheej calcium rau lub raum pob zeb ntawm cov tub ntxhais hluas. Hauv ntau qhov kev ntsuam xyuas rhiab heev, qhov txawv ntawm cov pob zeb calcium tsis tu ncua 60 feem pua qis ntawm cov neeg mob uas muaj zinc noj txhua hnub ntawm 75 feem pua piv rau cov neeg ntawm 25 feem pua.
Kev noj cov zinc txhua hnub yog qhov tsim nyog los tswj cov cellular metabolism, kom cov pob txha txaus, thiab kev loj hlob ib txwm nyob rau thaum yau. Qhov pom zoo noj zinc txhua hnub rau cov tub thiab cov ntxhais hnub nyoog 14-18 xyoo yog 11mg thiab 9mg, feem.16 Hauv peb txoj kev tshawb fawb, qhov nruab nrab zinc noj txhua hnub ntawm cov tub thiab ntxhais nrog pob zeb yog 2mg thiab 1.2mg qis dua, raws li cov no. kev xav tau. Cov peev txheej ntawm zinc tau zoo sib xws ntawm cov pab pawg, uas qhia tias muaj ntau dua li cov khoom noj uas muaj zinc rau kev koom tes ntawm zinc thiab pob zeb. Cov kev tshawb pom no qhia tias kev noj cov zinc tsis txaus yuav ua rau muaj kev pheej hmoo rau kev tsim cov pob zeb calcium thaum menyuam yaus.
Qhov feem ntau yuav piav qhia rau qhov sib txawv ntawm kev noj zaub mov zinc thiab teeb meem calcium pob zeb yog qhov inhibitory nyhuv ntawm zinc ntawm CaP crystallization. Zinc txhawb nqa CaP theem ntau dua, txo qhov loj ntawm CaP muaju, thiab inhibits kev hloov ntawm brushite rau hydroxyapatite.8, 17 Qhov no inhibition ntawm CaP crystallization thiab transformation tseem ceeb rau ob qho tib si CaP thiab CaOx pob zeb tsim. Idiopathic CaOx pob zeb tsim ntawm Randall's plaques, uas yog deposits ntawm hydroxyapatite uas pib nyob rau hauv lub qab daus daim nyias nyias ntawm lub nyias loops ntawm Henle.18, 19 Ib tug hypothesis rau lub koom haum peb pom yog tias zinc inhibits CaP crystallization thaum ntxov nyob rau hauv lub raum thiab hais tias qhov no proximal. inhibition tiv thaiv kev loj hlob ntawm CaP pob zeb thiab pib tsim ntawm Randall's plaques. Cov kev tshawb fawb ntxiv thiab kev tshawb fawb ntxiv yog xav tau los txiav txim siab cov txiaj ntsig ntawm zinc nyob rau theem pib ntawm calcium pob zeb tsim.
Prior studies demonstrated conflicting results about the direction of the association between zinc and nephrolithiasis. The rapid stone formation was reported in an adult woman with zinc toxicity.20 Additionally, an analysis of NHANES found that adults older than 30 years with zinc intake >15mg / hnub (uas deb tshaj li kev noj haus rau cov neeg laus) muaj 70 feem pua nce ntawm nephrolithiasis piv rau cov neeg uas tau noj tsawg dua 7 mg / hnub.9 Txawm li cas los xij, zinc tau txais 1mg qis dua ntawm 18-29-cov hnub nyoog nrog keeb kwm ntawm pob zeb dua li ntawm 18-29-cov hnub nyoog tsis muaj pob zeb. Ib qho kev piav qhia rau cov txiaj ntsig tsis sib xws yog tias ob qho tib si ntau dhau thiab tsis txaus zinc txhawb kev tsim pob zeb. Nws kuj tseem muaj peev xwm hais tias qhov tseem ceeb dua ntawm kev noj zinc txaus thaum lub hnub nyoog hluas yuav suav nrog qhov sib txawv ntawm cov neeg mob hluas thiab cov laus. Ntau cov kev tshawb fawb ua ntej tau pom tias kev noj zinc ntau dua yog txuam nrog cov pob txha pob txha ntau dua thiab qhov ntom ntom ntawm cov menyuam yaus thiab cov hluas. thaum lub sij hawm loj hlob. Cov kev tshawb fawb ntxiv yog xav tau los qhia txog cov txiaj ntsig lom neeg ntawm kev noj zaub mov zinc ntawm calcium pob zeb tsim thiab nws txoj kev sib raug zoo rau cov pob txha txawv txav homeostasis.23, 24
Peb kuj pom muaj kev koom tes ntawm kev noj zaub mov ntau dua phytate thiab qis dua ntawm qhov xwm txheej calcium nephrolithiasis, uas zoo ib yam nrog kev tshawb pom ntawm cov poj niam hluas.25 Phytate, uas yog lub ntsiab lus tseem ceeb ntawm phosphate hauv cov nroj tsuag, khi zinc hauv plab thiab txo nws cov bioavailability. Tsis tas li ntawd, phytate inhibits hydroxyapatite thiab CaOx crystallization26 thiab tej zaum yuav muaj kev ywj pheej inhibitory nyhuv ntawm pob zeb tsim.27 Txawm li cas los xij, peb cov txiaj ntsig yuav tsum raug suav tias yog qhov ua ntej txij li kev koom tes ntawm phytate thiab calcium pob zeb tau dhau los ua qhov tsis tseem ceeb tom qab tsis suav nrog cov neeg koom nrog kev noj zaub mov oxalate siab. Peb kuj tau kuaj pom qhov sib txawv ntawm kev noj haus oxalate thiab calcium nephrolithiasis. Lub koom haum no yuav zoo li spurious vim tias nws tau tsav los ntawm ib qho kev tswj hwm nrog kev noj oxalate siab heev thiab tsis muaj biologic plausibility rau lub koom haum no. Sodium tau txais ntau dua 3gm / hnub nyob rau hauv rooj plaub thiab tswj thiab tsis cuam tshuam nrog cov xwm txheej pob zeb. Qhov txiaj ntsig no zoo ib yam li kev tshawb pom ntawm cov txiv neej thiab cov poj niam laus, 1, 28 tab sis txawv ntawm qhov muaj feem cuam tshuam nrog kev noj cov sodium siab ntawm cov poj niam hluas.25 Tsis muaj qhov sib txawv ntawm kev haus dej ntawm cov neeg mob thiab kev tswj hwm. Txawm hais tias nws muaj peev xwm hais tias kev noj zaub mov ntau thiab kev haus dej tsawg tsis yog qhov tseem ceeb ntawm cov tub ntxhais hluas, nws muaj feem ntau tias cov neeg koom nrog cov pob zeb tshiab tau txo qis sodium thiab nce cov kua dej ua ntej kev soj ntsuam kev noj haus raws li cov lus pom zoo rau kev tiv thaiv pob zeb yog yooj yim. siv tau.29
Muaj kev sib raug zoo zoo ntawm kev noj zaub mov thiab tso zis zinc, uas zoo ib yam nrog cov kev tshawb fawb ua ntej ntawm cov poj niam laus.30 Peb cov txiaj ntsig tau qhia tias cov zis zinc qib qhia txog kev noj zaub mov zinc ntawm cov tub ntxhais hluas uas muaj thiab tsis muaj nephrolithiasis. Txawm li cas los xij, nws tseem tsis tau paub tias kev noj zaub mov lossis tso zis zinc qhia txog zinc concentration thiab kev ua haujlwm ntawm lub raum papillae, uas yog qhov chaw ua haujlwm rau pob zeb inhibition. Kuj tseem muaj pov thawj tsis muaj zog uas cov tub ntxhais hluas uas muaj cov pob zeb calcium tso tawm tsawg dua zinc hauv cov zis rau txhua qhov kev noj zaub mov zinc ntxiv. Qhov ua tau ntawm cov zis zinc tso zis qis ntawm cov tub ntxhais hluas nrog calcium nephrolithiasis yog qhov zoo rau kev kawm ntxiv.
Muaj kev txwv nyob rau hauv causal inference muaj feem xyuam rau case-control design. Txoj kev tshawb fawb zoo tshaj plaws yuav ntsuas kev noj zaub mov kom tsawg ua ntej kuaj pob zeb. Txawm li cas los xij, cov kev tshawb fawb yav tom ntej ntawm cov menyuam yaus uas ntsuas kev noj haus thiab lub raum pob zeb tsis muaj nyob. Lub raum pob zeb kuj tsis tshua muaj thaum menyuam yaus, uas yuav tsum muaj kev tswj xyuas cov ntaub ntawv los tshuaj xyuas cov koom haum no. Txawm hais tias qhov kev txwv no, nws tsis zoo li cov neeg mob paub txog lossis tsis pom zoo txo qis zinc noj tom qab kuaj pob zeb. Tsis txhob hloov cov zinc noj los yog txo cov protein kom tsawg (qhov tseem ceeb ntawm zinc) tam sim no pom zoo rau cov menyuam yaus uas muaj pob zeb. Tsis tas li ntawd, cov khoom noj khoom haus rov qab thiab kuaj zis tau txais ua ntej kev tawm tswv yim rau cov neeg mob txog kev hloov pauv kev noj zaub mov kom tsis txhob mob raum pob zeb. Thaum kawg, cov xwm txheej tau raug tshuaj xyuas thiab sau npe, thiab qhov kev tshawb fawb no tau ua nyob rau hauv ib qho kev suav cov pej xeem, uas txo qis kev xaiv tsis ncaj ncees. Thib ob, kev tswj hwm tsis tau kuaj pom, nce qhov muaj peev xwm uas lawv yuav muaj asymptomatic raum pob zeb. Qhov no tsis zoo li xav txog<1% of="" people="" have="" nephrolithiasis="" by="" 18="" years.3="" third,="" we="" did="" not="" assess="" supplemental="" zinc="" intake.="" however,="" zinc="" supplementation="" is="" not="" prescribed="" routinely="" during="" childhood="" and="" is="" not="" related="" to="" kidney="" stone="" status.="" it="" is="" likely="" that="" any="" zinc="" supplement="" use,="" should="" it="" exist,="" would="" be="" similar="" between="" groups.="" fourth,="" we="" measured="" spot="" rather="" than="" 24-hour="" urine="" chemistries.="" future="" studies="" of="" dietary="" zinc="" should="" examine="" 24-hour="" zinc="" excretion.="" finally,="" although="" residual="" confounding="" is="" possible,="" it="" is="" unlikely="" that="" other="" dietary="" factors="" would="" negate="" the="" strong="" association="" between="" higher="" dietary="" zinc="" and="" reduced="" risk="" of="" stones="" among="">
Hauv kev xaus, kev noj zaub mov tsis txaus ntawm zinc tau ua rau nws tus kheej cuam tshuam nrog qhov xwm txheej calcium rau lub raum pob zeb kab mob hauv cov neeg hluas no.
1 Department of Surgery, Division of Pediatric Urology, Children's Hospital of Philadelphia, Philadelphia, PA
2 Department of Surgery, Division of Urology; Perelman Tsev Kawm Ntawv Kho Mob ntawm University of Pennsylvania, Philadelphia, PA
3 Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA
4 Center for Clinical Epidemiology and Biostatistics, Perelman Tsev Kawm Ntawv ntawm Tshuaj ntawm University of Pennsylvania, Philadelphia, PA
5 Department of Biostatistics thiab Epidemiology, Perelman Tsev Kawm Ntawv Tshuaj Kho Mob ntawm University of Pennsylvania, Philadelphia, PA
6 Department of Pediatrics, Perelman Tsev Kawm Ntawv Kho Mob ntawm University of Pennsylvania, Philadelphia, PA
7 Department of Pediatrics, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
8 Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA
9 Department of Pediatrics, Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA
10 Department of Urology, University of California, San Francisco, San Francisco, CA 11Center for Nutrition and Metabolism, Children's Hospital Oakland Research Institute, Oakland, CA
Cov ntaub ntawv
1. Curhan, GC, Willett, WC, Rimm, EB et al.: Kev kawm yav tom ntej ntawm kev noj zaub mov calcium thiab lwm yam khoom noj thiab kev pheej hmoo ntawm cov tsos mob raum pob zeb. In: N Engl J Med, vol. 328, ib., 1993
2. Ramaswamy, K., Killilea, DW, Kapahi, P. et al.: Lub elementome ntawm calcium-based urinary pob zeb thiab nws lub luag haujlwm hauv urolithiasis. Nat Rev Urol, Kaum Ib Hlis 12: 543, 2015
3. Tasian, GE, Ross, ME, Song, L. et al.: Ib xyoos ib zaug ntawm Nephrolithiasis ntawm Cov Me Nyuam thiab Cov Neeg Laus hauv South Carolina los ntawm 1997 txog 2012. Clin J Am Soc Nephrol, 11: 488, 2016
4. Tasian, GE, Kabarriti, AE, Kalmus, A. li al.: Lub raum pob zeb rov tshwm sim ntawm cov menyuam yaus thiab cov tub ntxhais hluas. J Urol, Kaum Ib Hlis 2016
5. Carpentier, X., Bazin, D., Combes, C. et al.: High Zn ntsiab lus ntawm Randall's plaque: kev tshawb nrhiav mu-X-ray fluorescence. J Trace Elem Med Biol, 25: 160, 2011
6. Chi, T., Kim, MS, Lang, S. et al.: Drosophila qauv qhia lub luag haujlwm tseem ceeb rau zinc hauv mineralization rau kab mob raum pob zeb. PLoS Ib, 10: e0124150, 2015
7. Kimmel, PL, Watkins, DW, Gubish, CT et al.: Zinc noj zaub mov hloov pauv qhov 1,25-(OH)2D. Teb nyob rau hauv uremic nas. Miner Electrolyte Metab, 17: 307, 1991
8. LeGeros, RZ, Bleiwas, CB, Retino, M. et al.: Zinc cuam tshuam rau kev tsim cov calcium phosphates hauv vitro: cuam tshuam rau kev kho mob inhibition ntawm kev tsim cov calculus. Am J Dent, 12:65, 1999
9. Tang, J., McFann, K., Chonchol, M.: Kev noj cov zinc noj thiab lub raum pob zeb tsim: kev ntsuam xyuas ntawm NHANES III. Am J Nephrol, 36: 549, 2012
10. Atakan, IH, Kaplan, M., Seren, G. et al.: Serum, urinary thiab pob zeb zinc, hlau, magnesium, thiab tooj liab qib hauv cov neeg mob pob zeb idiopathic CaOx. Int Urol Nephrol, 39: 351, 2007
11. Trinchieri, A., Manfredi, A., Luongo, P. et al.: tso zis ntawm citrate, glycosaminoglycans, magnesium, thiab zinc nyob rau hauv lub hnub nyoog thiab poj niam txiv neej nyob rau hauv ib txwm kawm thiab nyob rau hauv cov neeg mob uas tsim calcium pob zeb. Scand J Urol Nephrol, 26: 379, 1992
12. Schlemmer, U., Frolich, W., Prieto, RM et al.: Phytate nyob rau hauv cov khoom noj thiab qhov tseem ceeb rau tib neeg: cov khoom noj, kev noj haus, kev ua, bioavailability, tiv thaiv lub luag hauj lwm thiab tsom xam. Mol Nutr Food Res, 53 Suppl 2: S330, 2009
13. Feskanich, D., Sielaff, BH, Chong, K. et al.: Computerized collection and analysis of dietary intake information. Comput Methods Programs Biomed, 30:47, 1989
14. Johnson, RK, Driscoll, P., Goran, MI: Kev sib piv ntawm ntau-pass 24-teev rov qab kwv yees ntawm kev siv hluav taws xob nrog tag nrho cov kev siv hluav taws xob txiav txim siab los ntawm ob txoj kev sau npe dej hauv cov menyuam yaus. J Am Diet Assoc, 96: 1140, 1996
15. Mullenbach, V., Kushi, LH, Jacobson, C. et al.: Sib piv ntawm 3-hnub cov ntaub ntawv noj mov thiab 24- teev rov qab los ntawm xov tooj rau kev ntsuas kev noj haus hauv cov tub ntxhais hluas. J Am Diet Assoc, 92: 743, 1992
