Trace element supplementation after major burns increases burned skin trace element concentrations and modulates local protein metabolism but not whole-body substrate metabolism
Trace element supplementation after major burns increases burned skin trace element concentrations and modulates local protein metabolism but not whole-body substrate metabolism
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DOI：
10.1093/ajcn/85.5.1301
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发表时间：
2007-05-01
影响因子：
7.1
通讯作者：
Tappy, Luc
中科院分区：
文献类型：
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作者：
Berger, Mette M.;Binnert, Christophe;Tappy, Luc
背景：严重烧伤后，患者表现出强烈的分解代谢，伤口需要手术和移植来闭合。微量元素 (TE) 缺乏会加剧体重减轻和伤口愈合延迟等并发症。目的：我们旨在评估严重烧伤后伤口愈合过程中，TE 补充剂对全身底物周转和局部蛋白质代谢的影响。设计：这是一项前瞻性、随机、安慰剂对照试验，受试者为 21 名年龄为 35 +/- 11 岁、身体表面积为 45 +/- 16% 的烧伤患者； 12 名患者在第 3、10 和 20 天进行了皮肤活检，10 名患者在第 10 天进行了稳定同位素检查。静脉注射铜、硒和锌（TE 组）或载体（V 组）与盐水溶液一起给药 14-21 天。第10天，输注[C-13]苯丙氨酸（600μg/kg推注，随后12μg.kg(-1).min(-1)）加6-[H-2(2)]葡萄糖和[H-2(5)]甘油输注6It以确定皮肤蛋白质周转率。在输注开始后 1 小时和 6 小时进行活组织检查，以确定 [C-13] 苯丙氨酸富集情况。结果：患者的平均年龄和烧伤严重程度在各组之间以及皮肤检查亚组之间没有显着差异。 TE 组的血浆 TE 浓度显着较高。在烧伤区域，皮肤中硒（P = 0.02）和锌（P = 0.03）的含量在第20天时增加。烧伤皮肤中上清液与血浆C-13的富集比在1小时（NS）和0.592 +/-后分别为0.363 +/- 0.094（TE组）和0.286 +/- 0.130（V组） 6 小时后为 0.153（TE 组）和 0.262 +/- 0.171（V 组），这反映了 TE 组分解代谢较低（P = 0.03）。各组之间的全身底物周转率没有显着差异。结论：补充 TE 与皮肤组织中硒和锌含量的增加以及皮肤蛋白质分解代谢的减少有关。
Background: After major burns, patients exhibit an intense catabolism, and the wounds require surgery and grafting for closure. Complications, such as weight loss and delayed wound healing, are worsened by trace element (TE) deficiencies.Objective: We aimed to assess the effects of TE supplements on systemic substrate turnover and local protein metabolism during wound healing after major burns.Design: This was a prospective, randomized, placebo-controlled trial in 21 patients aged 35 +/- 11 y with burns on 45 +/- 16% of their body surface area; 12 had skin biopsies performed on days 3, 10, and 20, and 10 patients underwent a stable-isotope investigation on day 10. Intravenous copper, selenium, and zinc (TE group) or vehicle (V group) was given with a saline solution for 14-21 d. On day 10, [C-13] phenylalanine (600- mu g/kg bolus followed by 12 mu g . kg(-1) . min(-1)) plus 6-[H-2(2)] glucose and [H-2(5)] glycerol were infused for 6 It to determine skin protein turnover. Biopsies were performed I and 6 h after the start of infusion to determine [C-13] phenylalanine enrichment.Results: The patients' mean age and burn severity did not differ significantly between the groups nor between the skin investigations subgroups. Plasma TE concentrations were significantly higher in the TE group. In the burned areas, the skin contents of selenium (P = 0.02) and zinc (P = 0.03) increased by day 20. The supernatant-to-plasma C-13 enrichment ratio in burned skin was 0.363 +/- 0.094 (TE group) and 0.286 +/- 0.130 (V group) after 1 h (NS) and 0.592 +/- 0.153 (TE group) and 0.262 +/- 0.171 (V group) after 6 h, which reflected lower catabolism in the TE group (P = 0.03). No significant differences in whole-body substrate turnover were found between the groups.Conclusion: TE supplementation was associated with an increased skin tissue content of selenium and zinc and with a reduction in skin protein catabolism.