High dose zinc increases hospital admissions due to genitourinary complications
High dose zinc increases hospital admissions due to genitourinary complications
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DOI：
10.1016/j.juro.2006.09.047
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发表时间：
2007-02-01
影响因子：
6.6
通讯作者：
Jarrard, David F.
中科院分区：
文献类型：
--
作者：
Johnson, Aaron R.;Munoz, Alejandro;Jarrard, David F.
目的：锌是一种常见的膳食补充剂，被广泛认为对健康有益。为了评估高剂量补充锌对泌尿生殖系统疾病的影响，我们分析了最近的一项随机试验，比较了锌、抗氧化剂及其组合与安慰剂对泌尿生殖道相关并发症的影响。材料和方法：在对最近的年龄相关眼病研究的进一步分析中，我们检查了主要国际疾病分类的数据池，即与泌尿系统问题相关的入院代码第 9 版。年龄相关性眼病研究将 3,640 名年龄相关性黄斑变性患者随机分配到 4 个研究组中的 1 个，包括安慰剂、抗氧化剂（500 毫克维生素 C、400 IU 维生素 E 和 15 毫克 β-胡萝卜素）、80 毫克锌和抗氧化剂加锌。使用 Fisher 精确检验进行统计分析。结果：我们发现服用锌制剂的患者与服用非锌制剂的患者相比，由于泌尿生殖系统原因而入院的患者显着增加（11.1% vs 7.6%，p = 0.0003）。男性患者的风险最大（RR 1.26，95% Cl 1.07-1.50，p = 0.008）。在需要住院治疗的 343 名患者的研究组中，最常见的主要国际疾病分类，第 9 版修订代码包括良性前列腺增生/尿潴留（良性前列腺增生）、尿路感染、尿路结石和肾功能衰竭。将锌与安慰剂进行比较时，发现尿路感染显着增加（p = 0.004），尤其是女性（2.3% vs 0.4%，RR 5.77，95% CI 1.30-25.66，p = 0.013）。与服用安慰剂的男性相比，服用锌的男性因尿路结石入院的情况接近显着性（2.0% vs 0.5%，RR = 4.08，95% Cl 0.87-19.10）。补充锌并没有增加前列腺癌或其他癌症的发生率。与安慰剂相比，接受抗氧化剂的患者前列腺癌诊断率显着下降（RR = 0.6，95% Cl 0.49-0.86，p = 0.049）。亚组分析显示，这一发现在吸烟男性中显着，但在不吸烟男性中则不然。结论：与安慰剂相比，补充高水平的锌会导致因泌尿并发症住院的人数增加。这些数据支持这样的假设：高剂量锌补充剂对泌尿生理学的某些方面有负面影响。
Purpose: Zinc is a common dietary supplement that is widely believed to have beneficial health effects. To assess the impact of high dose supplemental zinc on genitourinary diseases we analyzed a recent randomized trial comparing zinc, antioxidants and their combination to placebo for complications related to the genitourinary tract.Materials and Methods: In a further analysis of the recent Age-related Eye Disease Study we examined the data pool for primary International Classification of Diseases, 9th revision codes given for hospital admissions related to urological problems. The Age-Related Eye Disease Study randomized 3,640 patients with age related macular degeneration to 1 of 4 study arms, including placebo, antioxidants (500 mg vitamin C, 400 IU vitamin E and 15 mg beta-carotene), 80 mg zinc and antioxidant plus zinc. Statistical analyses using Fisher's exact test were performed.Results: We found a significant increase in hospital admissions due to genitourinary causes in patients on zinc vs nonzinc formulations (11.1% vs 7.6%, p = 0.0003). The risk was greatest in male patients (RR 1.26, 95% Cl 1.07-1.50, p = 0.008). In the study group of 343 patients requiring hospital admission the most common primary International Classification of Diseases, 9th revision codes included benign prostatic hyperplasia/urinary retention (benign prostatic hyperplasia), urinary tract infection, urinary lithiasis and renal failure. When comparing zinc to placebo, significant increases in urinary tract infections were found (p = 0.004), especially in females (2.3% vs 0.4%, RR 5.77, 95% CI 1.30-25.66, p = 0.013). Admissions for urinary lithiasis approached significance in men on zinc compared to placebo (2.0% vs 0.5%, RR = 4.08, 95% Cl 0.87-19.10). There was no increase in prostate or other cancers with zinc supplementation. A significant decrease in prostate cancer diagnoses was seen in patients receiving antioxidants vs placebo (RR = 0.6, 95% Cl 0.49-0.86, p = 0.049). Subgroup analysis revealed that this finding was significant in men who smoked but not in nonsmokers.Conclusions: Zinc supplementation at high levels results in increased hospitalizations for urinary complications compared to placebo. These data support the hypothesis that high dose zinc supplementation has a negative effect on select aspects of urinary physiology.