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      Serum zinc and hormonal profile in male dialysis patients receiving human recombinant erythropoietin Translated title: Zinco sérico e perfil hormonal de pacientes do sexo masculino submetidos à hemodiálise em uso de eritropoetina humana recombinante

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          Abstract

          INTRODUCTION: Treatment with recombinant human erythropoietin (rHuEpo) is associated with an improvement in well-being and quality of life in patients submitted to maintenance hemodialysis (HD). OBJECTIVES: The goal of this work was to evaluate the levels of sex hormones, hematocrit, albumin and zinc in HD patients with rHuEpo therapy and compare them with those observed in patients without rHuEpo treatment. MATERIAL AND METHODS: Two groups of twelve male HD patients each were selected for a transversal study; one did not receive rHuEpo (group 1) whereas the other one did (group 2). Levels of hematocrit, albumin, zinc, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and testosterone were determined. RESULTS: Group 2 patients showed significantly higher medians (p < 0.05) of testosterone (4.65 vs. 3.5ng/mL), hematocrit (30.5 vs. 22%), albumin (3,9 vs. 3,7g/dL) and zinc (62.5 vs. 50.5microg/dL) than group 1 patients. DISCUSSION: In this study rHuEpo treatment resulted in higher hematocrit, testosterone, zinc and albumin. It is suggested that, in patients recipients of rHuEpo, higher levels of zinc and testosterone may be factors that contribute to relieve sexual dysfunction and improve quality of life. CONCLUSIONS: In HD patients, hematocrit, albumin, serum zinc and testosterone levels were higher in rHuEpo recipients when compared with patients not receiving this hormone therapy.

          Translated abstract

          INTRODUÇÃO: Em pacientes submetidos à hemodiálise crônica (HD), o tratamento com eritropoetina humana recombinante (rHuEpo) está associado a melhora no bem-estar geral e na qualidade de vida. OBJETIVOS: O objetivo do presente trabalho foi avaliar os níveis dos hormônios sexuais e do zinco em pacientes sob HD e em uso de rHuEpo em comparação com pacientes sem tratamento com essa droga. MATERIAL E MÉTODOS: Dois grupos de doze pacientes do sexo masculino cada um, submetidos à HD, sendo um deles sem uso de rHuEpo (grupo 1) e o outro utilizando a droga (grupo 2), foram selecionados para um estudo transversal, comparando-se os níveis séricos do zinco, da albumina, dos hormônios FSH, LH, prolactina, testosterona e do hematócrito. RESULTADOS: No grupo 2, os valores de testosterona (4,65 vs. 3,5ng/ml), hematócrito (30,5 vs. 22%), albumina (3,9 vs. 3,7g/dl) e zinco (62,5 vs. 50,5microg/dl) foram significativamente maiores do que no grupo 1 (p < 0,05). DISCUSSÃO: Sugere-se que, em pacientes recipientes da rHuEpo, os níveis mais altos de hematócrito, zinco, albumina e testosterona possam ser fatores que contribuam para melhorar a disfunção sexual e a qualidade de vida dos pacientes hemodialisados. CONCLUSÃO: Os pacientes em HD em uso da rHuEpo apresentaram níveis mais elevados de testosterona, zinco e hematócrito quando comparados com os pacientes sem a terapia hormonal.

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          Most cited references36

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          Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis.

          Patients on maintenance hemodialysis (MHD) often show substantial reductions in quality of life (QoL). The SF36 (Short Form with 36 questions), a well-documented, self-administered QoL scoring system that includes eight independent scales and two main dimensions, has been widely used and validated. In 65 adult outpatients on MHD, the SF36 and its scales and dimensions, scored as a number between 0 and 100, and the nutritional and inflammatory state measured by subjective global assessment, near-infrared (NIR) body fat, body mass index (BMI), and pertinent laboratory values, including hemoglobin, albumin, and C-reactive protein were assessed. Twelve-month prospective hospitalization rates and mortality were used as the clinical outcomes. Multivariate (case-mix) adjusted correlation coefficients were statistically significant between SF36 scores and serum albumin and hemoglobin concentrations. There were significant inverse correlations between SF36 scores and the BMI and NIR body fat percentage. Hypoalbuminemic, anemic, and obese patients on MHD had a worse QoL. Prospective hospitalizations correlated significantly with the SF36 total score and its two main dimensions (r between -0.28 and -0.40). The Cox proportional regression relative risk of death for each 10 unit decrease in SF36 was 2.07 (95% CI, 1.08 to 3.98; P = 0.02). Of the eight components and two dimensions of the SF36, the Mental Health dimension and the SF36 total score had the strongest predictive value for mortality. Thus, in patients on MHD the SF36 appears to have significant associations with measures of nutritional status, anemia, and clinical outcomes, including prospective hospitalization and mortality. Even though obesity, unlike undernutrition, is not generally an indicator of poor outcome in MHD, the SF36 may detect obese patients on MHD at higher risk for morbidity and mortality.
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            Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men.

            Identification of the andrological variables most sensitive to zinc depletion would expedite the diagnosis of male reproductive pathology induced by zinc deficiency. Eleven volunteers living on a metabolic ward were fed a diet composed of a mixture of a semisynthetic formula and conventional foods supplemented with ZnSO4 to supply a total of 1.4, 2.5, 3.4, 4.4, or 10.4 mg Zn/d. After an equilibration period of 28 d (10.4 mg Zn/d), all treatments were presented for 35 d each, the first four in random order and the fifth last. Compared with when they were consuming 10.4 mg Zn/d, volunteers consuming 1.4 mg Zn/d exhibited decreased semen volumes (3.30 vs 2.24 mL) and serum testosterone concentrations (26.9 vs 21.9 nmol/L), and no change in seminal zinc concentrations. Compared with 10.4 mg Zn/d, treatments of 1.4, 2.5, and 3.4 mg Zn/d decreased the total semen zinc loss per ejaculate (6.29 vs 3.81, 4.68, and 5.03 mumols/ejaculate). Seminal loss accounted for 9% of total body zinc loss when 1.4 mg Zn/d was consumed. Seminal phosphorus concentrations were elevated during all four phases of zinc depletion (28.4 vs 32.9, 31.0, 34.2, and 33.6 mmol/L). The findings suggest that serum testosterone concentrations, seminal volume, and total seminal zinc loss per ejaculate are sensitive to short-term zinc depletion in young men.
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              Trace Elements and Complications in Patients Undergoing Chronic Hemodialysis

              Abnormalities of trace elements such as aluminum, silicon, zinc, manganese and nickel were found in chronic hemodialysis (HD) patients. The relationship between serum concentration of trace elements and complications such as anemia bone disease, neurological disorder and nutritional disorder in 100 chronic HD patients was examined. Serum Al and Si levels were very high in these patients, and were negatively correlated with indicators of anemia such as RBC, hemoglobin and hematocrit values. Serum Al and Si levels in the HD patients with peripheral neurological disorder (excluding encephalopathy) and with bone disease were significantly high. The levels of serum Zn, Mn and Ni were low, and were correlated with total serum protein levels. In summary, in order to prevent some complications in chronic HD patients, it is very important to regulate levels of trace elements.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jbpml
                Jornal Brasileiro de Patologia e Medicina Laboratorial
                J. Bras. Patol. Med. Lab.
                Sociedade Brasileira de Patologia Clínica (Rio de Janeiro )
                1678-4774
                August 2005
                : 41
                : 4
                : 245-250
                Affiliations
                [1 ] Universidade de Brasília Brazil
                [2 ] Universidade de Brasília Brazil
                Article
                S1676-24442005000400005
                10.1590/S1676-24442005000400005
                572954b1-6394-4138-903c-c6d6a29af6ad

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1676-2444&lng=en
                Categories
                MEDICAL LABORATORY TECHNOLOGY
                MEDICINE, RESEARCH & EXPERIMENTAL
                PATHOLOGY

                Pathology,Medicine,Clinical chemistry
                Albumin,Hemodialysis,Hemodiálise,Eritropoetina,Hematócrito,Albumina,Testosterona,Zinco,Erythropoietin,Hematocrit,Testosterone,Zinc

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