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High Dose Zinc Increases Hospital Admissions Due to Genitourinary Complications

医学 泌尿生殖系统 重症监护医学 泌尿科 内科学 冶金 材料科学
作者
Aaron R. Johnson,Alejandro Munoz,Justin L. Gottlieb,David F. Jarrard
出处
期刊:The Journal of Urology [Lippincott Williams & Wilkins]
卷期号:177 (2): 639-643 被引量:111
标识
DOI:10.1016/j.juro.2006.09.047
摘要

No AccessJournal of UrologyAdult urology1 Feb 2007High Dose Zinc Increases Hospital Admissions Due to Genitourinary Complications Aaron R. Johnson, Alejandro Munoz, Justin L. Gottlieb, and David F. Jarrard Aaron R. JohnsonAaron R. Johnson Department of Surgery (Division of Urology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Alejandro MunozAlejandro Munoz Department of Surgery (Division of Urology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Justin L. GottliebJustin L. Gottlieb Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , and David F. JarrardDavid F. Jarrard Department of Surgery (Division of Urology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.09.047AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract 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 β-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% CI 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% CI 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% CI 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. References 1 : Zinc intake of the U.S. population: findings from the third National Health and Nutrition Examination Survey, 1988–1994. J Nutr2000; 130: 1367S. Google Scholar 2 : Clinical, endocrinologic, and biochemical effects of zinc deficiency. Spec Top Endocrinol Metab1985; 7: 45. Google Scholar 3 : Zinc in the human prostate gland: normal, hyperplastic and cancerous. Int Urol Nephrol1997; 29: 565. Google Scholar 4 : Zinc for prostate disease and other conditions: a little evidence, a lot of hype, and a significant potential problem. Urol Nurs2004; 24: 49. Google Scholar 5 : Diet and benign prostatic hyperplasia: a study in Greece. Urology1999; 54: 284. 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Google Scholar 14 : Molecular mechanisms of zinc-dependent leukocyte adhesion involving the urokinase receptor and beta2-integrins. Blood1999; 93: 2976. Google Scholar 15 : The Ig-related killer cell inhibitory receptor binds zinc and requires zinc for recognition of HLA-C on target cells. J Immunol1995; 155: 4143. Google Scholar 16 : Excessive intake of zinc impairs immune responses. JAMA1984; 252: 1443. Google Scholar 17 : Zinc and the immune system. Proc Nutr Soc2000; 59: 541. Google Scholar 18 : A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol2001; 119: 1417. Google Scholar 19 : Influence of oral zinc supplementation on the lymphocyte response to mitogens of normal subjects. Am J Clin Nutr1981; 34: 88. Google Scholar 20 : Associations of mortality with ocular disorders and an intervention of high-dose antioxidants and zinc in the Age-Related Eye Disease Study: AREDS Report No. 13. Arch Ophthalmol2004; 122: 716. Google Scholar 21 : Novel role of zinc in the regulation of prostate citrate metabolism and its implications in prostate cancer. Prostate1998; 35: 285. Google Scholar 22 : The effect of zinc supplements on lipoproteins and copper status. Atherosclerosis1988; 70: 247. Google Scholar 23 : Vitamin and mineral supplement use is associated with reduced risk of prostate cancer. Cancer Epidemiol Biomarkers Prev1999; 8: 887. Google Scholar 24 : Effects of alpha-tocopherol and beta-carotene supplements on cancer incidence in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study. Am J Clin Nutr1995; 62: 1427S. Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byZhang Y, Song M, Mucci L and Giovannucci E (2022) Regular, Long-Duration Multivitamin Use and Risk of Overall and Aggressive Prostate Cancer in the Health Professionals Follow-Up StudyJournal of Urology, VOL. 208, NO. 3, (633-640), Online publication date: 1-Sep-2022.Ferraro P and Curhan G (2018) Zinc as a Contributing Factor in Lithogenesis: Not Yet Ready for the ClinicJournal of Urology, VOL. 197, NO. 5, (1187-1188), Online publication date: 1-May-2017. Volume 177Issue 2February 2007Page: 639-643 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordszincprostatic neoplasmscomplicationsprostateprostatic hyperplasiaAcknowledgmentsGary Gensler, EMMES Corp. assisted with data set analysis.MetricsAuthor Information Aaron R. Johnson Department of Surgery (Division of Urology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Alejandro Munoz Department of Surgery (Division of Urology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Justin L. Gottlieb Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author David F. Jarrard Department of Surgery (Division of Urology), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin More articles by this author Expand All Advertisement PDF downloadLoading ...
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