Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan ; Second Department of Internal Medicine, Osaka Medical College, Daigaku-machi 2-7 Takatsuki, Osaka 569-8686, Japan.
Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan.
J Clin Biochem Nutr. 2014 Sep;55(2):147-52. doi: 10.3164/jcbn.14-33. Epub 2014 Jul 26.
The relationships between the serum mineral concentrations and the endoscopic findings of esophageal varices have been poorly investigated. In this study, we investigated hepatitis virus-positive patients who had undergone a liver biopsy (n = 576) and 75 patients with compensated cirrhosis in order to evaluate the association of the zinc value with the severity of liver fibrosis and esophageal varices. The mean zinc values decreased with the progression of fibrosis (METAVIR score; F0-1: 71.3 ± 11.3, F2: 68.9 ± 11.7, F3: 66.3 ± 11.8, F4: 63.9 ± 15.0). In the hepatitis virus-related compensated cirrhosis, the mean zinc value decreased with the severity of varices (patients without varices: 66.3 ± 12.6, patients with low-risk varices: 62.5 ± 13.7, patients with high-risk varices: 55.6 ± 13.0). The zinc value was significantly lower in patients with varices than in those without varices (59.3 ± 13.6 vs 66.3 ± 12.6, p<0.05). The zinc value was also significantly lower in the patients with a high risk of bleeding than in those with a low risk (55.6 ± 13.0 vs 64.6 ± 13.1, p<0.01). These findings suggest that the zinc value is not only an indicator of an abnormal metal metabolism, but is also a simple parameter associated with hepatitis virus-related various conditions, including the degree of liver fibrosis and the severity of esophageal varices in compensated cirrhosis.
血清矿物质浓度与食管静脉曲张内镜表现之间的关系尚未得到充分研究。本研究调查了接受肝活检的乙型肝炎病毒阳性患者(n=576)和 75 例代偿性肝硬化患者,以评估锌值与肝纤维化和食管静脉曲张严重程度的关系。随着纤维化的进展,锌值呈下降趋势(METAVIR 评分;F0-1:71.3±11.3,F2:68.9±11.7,F3:66.3±11.8,F4:63.9±15.0)。在乙型肝炎病毒相关的代偿性肝硬化中,锌值随静脉曲张严重程度而降低(无静脉曲张患者:66.3±12.6,低危静脉曲张患者:62.5±13.7,高危静脉曲张患者:55.6±13.0)。有静脉曲张的患者锌值明显低于无静脉曲张的患者(59.3±13.6 vs 66.3±12.6,p<0.05)。高危出血的患者锌值也明显低于低危出血的患者(55.6±13.0 vs 64.6±13.1,p<0.01)。这些发现表明,锌值不仅是一种异常金属代谢的指标,也是与乙型肝炎病毒相关的各种情况相关的简单参数,包括肝纤维化程度和代偿性肝硬化中食管静脉曲张的严重程度。