Katayama Kazuhiro, Kawaguchi Takumi, Shiraishi Koichi, Ito Toshifumi, Suzuki Kazutomo, Koreeda Chizu, Ohtake Takaaki, Iwasa Motoh, Tokumoto Yoshio, Endo Ryujin, Kawamura Naohiro, Shiraki Makoto, Hanai Tatsunori, Habu Daiki, Tsuruta Satoru, Sakai Hironori, Miwa Yoshiyuki, Kawada Norifumi, Kato Akinobu, Takei Yoshiyuki, Mine Tetsuya, Kohgo Yutaka, Seki Toshihito, Sata Michio, Ito Yuri, Fukui Keisuke, Nishiguchi Shuhei, Moriwaki Hisataka, Suzuki Kazuyuki
Department of Hepato-Biliary and Pancreatic Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan.
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-cho, Kurume 830-0011, Japan.
J Clin Med Res. 2018 May;10(5):437-444. doi: 10.14740/jocmr3374w. Epub 2018 Mar 16.
Patients with liver cirrhosis often exhibit zinc deficiency. Although zinc is involved in many bioactivities, many aspects of clinical implications of zinc deficiency in liver cirrhosis remain unclear. We aimed to reveal the prevalence and implications of zinc deficiency in liver cirrhosis by assessing associations with parameters such as clinical symptoms and laboratory data.
In 235 cirrhosis patients enrolled at multiple medical institutions in 2009, we assessed how blood zinc levels were associated with their clinical symptoms, patients characteristics, and liver function test results.
Blood zinc levels were most strongly correlated with blood albumin levels among the study parameters (r = 0.587, P < 0.0001). When blood albumin levels were ≤ 3.5 g/dL, blood zinc levels were < 70 μg/dL in 88% of patients. Additionally, significant correlations were observed with age (r = -0.253, P = 0.0014), aspartate aminotransferase levels (r = -0.254, P = 0.0020), total bilirubin levels (r = -0.222, P = 0.0053), prothrombin time (r = -0.255, P = 0.0029), branched-chain amino acid to tyrosine ratio (r = 0.357, P < 0.0001), Child-Pugh score (r = 0.469, P < 0.0001), ammonia levels (r = -0.246, P = 0.0028), and total cholesterol levels (r = 0.314, P < 0.0001). Blood zinc levels were significantly lower in patients with edema/ascites (P < 0.0001), those with hepatic encephalopathy (P = 0.0215), those receiving oral diuretics (P = 0.0045), and those receiving oral branched-chain amino acids (P < 0.0001) than in those without these conditions.
Zinc deficiency is prevalent in cirrhosis patients, whereas nitrogen metabolic disorders, particularly hypoalbuminemia, can be an indicator of zinc deficiency. Thus, cirrhosis patients exhibiting a nitrogen metabolic disorder should be examined for the presence of zinc deficiency.
肝硬化患者常存在锌缺乏。尽管锌参与多种生物活性，但肝硬化中锌缺乏的临床意义的许多方面仍不清楚。我们旨在通过评估与临床症状和实验室数据等参数的关联，揭示肝硬化中锌缺乏的患病率及其意义。
在2009年于多个医疗机构招募的235例肝硬化患者中，我们评估了血锌水平与他们的临床症状、患者特征及肝功能检查结果之间的关系。
在研究参数中，血锌水平与血白蛋白水平的相关性最强（r = 0.587，P < 0.0001）。当血白蛋白水平≤3.5 g/dL时，88%的患者血锌水平<70 μg/dL。此外，还观察到与年龄（r = -0.253，P = 0.0014）、天冬氨酸转氨酶水平（r = -0.254，P = 0.0020）、总胆红素水平（r = -0.222，P = 0.0053）、凝血酶原时间（r = -0.255，P = 0.0029）、支链氨基酸与酪氨酸比值（r = 0.357，P < 0.0001）、Child-Pugh评分（r = 0.469，P < 0.0001）、氨水平（r = -0.246，P = 0.0028）和总胆固醇水平（r = 0.314，P < 0.0001）有显著相关性。有水肿/腹水的患者（P < 0.0001）、有肝性脑病的患者（P = 0.0215）、接受口服利尿剂的患者（P = 0.0045）以及接受口服支链氨基酸的患者（P < 0.0001）的血锌水平显著低于无这些情况的患者。
锌缺乏在肝硬化患者中普遍存在，而氮代谢紊乱，尤其是低白蛋白血症，可能是锌缺乏的一个指标。因此，对表现出氮代谢紊乱的肝硬化患者应检查是否存在锌缺乏。
