Sakurai Kensuke, Furukawa Shigeru, Katsurada Takehiko, Otagiri Shinsuke, Yamanashi Kana, Nagashima Kazunori, Onishi Reizo, Yagisawa Keiji, Nishimura Haruto, Ito Takahiro, Maemoto Atsuo, Sakamoto Naoya
Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan.
Inflammatory Bowel Disease Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan.
Intest Res. 2022 Jan;20(1):78-89. doi: 10.5217/ir.2020.00124. Epub 2021 Jan 22.
BACKGROUND/AIMS: Inflammatory bowel disease (IBD) patients frequently have zinc deficiency. IBD patients with zinc deficiency have higher risks of IBD-related hospitalization, complications, and requiring surgery. This study aimed to examine the effectiveness of zinc acetate hydrate (ZAH; Nobelzin) in IBD patients with zinc deficiency.
IBD patients with zinc deficiency who received ZAH from March 2017 to April 2020 were registered in this 2-center, retrospective, observational study. Changes in serum zinc levels and disease activity (Crohn's Disease Activity Index [CDAI]) before and after ZAH administration were analyzed.
Fifty-one patients with Crohn's disease (CD, n = 40) or ulcerative colitis (UC, n = 11) were registered. Median serum zinc level and median CDAI scores significantly improved (55.5-91.0 μg/dL, P< 0.001; 171.5-129, P< 0.001, respectively) in CD patients 4 weeks after starting ZAH administration. Similarly, median serum zinc levels and CDAI scores significantly improved (57.0-81.0 μg/dL, P< 0.001; 177-148, P= 0.012, respectively) 20 weeks after starting ZAH administration. Similar investigations were conducted in groups where no treatment change, other than ZAH administration, was implemented; significant improvements were observed in both serum zinc level and CDAI scores. Median serum zinc levels in UC patients 4 weeks after starting ZAH administration significantly improved from 63.0 to 94.0 μg/dL (P= 0.002), but no significant changes in disease activity were observed. One patient experienced side effects of abdominal discomfort and nausea.
ZAH administration is effective in improving zinc deficiency and may contribute to improving disease activity in IBD.
背景/目的:炎症性肠病(IBD)患者常存在锌缺乏。锌缺乏的IBD患者因IBD相关住院、并发症及需要手术的风险更高。本研究旨在探讨水合醋酸锌(ZAH;Nobelzin)对锌缺乏的IBD患者的疗效。
本2中心回顾性观察研究纳入了2017年3月至2020年4月期间接受ZAH治疗的锌缺乏IBD患者。分析了ZAH给药前后血清锌水平和疾病活动度(克罗恩病活动指数[CDAI])的变化。
共纳入51例克罗恩病(CD,n = 40)或溃疡性结肠炎(UC,n = 11)患者。CD患者在开始ZAH治疗4周后,血清锌水平中位数和CDAI评分中位数显著改善(分别为55.5 - 91.0μg/dL,P < 0.001;171.5 - 129,P < 0.001)。同样,在开始ZAH治疗20周后,血清锌水平中位数和CDAI评分也显著改善(分别为57.0 - 81.0μg/dL,P < 0.001;177 - 148,P = 0.012)。在除ZAH给药外未实施其他治疗改变的组中进行了类似研究;血清锌水平和CDAI评分均有显著改善。UC患者在开始ZAH治疗4周后血清锌水平中位数从63.0μg/dL显著提高至94.0μg/dL(P = 0.002),但疾病活动度无显著变化。1例患者出现腹部不适和恶心的副作用。
ZAH给药可有效改善锌缺乏,并可能有助于改善IBD的疾病活动度。