Kakumanu Vidyadhari, Mantur Prakash G
Internal Medicine, Shri B.M. Patil Medical College, Hospital and Research Centre, Bharathiya Lingayat Development Educational Association (BLDE) (Deemed to be University), Vijayapura, IND.
Cureus. 2025 Jul 4;17(7):e87277. doi: 10.7759/cureus.87277. eCollection 2025 Jul.
Introduction Liver cirrhosis represents the final common pathway for chronic liver diseases, characterized by extensive fibrosis and hepatocyte dysfunction. Zinc, an essential micronutrient with critical roles in protein synthesis, enzymatic reactions, and antioxidant defense, has been implicated in liver pathophysiology. This study aimed to evaluate serum zinc levels in patients with liver cirrhosis and correlate them with disease severity as measured by the Child-Pugh classification. Methods This hospital-based cross-sectional study was conducted among 85 patients with liver cirrhosis attending the outpatient and inpatient departments of BLDE University's Shri BM Patil Medical College Hospital. Clinical evaluation and biochemical investigations were performed, including serum zinc levels and Child-Pugh scoring. Zinc deficiency is defined as serum levels below 51 μg/dL. Statistical analysis included descriptive statistics, chi-square tests, and analysis of variance (ANOVA) to assess relationships between variables. Results The study cohort comprised predominantly middle-aged men (95.3%), with alcoholic etiology (n=76, 89.4%) being the leading cause of cirrhosis. Advanced disease was common, with 67.1% of patients categorized as Child-Pugh Class C. Zinc deficiency was observed in 97.6% (n=83) of patients, with mean zinc levels showing a significant progressive decrease from Child-Pugh Class A (50.4±4.31 μg/dL) to Class B (42.32±4.86 μg/dL) to Class C (37.02±3.68 μg/dL) (p<0.001). There was a perfect parallelism between zinc and albumin deficiency (n=83, 97.6%). The mortality rate during the study period was 15.3% (n=13). Conclusion This study reveals a markedly high prevalence of zinc deficiency among patients with liver cirrhosis and establishes a significant inverse correlation between serum zinc levels and disease severity. The observed progressive decline in zinc concentrations with advancing Child-Pugh scores indicates that zinc deficiency may function both as a clinical marker of disease progression and as a contributing factor to hepatic deterioration. These findings highlight the potential value of incorporating routine zinc assessment in the evaluation of cirrhotic patients. Moreover, zinc supplementation may be considered as an adjunctive therapeutic strategy, particularly in those with advanced-stage disease.
引言
肝硬化是慢性肝病的最终共同通路,其特征为广泛纤维化和肝细胞功能障碍。锌是一种必需的微量营养素,在蛋白质合成、酶促反应和抗氧化防御中起关键作用,已被认为与肝脏病理生理学有关。本研究旨在评估肝硬化患者的血清锌水平,并将其与通过Child-Pugh分类法测量的疾病严重程度相关联。
方法
本基于医院的横断面研究在BLDE大学Shri BM Patil医学院医院门诊和住院部的85例肝硬化患者中进行。进行了临床评估和生化检查,包括血清锌水平和Child-Pugh评分。锌缺乏定义为血清水平低于51μg/dL。统计分析包括描述性统计、卡方检验和方差分析(ANOVA),以评估变量之间的关系。
结果
研究队列主要由中年男性组成(95.3%),酒精性病因(n = 76,89.4%)是肝硬化的主要原因。晚期疾病很常见,67.1%的患者被归类为Child-Pugh C级。97.6%(n = 83)的患者观察到锌缺乏,平均锌水平显示从Child-Pugh A级(50.4±4.31μg/dL)到B级(42.32±4.86μg/dL)再到C级(37.02±3.68μg/dL)有显著的逐渐下降(p<0.001)。锌缺乏与白蛋白缺乏之间存在完美的平行关系(n = 83,97.6%)。研究期间的死亡率为15.3%(n = 13)。
结论
本研究揭示了肝硬化患者中锌缺乏的患病率明显很高,并确定了血清锌水平与疾病严重程度之间存在显著的负相关。随着Child-Pugh评分的升高,观察到锌浓度逐渐下降,这表明锌缺乏可能既是疾病进展的临床标志物,也是肝脏恶化的一个促成因素。这些发现突出了在肝硬化患者评估中纳入常规锌评估的潜在价值。此外,锌补充剂可被视为一种辅助治疗策略,特别是在晚期疾病患者中。