scholarly journals Serum Zinc Level and non-Protein Respiratory Quotient in Patients with Chronic Liver Diseases

2020 ◽  
Vol 9 (1) ◽  
pp. 255
Author(s):  
Hiroki Nishikawa ◽  
Ryo Takata ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
...  

We sought to clarify the correlation between non-protein respiratory quotient (npRQ) in indirect calorimetry and serum zinc (Zn) level in chronic liver diseases (CLDs, n = 586, 309 liver cirrhosis (LC) patients, median age = 63 years). Clinical parameters potentially linked to npRQ <0.85 (best cutoff point for the prognosis in LC patients) were also examined in receiver operating characteristic curve (ROC) analyses. The median npRQ was 0.86. The median serum Zn level was 64 μg/dL. The median npRQ in patients with non-LC, Child–Pugh A, Child–Pugh B and Child–Pugh C were 0.89, 0.85, 0.83 and 0.82 (overall p < 0.0001)). The median serum Zn level in patients with npRQ <0.85 (58 μg/dL) was significantly lower than that in patients with npRQ ≥ 0.85 (68 μg/dL) (p < 0.0001). The correlation coefficient (r) between npRQ level and serum Zn level for all cases was 0.40 (p < 0.0001). Similar tendencies were observed in all subgroup analyses. The highest correlation coefficient between serum Zn level and npRQ was found in patients with Child–Pugh C (n = 22, r = 0.69). In ROC analyses for npRQ <0.85, serum Zn level had the highest area under the ROC (AUC) among baseline laboratory parameters (AUC = 0.69). In conclusion, serum Zn level can be helpful for npRQ in patients with CLDs.

2020 ◽  
Vol 9 (5) ◽  
pp. 1570 ◽  
Author(s):  
Hiroki Nishikawa ◽  
Kazunori Yoh ◽  
Hirayuki Enomoto ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  

We sought to examine the serum zinc (Zn) level and frailty in patients with chronic liver diseases (CLDs, n = 285, 107 liver cirrhosis cases, median age = 66 years). Frailty was defined as a clinical syndrome in which three or more of the following criteria were met (frailty score 3, 4, or 5): unintentional body weight loss, self-reported exhaustion, muscle weakness (grip strength: <26 kg in men and <18 kg in women), slow walking speed (<1.0 m/s), and low physical activity. Robust (frailty score 0), prefrail (frailty score 1 or 2), and frailty were found in 90 (31.6%), 157 (55.1%), and 38 (13.3%), respectively. The median serum Zn levels in patients with frailty, prefrailty, and robust were 59.7 μg/dL, 72.8 μg/dL, and 76.9 μg/dL, respectively (p-values: frailty vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0063; frailty vs. robust, p < 0.0001; overall p < 0.0001). For all cases, variables with absolute values of correlation coefficient with frailty score (0–5) ≥ 0.3 were age (rs = 0.3570, p < 0.0001), serum albumin (rs = −0.3212, p < 0.0001), extracellular water to total body water ratio using bioimpedance analysis (rs = 0.4386, p < 0.0001), and serum Zn level (rs = −0.3406, p < 0.0001). In conclusion, decreased serum Zn level in patients with CLDs can be closely associated with the presence of frailty.


2019 ◽  
Vol 8 (3) ◽  
pp. 336 ◽  
Author(s):  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  

We sought to investigate the influence of serum zinc (Zn) concentration on sarcopenia in chronic liver diseases (CLDs, n = 372, median age = 65 years, 147 liver cirrhosis (LC) cases (39.5%)). Sarcopenia was defined by low grip strength and low skeletal muscle mass. Study subjects were divided into the following three groups (High-, Intermediate-, and Low-Zn groups) based on the baseline serum Zn level. The impacts of serum Zn concentration on sarcopenia were examined. The median (interquartile range) serum Zn concentration for all cases was 72.85 (63.7, 81.45) μg/dL. The proportions of sarcopenia in the High-Zn, Intermediate-Zn, and Low-Zn groups were 10.75% (10/93), 11.23% (21/187), and 27.17% (25/92), respectively (P = 0.9046 (High vs. Intermediate), P = 0.0007 (Intermediate vs. Low), P = 0.0044 (High vs. Low), overall P value = 0.0009). The median serum Zn concentrations in patients with sarcopenia, pre-sarcopenia, and control were 66.35, 73.1 and 73.8 μg/dL, respectively (P = 0.0234 (sarcopenia vs. pre-sarcopenia), P = 0.2116 (pre-sarcopenia vs. control), P = 0.0002 (sarcopenia vs. control), overall P value = 0.0016). In the multivariate analyses of factors linked to the presence of sarcopenia, Low-Zn was an independent predictor for all cases (P = 0.0236) and LC cases (P = 0.0082). In conclusion, Zn deficiency can be an independent predictor for sarcopenia in patients with CLDs.


2019 ◽  
Vol 8 (9) ◽  
pp. 1485 ◽  
Author(s):  
Ryo Takata ◽  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
...  

We sought to elucidate the relationship between albumin-bilirubin (ALBI) grade and non-protein respiratory quotient (npRQ) calculated by indirect calorimetry in chronic liver disease (CLD) patients (n = 601, median age = 63 years). Factors linked to npRQ < 0.85, which is reported to be an optimal cutoff point for the prognosis in liver cirrhosis (LC) patients, were also investigated using univariate and multivariate analyses. The median npRQ for all cases was 0.86. In total, 253 patients (42.1%) had npRQ < 0.85. The proportions of patients with npRQ < 0.85 in LC and non-LC patients were 51.9% (166/320) in LC patients and 31.0% (87/281) in non-LC patients (p < 0.0001). The median npRQ in ALBI grades 1, 2, and 3 for all cases were: 0.89, 0.85, and 0.82 (overall p < 0.0001). The proportions of patients with npRQ < 0.85 were 31.0% (71/229) in ALBI grade 1, 46.34% (152/328) in ALBI grade 2, and 68.18% (30/44) in ALBI grade 3 (overall p < 0.0001). In multivariate analyses of factors linked to npRQ < 0.85, ALBI grade 3 (p = 0.0095, hazard ratio = 3.242, ALBI grade 1 as a reference) was an independent predictor along with prothrombin time (p = 0.0139). In conclusion, ALBI grade can be a useful marker for npRQ in patients with CLDs.


Kanzo ◽  
2019 ◽  
Vol 60 (3) ◽  
pp. 99-101
Author(s):  
Yohji Honda ◽  
Keiichi Masaki

Medicine ◽  
2020 ◽  
Vol 99 (1) ◽  
pp. e18632 ◽  
Author(s):  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  

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