scholarly journals Serum Zinc Level Is Associated with Frailty in Chronic Liver Diseases

2020 ◽  
Vol 9 (5) ◽  
pp. 1570 ◽  
Author(s):  
Hiroki Nishikawa ◽  
Kazunori Yoh ◽  
Hirayuki Enomoto ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  
Keyword(s):  
Liver Diseases ◽  
Serum Zinc ◽  
Body Weight Loss ◽  
Zinc Level ◽  
Clinical Syndrome ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Serum Zn ◽  
Total Body ◽  
Frailty Score

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.

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 ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Respiratory Quotient ◽  
Liver Diseases ◽  
Characteristic Curve ◽  
Serum Zinc ◽  
Zinc Level ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Median Serum ◽  
Serum Zn

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.

scholarly journals Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases

2019 ◽  
Vol 8 (3) ◽  
pp. 336 ◽  
Author(s):  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  
Keyword(s):  
Liver Diseases ◽  
Independent Predictor ◽  
Serum Zinc ◽  
Chronic Liver ◽  
Zn Deficiency ◽  
P Value ◽  
Chronic Liver Diseases ◽  
Baseline Serum ◽  
Zn Concentration ◽  
Serum Zn

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.

scholarly journals Frailty and Sleep Disorder in Chronic Liver Diseases

Life ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 137
Author(s):  
Hiroki Nishikawa ◽  
Kazunori Yoh ◽  
Hirayuki Enomoto ◽  
Yoshinori Iwata ◽  
Takashi Nishimura ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disorder ◽  
Liver Diseases ◽  
Body Weight Loss ◽  
Japanese Version ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Sleep Complaints ◽  
Slow Walking ◽  
Slow Walking Speed

We aimed to investigate the association in frailty and sleep disorder as assessed by the Japanese version of Pittsburgh Sleep Quality Index (PSQI-J) in patients with chronic liver diseases (CLDs, n = 317, 141 males). Frailty was determined using the following five phenotypes: unintentional body weight loss, self-reported exhaustion, muscle weakness, slow walking speed, and low physical activity. Sleep disorder was defined as patients with PSQI-J score 6 or greater. Robust (phenotype, 0), prefrail (1 or 2 phenotypes) and frailty (3 phenotypes or greater) were observed in 101 (31.9%), 174 (54.9%) and 42 (13.2%), respectively. The median (interquartile range (IQR)) PSQI-J score was 4 (3, 7). Sleep disorder was found in 115 patients (36.3%). The median (IQR) PSQI-J scores in patients of the robust, prefrail, and frail groups were 3 (2, 5), 5 (3, 7), and 8 (4.75, 10.25), respectively (p < 0.0001 between any two groups and overall p < 0.0001). The ratios of sleep disorder in patients with robust, prefrail and frailty were 15.8% (16/101), 39.1% (68/174), and 73.8% (31/42), respectively (overall p < 0.0001). In conclusion, CLD patients with frailty can involve poorer sleep quality. As sleep disorder in CLDs is potentially remediable, future frailty-preventive strategies must take sleep complaints into account.

scholarly journals Examination of serum zinc levels in patients with chronic liver diseases

Kanzo ◽  
2019 ◽  
Vol 60 (3) ◽  
pp. 99-101
Author(s):  
Yohji Honda ◽  
Keiichi Masaki
Keyword(s):  
Liver Diseases ◽  
Serum Zinc ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Zinc Levels ◽  
Serum Zinc Levels

scholarly journals Walking Speed: Japanese Data in Chronic Liver Diseases

2020 ◽  
Vol 9 (1) ◽  
pp. 166
Author(s):  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  
Keyword(s):  
Liver Diseases ◽  
Walking Speed ◽  
Handgrip Strength ◽  
Extracellular Fluid ◽  
Chronic Liver ◽  
P Value ◽  
Extracellular Water ◽  
Chronic Liver Diseases ◽  
Total Body ◽  
The Impact

We aim to clarify the impact of walking speed (WS) and analyze factors linked to WS decline in patients with chronic liver diseases (CLDs, 165 males and 191 females, 137 liver cirrhosis patients). The WS decline is defined as <0.8 m/second (m/s), referring to the guidelines. The median (range) WS was 1.3 m/s (0.2–2.02 m/s). There were 17 patients with WS < 0.8 m/s (4.8%). The WS value was significantly correlated with the handgrip strength value both in males (r2 = 0.252, p < 0.0001) and females (r2 = 0.256, p < 0.0001). In the multivariate analysis of factors associated with WS decline, only the extracellular water (ECW) to total body water (TBW) ratio using bioimpedance analysis was an independent predictor (p = 0.0398). Extracellular fluid excess was categorized as follows: normal condition (ECW to TBW ratio < 0.390), mild overhydrated condition (ECW to TBW ratio 0.390–0.399), and moderate to severe overhydrated condition (ECW to TBW ratio ≥ 0.400). The WS value was well stratified according to the ECW to TBW ratio (normal vs. mild, p = 0.0001; mild vs. moderate to severe, p < 0.0001; normal vs. moderate to severe, p < 0.0001; overall p-value < 0.0001). In conclusion, the ECW to TBW ratio can be closely linked to WS decline in CLD patients.

scholarly journals Close Correlation between Frailty and Depressive State in Chronic Liver Diseases

Medicina ◽  
2020 ◽  
Vol 56 (7) ◽  
pp. 319
Author(s):  
Hiroki Nishikawa ◽  
Kazunori Yoh ◽  
Hirayuki Enomoto ◽  
Yoshinori Iwata ◽  
Yoshiyuki Sakai ◽  
...  
Keyword(s):  
Body Weight Loss ◽  
Close Correlation ◽  
Clinical Syndrome ◽  
Chronic Liver ◽  
Depressive State ◽  
Slow Walking ◽  
Few Data ◽  
The Relationship ◽  
Slow Walking Speed ◽  
Frailty Score

Background and objectives: Few data with regard to the relevance between depression and frailty in chronic liver disease (CLD) patients are currently available. We aimed to elucidate the relationship between frailty and depression as evaluated by the Beck Depression Inventory—2nd edition (BDI-II) in CLD patients (n = 340, median age = 65.0 years). Methods: Frailty was defined as a clinical syndrome in which three or more of the following criteria were met: body weight loss, exhaustion, muscle weakness, slow walking speed and low physical activity. Depressive state was defined as BDI-II score 11 or greater. Results: Robust (frailty score = zero), prefrail (frailty score = one or two) and frailty were identified in 114 (33.5%), 182 (53.5%) and 44 (12.9%). The median BDI-II score was five. Depressive state was identified in 84 patients (24.7%). The median BDI-II scores in patients with robust, prefrail and frail traits were 2, 7 and 12.5 (robust vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0003; robust vs. frail, p < 0.0001; overall p < 0.0001). The proportions of depressive state in patients with robust, prefrail and frail traits were 3.51%, 30.77% and 54.55% (robust vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0046; robust vs. frail, p < 0.0001; overall p < 0.0001). BDI-II score significantly correlated with frailty score (rs = 0.5855, p < 0.0001). Conclusions: The close correlation between frailty and depression can be found in CLD. Preventing frailty in CLD should be approached both physiologically and psychologically.

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