Serum Zinc Level Classification System: Usefulness in Patients with Liver Cirrhosis
by
Hiroki Nishikawa 1,2,*, Hirayuki Enomoto 1, Kazunori Yoh 1, Yoshinori Iwata 1, Yoshiyuki Sakai 1, Kyohei Kishino 1, Naoto Ikeda 1, Tomoyuki Takashima 1, Nobuhiro Aizawa 1, Ryo Takata 1, Kunihiro Hasegawa 1, Noriko Ishii 1, Yukihisa Yuri 1, Takashi Nishimura 1, Hiroko Iijima 1 and Shuhei Nishiguchi 1
Hiroki Nishikawa 1,2,*, Hirayuki Enomoto 1, Kazunori Yoh 1, Yoshinori Iwata 1, Yoshiyuki Sakai 1, Kyohei Kishino 1, Naoto Ikeda 1, Tomoyuki Takashima 1, Nobuhiro Aizawa 1, Ryo Takata 1, Kunihiro Hasegawa 1, Noriko Ishii 1, Yukihisa Yuri 1, Takashi Nishimura 1, Hiroko Iijima 1 and Shuhei Nishiguchi 1
1
Division of Hepatobiliary and Pancreatic disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
2
Center for clinical research and education, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2057; https://doi.org/10.3390/jcm8122057
Received: 28 September 2019 / Revised: 20 November 2019 / Accepted: 21 November 2019 / Published: 22 November 2019
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
Currently, the Japanese society of clinical nutrition (JSCN) defines serum zinc (Zn) level < 60 μg/dL as Zn deficiency and 60 μg/dL ≤ serum Zn level < 80 μg/dL as subclinical Zn deficiency, and 80 μg/dL ≤ serum Zn level < 130 μg/dL as normal Zn range. We aimed to elucidate the prognostic impact of this Zn classification system in patients with liver cirrhosis (LC) compared to the Child–Pugh classification and the albumin–bilirubin (ALBI) grading system (n = 441, median age = 66 years). The Akaike information criterion (AIC) with each evaluation method was tested in order to compare the overall survival (OS). The median serum Zn level was 65 μg/dL. There were 56 patients with normal Zn level, 227 with subclinical Zn deficiency and 158 with Zn deficiency. OS was well stratified among three groups of serum Zn level (p < 0.0001). The AIC value for survival by the Zn classification system was the lowest among three prognostic models (AIC: 518.99 in the Child–Pugh classification, 502.411 in ALBI grade and 482.762 in the Zn classification system). Multivariate analyses of factors associated with OS revealed that serum Zn classification by JSCN was an independent factor. In conclusion, the serum Zn classification proposed by JSCN appears to be helpful for estimating prognosis in LC patients.
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Keywords:
serum zinc; classification system; liver cirrhosis; Child–Pugh classification; ALBI grade; prognosis
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MDPI and ACS Style
Nishikawa, H.; Enomoto, H.; Yoh, K.; Iwata, Y.; Sakai, Y.; Kishino, K.; Ikeda, N.; Takashima, T.; Aizawa, N.; Takata, R.; Hasegawa, K.; Ishii, N.; Yuri, Y.; Nishimura, T.; Iijima, H.; Nishiguchi, S. Serum Zinc Level Classification System: Usefulness in Patients with Liver Cirrhosis. J. Clin. Med. 2019, 8, 2057.
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