Efficacy of Zinc Acetate Treatment for Patients with Decompensated Liver Cirrhosis Complicated by Hypozincemia

Horiguchi, Suguru; Naganuma, Atsushi; Tateyama, Yumeo; Suzuki, Yuhei; Hoshino, Takashi; Hatanaka, Takeshi; Takakusagi, Satoshi; Kosone, Takashi; Takagi, Hitoshi; Uraoka, Toshio; Kakizaki, Satoru

doi:10.1007/s12011-021-02675-5

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…In a previous report, Horiguchi et al compared L3 SMI before zinc drug loading with a cut-off serum zinc concentration of 60 µg/dL and reported no significant difference between the two groups (P=0.61) ( 23 ), which is similar to our findings.…”

Section: Discussionsupporting

confidence: 92%

Serum zinc concentration as a potential predictor of presarcopenia in patients with chronic liver disease: a preliminary study

Suzuki,

Ishikawa,

Ohashi

et al. 2024

Transl Gastroenterol Hepatol

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Background Presarcopenia is a common complication of chronic liver disease. However, the relationship between serum zinc concentration and presarcopenia in patients with chronic liver disease remains unclear. Herein, we examined whether serum zinc concentration could predict presarcopenia in patients with chronic liver disease. Methods Between October 2015 and December 2019, 278 patients with chronic liver disease (median age, 68 years; women/men, 133/145; hepatitis B virus/hepatitis C virus/negative hepatitis B surface antigen and negative anti-hepatitis C virus antibody, 55/124/99) who underwent abdominal computed tomography (CT) and simultaneous measurement of serum zinc concentration were included. Zinc deficiency and subclinical zinc deficiency were classified using serum zinc concentration cutoff values of <60 and <80 μg/dL [based on the Japanese Society of Clinical Nutrition (JSCN) guidelines], respectively. Additionally, presarcopenia was evaluated based on the skeletal muscle mass as per the Japan Society of Hepatology (JSH)’s sarcopenia criteria. Results Univariate analysis revealed that the following factors were significantly associated with the presence of presarcopenia in patients with chronic liver disease: age (P<0.001), male sex (P<0.001), body mass index (BMI) (P<0.001), serum zinc concentration (P=0.005), fibrosis-4 index (P<0.001), and serum albumin concentration (P=0.03). Additionally, the median L3 skeletal muscle indices were as follows: men, non-presarcopenia group/presarcopenia group, 47.56/37.91 cm 2 /m 2 (P<0.001); women, non-presarcopenia group/presarcopenia group, 41.64/32.88 cm 2 /m 2 (P<0.001). Multivariate analysis using logistic regression analysis revealed that male sex [odds ratio (OR), 0.194; 95% confidence interval (CI): 0.089–0.419; P<0.001], BMI (OR, 0.666; 95% CI: 0.582–0.761; P<0.001), and serum zinc concentration <60 μg/dL (OR, 5.930; 95% CI: 1.480–23.80; P=0.01) were factors associated with presarcopenia. The OR for serum zinc concentration between 60 and 80 μg/dL was 1.910 (95% CI: 0.824–4.420; P=0.13). Conclusions Low serum zinc levels may be an independent predictor of presarcopenia in patients with chronic liver disease.

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Section: Discussionsupporting

confidence: 92%

Serum zinc concentration as a potential predictor of presarcopenia in patients with chronic liver disease: a preliminary study

Suzuki,

Ishikawa,

Ohashi

et al. 2024

Transl Gastroenterol Hepatol

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“…In addition, Van der Rijt et al [117] have reported an association between episodes of overt HE and zinc deficiency, with improvement in the patient's HE stage following zinc supplementation. Horiguchi et al [118] and Miwa et al [119] also report positive effects of zinc supplementation in HE and the overall condition of patients with cirrhosis and confirmed zinc deficiency. In contrast to these positive effects of zinc supplementation on HE, Riggio et al [120] did not observe a corresponding improvement in a placebo-controlled study that followed patients for seven days.…”

Section: Zinc Supplementation In Liver Diseasementioning

confidence: 87%

“…The efficacy of zinc supplementation is also controversial in relation to HE [48]. Studies that demonstrate a positive influence on HE [107,[114][115][116][117][118][119] are contrasted by others in which no effect was found [118]. An early double-blind study of 22 cirrhotic patients treated with zinc acetate (600 mg/d for 7 days) [115] found-besides normalization of serum zinc concentrations-an increase in the rate of urea production and improvement in performance of psychometric tests in patients treated with the zinc preparation.…”

Section: Zinc Supplementation In Liver Diseasementioning

confidence: 99%

Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc

et al. 2021

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Decompensated liver cirrhosis has a dismal prognosis, with patients surviving on average for 2–4 years after the first diagnosis of ascites. Albumin is an important tool in the therapy of cirrhotic ascites. By virtue of its oncotic properties, it reduces the risk of cardiovascular dysfunction after paracentesis. Treatment with albumin also counteracts the development of hepatorenal syndrome and spontaneous bacterial peritonitis. More recently, the positive impact of long-term albumin supplementation in liver disease, based on its pleiotropic non-oncotic activities, has been recognized. These include transport of endo- and exogenous substances, anti-inflammatory, antioxidant and immunomodulatory activities, and stabilizing effects on the endothelium. Besides the growing recognition that effective albumin therapy requires adjustment of the plasma level to normal physiological values, the search for substances with adjuvant activities is becoming increasingly important. More than 75% of patients with decompensated liver cirrhosis do not only present with hypoalbuminemia but also with zinc deficiency. There is a close relationship between albumin and the essential trace element zinc. First and foremost, albumin is the main carrier of zinc in plasma, and is hence critical for systemic distribution of zinc. In this review, we discuss important functions of albumin in the context of metabolic, immunological, oxidative, transport, and distribution processes, alongside crucial functions and effects of zinc and their mutual dependencies. In particular, we focus on the major role of chronic inflammatory processes in pathogenesis and progression of liver cirrhosis and how albumin therapy and zinc supplementation may affect these processes.

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“…( 13 , 23 , 24 ) Zinc acetate has been shown to improve zinc levels, but has not been shown to have a sufficient effect on liver reserve. ( 25 , 26 ) The amount of zinc preparations used differs among polaprezinc, zinc sulfate, and zinc acetate. ( 15 ) The highest daily dose of zinc used is zinc acetate, 50–200 mg/day, administered 2–3 times daily.…”

Section: Discussionmentioning

confidence: 99%

Zinc supplementation with polaprezinc was associated with improvements in albumin, prothrombin time activity, and hemoglobin in ‍chronic liver disease

Abiru,

Kugiyama,

Suehiro

et al. 2024

J. Clin. Biochem. Nutr.

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Zinc deficiency occurs in a variety of diseases, including chronic liver disease (CLD). We investigated the correlation between zinc levels and biochemical and hematological tests in CLD and the effect of zinc supplementation with polaprezinc on these values. The first study (Study 1) was a retrospective observational study of 490 patients with CLD not receiving zinc supplementation, with data available from September 2009 to August 2021. Univariate and multiple regression analysis showed that serum zinc levels correlated most strongly with albumin (Alb) and also significantly with prothrombin time activity (PT%) and hemoglobin (Hb). A subsequent study (Study 2) focused on patients with advanced CLD who used polaprezinc for more than 90 days between January 2005 and August 2021. Using a self-controlled design with the 6-month period prior to polaprezinc as the control period, comparisons showed that Alb ( p <0.0001), PT% ( p <0.0005), and Hb ( p <0.01) were significantly improved in the polaprezinc-treated patients compared to the control group. In conclusion, serum zinc levels were correlated with serum Alb, Hb, and PT% in patients with CLD, and zinc supplementation with polaprezinc was associated with improvements in Alb, Hb, and PT% within at least 6 months.

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Efficacy of Zinc Acetate Treatment for Patients with Decompensated Liver Cirrhosis Complicated by Hypozincemia

Cited by 7 publications

References 28 publications

Serum zinc concentration as a potential predictor of presarcopenia in patients with chronic liver disease: a preliminary study

Serum zinc concentration as a potential predictor of presarcopenia in patients with chronic liver disease: a preliminary study

Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc

Zinc supplementation with polaprezinc was associated with improvements in albumin, prothrombin time activity, and hemoglobin in ‍chronic liver disease

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