Zinc deficiency as an independent prognostic factor for patients with early hepatocellular carcinoma due to hepatitis virus

Hiraoka, Atsushi; Nagamatsu, Kensuke; Izumoto, Hirofumi; Adachi, Tomoko; Yoshino, Takeaki; Tsuruta, Miho; Aibiki, Toshihiko; Okudaira, Taeko; Yamago, Hiroka; Iwasaki, Ryuichiro; Suga, Yasuhiro; Mori, Kenichiro; Miyata, Hideki; Tsubouchi, Eiji; Nakamura, Tomoyuki; Kawasaki, Hideki; Hirooka, Masashi; Matsuura, Bunzo; Abe, Masanori; Hiasa, Yoichi; Michitaka, Kojiro

doi:10.1111/hepr.13430

Cited by 14 publications

(17 citation statements)

References 42 publications

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“…Thus, Zn supplementation in patients with chronic hepatitis C and liver cirrhosis improved liver function and long-term outcome, such as lower cumulative incidence of liver cancer. With the same aspect, poor survival in chronic viral patients with early HCC was significantly associated with Zn deficiency as well as incomplete infection control of the hepatitis virus [ 22 ]. The risk of esophageal variceal bleeding, the fatal complication of decompensated cirrhosis, was also correlated with the decreased level of Zn in patients with chronic viral hepatitis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Serum zinc level and hepatic fibrosis in patients with nonalcoholic fatty liver disease

et al. 2020

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This study aimed to investigate the relationship between serum zinc level and hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). A cross-sectional study was conducted using nationally representative samples from the Korea National Health and Nutrition Examination Survey 2010. Significant hepatic fibrosis was defined as Fibrosis-4 (FIB-4) index>1.3. Zinc level was measured using inductively coupled plasma mass spectrometry. Univariable and multivariable logistic regression analyses were performed to assess risk factors for significant hepatic fibrosis in patients with NAFLD. A total of 300 patients with NAFLD were analyzed in this study. The mean serum zinc level was 139.8±29.9 μg/dL. FIB-4 index was significantly increased as the serum zinc level decreased (Adjusted correlation coefficient = -0.177, p = 0.003). Significant liver fibrosis was observed in 62 patients (21%). The multivariable analysis showed that significant liver fibrosis in NAFLD was associated with diabetes mellitus (odds ratio [OR], 3.25; 95% confidence interval [CI], 1.71–6.19; p <0.001), male (OR, 2.59; 95% CI, 1.31–5.12; p = 0.006), and zinc level <140 μg/dL (OR, 2.14; 95% CI, 1.16–3.94; p = 0.015). There was an inverse relationship between serum zinc level and FIB-4 index in NAFLD. Low levels of serum zinc were an independent risk factor for significant hepatic fibrosis in NAFLD.

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Section: Discussionmentioning

confidence: 99%

Serum zinc level and hepatic fibrosis in patients with nonalcoholic fatty liver disease

et al. 2020

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“…Serum MT levels were correlated with the Cu/Zn ratio (p = 0.046; Fig 2O), but not Cu or Zn levels taken independently (Fig 2P and 2Q). Previous studies have shown that excess Cu and Zn deficiency were associated with HCC with viral hepatitis [5,9]. Associations between the Cu, Zn, Cu/Zn and MT levels and other test values with or without hepatitis virus are shown in S1 or S2 Figs, respectively.…”

Section: Associations Between the Cu/zn Ratio And Other Test Values (mentioning

confidence: 95%

“…In contrast, Zn deficiency was reported to be associated with increased liver fibrosis [6,7] and hepatocarcinogenesis in patients with hepatitis C-related liver cirrhosis [8]. Recently, Hiraoka et al reported that Zn deficiency is an independent prognostic factor for early stage HCC patients infected with viral hepatitis who are receiving antiviral therapy [9]. The Cu/Zn ratio has been observed to be elevated in patients with hepatitis, liver cirrhosis or HCC and appears to be correlated with the overall severity of liver disease [4,10,11].…”

Section: Introductionmentioning

confidence: 99%

Serum copper, zinc and metallothionein serve as potential biomarkers for hepatocellular carcinoma

et al. 2020

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Background Copper (Cu) and zinc (Zn) are essential nutrients and cofactors of enzymatic reactions with their binding partner. Metallothionein (MT) plays an important role in protecting against heavy metals and oxidative injury, however it may also portend drug resistance and a worse prognosis for hepatocellular carcinoma (HCC) patients. The aim of this study was to determine the amount of Cu, Zn, Cu/Zn and MT in evaluating a group of patients with HCC, including those treated with lenvatinib. Methods We enrolled 175 patients with HCC (139 men, 36 women; mean age 71.1 years; hepatitis C

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“…Notably, there is growing evidence that hypozincemia may be associated with human hepatocarcinogenesis in patients with hepatitis C, and it is also an independent poor prognostic factor for patients with early hepatocellular carcinoma. 2,3 Physicians should be aware of this zinc deficiency-related cutaneous disorder in patients with hepatitis C virus, because it may be a poor prognostic sign in such patients. Keywords: Hepatitis C; Hepatocellular Carcinoma; Necrolytic Acral Erythema.…”

Section: Answer To Image (Page 38): Necrolytic Acral Erythemamentioning

confidence: 99%

Erythematous Plaques on Legs and Feet in a Patient With Hepatitis C

Chen

2021

Gastroenterology

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Question: A 72-year-old woman presented with a 6month history of multiple erythematous plaques over her bilateral lower limbs. She had a history of hepatitis C for 10 years and was regularly followed up in the gastrointestinal outpatient department. Her a-fetoprotein level was within the normal range until 1 year ago, but it increased to 29.1 ng/mL (reference value, <15 ng/ml) 1 month after the onset of skin lesions. Magnetic resonance imaging revealed 1.9-cm nodular lesions in S3 of the hepatic lobule, which appeared hypointense on T1-weighted images and hyperintense on T2-weighted images with arterial enhancement, and then faded in the portal and equilibrium phase. The diagnosis of hepatocellular carcinoma was made based on image study.On physical examination, multiple itchy wellmarginated annular erythematous scaly plaques with purpuric change over her bilateral lower legs and feet were noted (Figure A). Skin scraping test showed a negative result for fungus infection. A skin biopsy was performed, and histopathology revealed parakeratosis, mild acanthosis with focally dyskeratotic cells, and epidermal pallor in the epidermis (Figure B, stain: hematoxylin and eosin, magnification Â40). Hypozincemia (54.3 mg/dL; normal range, 60-120 mg/dL) was also noted in the laboratory examination.What is your diagnosis? Look on page 39 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI.

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Zinc deficiency as an independent prognostic factor for patients with early hepatocellular carcinoma due to hepatitis virus

Cited by 14 publications

References 42 publications

Serum zinc level and hepatic fibrosis in patients with nonalcoholic fatty liver disease

Serum zinc level and hepatic fibrosis in patients with nonalcoholic fatty liver disease

Serum copper, zinc and metallothionein serve as potential biomarkers for hepatocellular carcinoma

Erythematous Plaques on Legs and Feet in a Patient With Hepatitis C

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