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

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Abstract

The aim of this study was to evaluate the efficacy of zinc acetate treatment for patients with decompensated liver cirrhosis complicated by hypozincemia. We retrospectively analyzed 49 patients with decompensated liver cirrhosis complicated by hypozincemia who received zinc acetate treatment from August 2017 to March 2020. The relationships between serum zinc levels and several parameters including the prognosis, sarcopenia, and immunity were evaluated. Serum zinc levels measured at 3 months post-treatment and the incidence of adverse events were also determined. The median age was 69.0 years (IQR:59.5–78.8) and the male to female ratio was 29:20. Twenty-seven patients had a Child-Pugh classification of B and 22 had a Child-Pugh classification of C; the median Child-Pugh score was 9.0 (IQR, 8.0–11.0). The median serum zinc levels measured at 3 months post-treatment (74.7 (IQR, 50.0–101.0) μg/dL) were significantly elevated in comparison to the pre-treatment levels (43.0 (IQR, 34.0–51.0) μg/dL, P < 0.0001). The overall survival of patients with pre-treatment serum zinc levels of ≥60 μg/dL was significantly better than that of those with pre-treatment serum zinc levels of <60 μg/dL (P = 0.013). The survival of patients with zinc levels of ≥70 μg/dL at 3 months post-treatment was significantly better than those with levels of <70 μg/dL (P = 0.013). The serum albumin level, Child-Pugh score, albumin-bilirubin (ALBI) score and model for end-stage liver disease (MELD) score were identified as factors predicting a good response at 3 months post-treatment. There were no significant relations between the pretreatment serum zinc levels and skeletal muscle mass, lymphocyte count, and neutrophil lymphocyte ratio. There were no obvious problematic adverse events in patients who received zinc acetate treatment. The patients with higher basal zinc levels and good responders to zinc acetate treatment had a better prognosis. Zinc acetate was useful and safe for patients with decompensated liver cirrhosis complicated by hypozincemia.

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Data availability

The data that support the findings of this study are available from the corresponding author, A.N., upon reasonable request.

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Acknowledgements

We thank Noriko Ozawa, Mariko Nudejima and Miyuki Tohma for their technical assistance.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Higashiagatsuma National Health Insurance Clinic, Higashiagatsuma, Japan

    Suguru Horiguchi

  2. Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan

    Suguru Horiguchi, Atsushi Naganuma, Yumeo Tateyama, Yuhei Suzuki & Takashi Hoshino

  3. Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan

    Naoto Saito & Takeshi Hatanaka

  4. Department of Gastroenterology and Hepatology, Kusunoki Hospital, Fujioka, Japan

    Satoshi Takakusagi, Takashi Kosone & Hitoshi Takagi

  5. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan

    Toshio Uraoka & Satoru Kakizaki

  6. Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan

    Satoru Kakizaki

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  1. Suguru Horiguchi
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Contributions

S.H., A.N., and S.K.: conceptualization. S.H., A.N., N.S., S.K., and T.K.: data curation. S.H. and A.N.: formal analysis. S.H., A.N., Y.T., Y.S., T.H., N.S., T.H., S.T., T.K., H.T., and S.K.: investigation. S.H., A.N., T.H., and S.K.: methodology. T.U. and S.K.: supervision. S.H., A.N., and S.K.: drafting and writing of the original article. A.N. and S.K.: writing – review and editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Atsushi Naganuma.

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Ethics approval and consent to participate

The study protocol was approved by the institutional review board of Takasaki General Medical Center (No. 2020-4) and its institution. The study protocol was in compliance with the Declaration of Helsinki. In the present study, informed consent was obtained in an opt-out form, which was displayed on the website and/or at Takasaki General Medical Center, Kusunoki Hospital, Gunma Saiseikai Maebashi Hospital and Gunma University Hospital.

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The authors declare no competing interests.

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Horiguchi, S., Naganuma, A., Tateyama, Y. et al. Efficacy of Zinc Acetate Treatment for Patients with Decompensated Liver Cirrhosis Complicated by Hypozincemia. Biol Trace Elem Res 200, 497–504 (2022). https://doi.org/10.1007/s12011-021-02675-5

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