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Zinc deficiency: its prevalence and relationship to renal function in Japan

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Abstract

Background

Although zinc deficiency is common among dialyzed patients, its prevalence among non-dialyzed subjects and its relationship to renal function remain unclear.

Methods

We selected 816 non-dialyzed subjects (495 males; mean age, 56 ± 18 years) who underwent measurement of serum zinc at Jikei University Hospital between April 2018 and March 2019 using the Standardized Structured Medical Information eXchange2 (SS-MIX2) system, a global standard in Japan that enables collection of structured medical records with automatic data transfer to a registry database system. A serum zinc level of 60–80 μg/dL was defined as marginal zinc deficiency and a level of < 60 μg/dL as absolute zinc deficiency. We investigated factors associated with serum zinc using multiple regression analysis.

Results

Marginal and absolute zinc deficiency were present in 52.3% and 30.6% of subjects, respectively. Serum zinc levels tended to decrease with increasing stage of chronic kidney disease (CKD) (P = 0.051). Estimated glomerular filtration rate (eGFR) was not independently associated with serum zinc levels. Instead, serum albumin (t = 4.69, P < 0.01), hemoglobin (t = 2.54, P = 0.01) and mean corpuscular volume (MCV) (t = − 2.20, P = 0.03) were independently associated with serum zinc. In sensitivity analyses, serum zinc was not associated with either serum copper- or iron-related parameters.

Conclusion

This large-scale study clarified the prevalence of zinc deficiency among non-dialyzed Japanese subjects. In addition, eGFR was not independently associated with serum zinc, probably due to confounding factors, such as nutritional status and degree of anemia. Further investigations are needed to clarify the epidemiology of zinc deficiency and its associations with CKD.

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Acknowledgements

We wish to thank Dr. Shinji Yasuno and Ms. Yasuyo Yamazaki, Clinical Research Support Center, the Jikei University School of Medicine, Tokyo, Japan for their technical support in the management of the SS-MIX2 system. We are grateful to the patients involved in our study for their participation and contributions.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi Minato-ku, Tokyo, 105-8471, Japan

    Yukio Maruyama, Akio Nakashima, Akira Fukui & Takashi Yokoo

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  1. Yukio Maruyama
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  2. Akio Nakashima
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  3. Akira Fukui
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  4. Takashi Yokoo
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Contributions

Research idea and study design: YM, AN, AF and TY; data acquisition: YM; data analysis/interpretation: YM; statistical analysis: YM; supervision or mentorship: AN, AF and TY. YM takes responsibility that this study has been reported honestly, accurately and transparently, and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

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Correspondence to Yukio Maruyama.

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10157_2021_2046_MOESM1_ESM.docx

Supplementary file1 (DOCX 30 KB) Table S1: Factors contributing to serum zinc levels, treating eGFR as continuous variable, before multiple imputation. Table S2: Factors contributing to serum zinc levels, treating eGFR as dichotomous variable, before multiple imputation.

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Maruyama, Y., Nakashima, A., Fukui, A. et al. Zinc deficiency: its prevalence and relationship to renal function in Japan. Clin Exp Nephrol 25, 771–778 (2021). https://doi.org/10.1007/s10157-021-02046-3

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