Abstract
Background: The relationships between serum zinc levels and body composition or clinical outcomes of incident hemodialysis (HD) patients remain unclear. Methods: This prospective observational study examined the relationships between serum zinc levels and clinical indexes, including body composition, in 142 incident HD patients using a bioelectrical impedance analysis. Patients were divided into three groups according to baseline serum zinc levels: tertile, <45, 45–59, and ≥60 µg/dL. The reference group was set as ≥60 µg/dL. Cox’s regression analysis was performed to investigate the relationships between serum zinc categories and cardiovascular events and all-cause mortality after adjustments for potential confounders. Results: Serum zinc levels positively correlated with the nutritional index and negatively correlated with fluid volume markers. In a mean follow-up of 2.5 years, there were 20 cases of cardiovascular events and 15 of all-cause mortality. In the Cox’s regression analysis for cardiovascular events and all-cause mortality, the hazard ratio increased with a decrease in serum zinc levels, but was not significant. Conclusion: Serum zinc levels were associated with nutritional and fluid volume markers in incident HD patients. To clarify the relationship between serum zinc levels and cardiovascular events or mortality, further studies with a larger number of cases will be necessary.
Highlights
Zinc is the second most abundant transition metal in the body after iron and is an essential trace element that plays a crucial role in cell metabolism, growth, tissue repair, the production of neurotransmitters, and antioxidant defenses [1,2,3]
Of zinc is combined with albumin in serum, with an increase in urinary albumin levels, while serum albumin and serum zinc levels decrease in patients with advanced chronic kidney disease
Previous studies indicated that poor outcomes in maintenance hemodialysis (HD) patients were attributed to zinc deficiency [7,8,9,10]
Summary
Zinc is the second most abundant transition metal in the body after iron and is an essential trace element that plays a crucial role in cell metabolism, growth, tissue repair, the production of neurotransmitters, and antioxidant defenses [1,2,3] It is involved in arterial pressure regulation and the etiopathogenesis of arterial hypertension via the renin-angiotensin-aldosterone system [4]. The relationships between serum zinc levels and body composition or clinical outcomes of incident hemodialysis (HD) patients remain unclear. Methods: This prospective observational study examined the relationships between serum zinc levels and clinical indexes, including body composition, in 142 incident HD patients using a bioelectrical impedance analysis. In the Cox’s regression analysis for cardiovascular events and all-cause mortality, the hazard ratio increased with a decrease in serum zinc levels, but was not significant. To clarify the relationship between serum zinc levels and cardiovascular events or mortality, further studies with a larger number of cases will be necessary
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