Abstract
Zinc deficiency is frequently observed in chronic liver diseases. However, no studies have focused on the zinc status in chronic hepatitis C (HCV)-infected patients receiving direct-acting antiviral agents (DAAs). In this retrospective study, we assessed the serum zinc status in DAA-treated HCV patients with sustained virologic response for over two years (Zn-2y). Ninety-five patients were enrolled, whose baseline characteristics and blood parameters at DAA therapy initiation were collected. Baseline Zn < 65 µg/dL (odds ratio (OR) = 10.56, p < 0.001) and baseline uric acid (UA) > 5.5 mg/dL (OR = 9.99, p = 0.001) were independent risk factors for Zn-2y deficiency. A decision-tree algorithm classified low-baseline Zn and high-baseline UA as the first two variables, suggesting that baseline hypozincemia and hyperuricemia are prognosticators for long-term zinc deficiency. Baseline Zn was negatively correlated with the Fibrosis-4 (FIB-4) index, while baseline UA was significantly higher in habitual alcohol drinkers. In conclusion, serum zinc levels should be closely monitored, considering that zinc status improvement is related to liver fibrosis regression. Hyperuricemia indicates risks of developing metabolic disorders and subsequent zinc deficiency, for which an adjustment of personal lifestyle or dietary habits should be recommended clinically.
Highlights
Zinc is an essential trace element, whose biological functions can be divided into three categories: catalytic activity of enzymes, structural integrity of proteins, and regulation of gene expression [1].Approximately 250 proteins contain zinc, including enzymes such as angiotensin-converting enzyme, alkaline phosphatase, deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) polymerase, copper–zinc superoxide dismutase, and metallothionein
We revealed that the change in serum zinc levels was negatively associated with the change in the FIB-4 index, demonstrating that the increased zinc level was positively related to the extent of liver fibrosis improvement
Patients with chronic HCV infection who were treated with direct-acting antiviral agents (DAAs) therapy showed overall improvements in zinc deficiency over two years after sustained virologic response (SVR)
Summary
Zinc is an essential trace element, whose biological functions can be divided into three categories: catalytic activity of enzymes, structural integrity of proteins, and regulation of gene expression [1]. 250 proteins contain zinc, including enzymes such as angiotensin-converting enzyme, alkaline phosphatase, deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) polymerase, copper–zinc superoxide dismutase, and metallothionein. Zinc absorption occurs mainly in the small intestine. 60% of the total body zinc is found in bone/muscle pools, and has a slow turnover [2]. Zinc circulates at a concentration of 70 μg/dL to 120 μg/dL with 60% loosely bound to albumin and 30% tightly bound to macroglobulin [3]. Zinc possesses anti-inflammatory, anti-fibrogenic, and anti-carcinogenic effects in various liver diseases [4]. Zinc supplementation exerts an anti-inflammatory effect on the liver in chronic hepatitis
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