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

Min Chul Kim,Jeong In Lee,Yong Kyun Cho,Byung Ik Kim,Woo Kyu Jeon,Hong Joo Kim,Won Sohn,Jung Hee Kim,Peter Starkel

doi:10.1371/journal.pone.0240195

Abstract

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.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease, which is defined as intrahepatic triglyceride content of >5%
We investigated the effect of serum Zn level on hepatic fibrosis represented by simple and noninvasive blood-based biomarker in patients with NAFLD
The present study demonstrates that there is a significant inverse relationship between serum Zn level and liver fibrosis represented by FIB-4 index in patients with NAFLD

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease, which is defined as intrahepatic triglyceride content of >5%. It has become widespread with the increasing prevalence of obesity and metabolic syndrome. The spectrum of NAFLD includes simple steatosis, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. It results in liver cancer [1]. NAFLD is a multifactorial disease with complex pathophysiology such as obesity, insulin resistance (IR), dyslipidemia, and metabolic syndrome [2]. In many cases, the progression of NASH to cirrhosis remained indolent without specific symptoms until advanced liver disease

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