Abstract
We sought to examine the serum zinc (Zn) level and frailty in patients with chronic liver diseases (CLDs, n = 285, 107 liver cirrhosis cases, median age = 66 years). Frailty was defined as a clinical syndrome in which three or more of the following criteria were met (frailty score 3, 4, or 5): unintentional body weight loss, self-reported exhaustion, muscle weakness (grip strength: <26 kg in men and <18 kg in women), slow walking speed (<1.0 m/s), and low physical activity. Robust (frailty score 0), prefrail (frailty score 1 or 2), and frailty were found in 90 (31.6%), 157 (55.1%), and 38 (13.3%), respectively. The median serum Zn levels in patients with frailty, prefrailty, and robust were 59.7 μg/dL, 72.8 μg/dL, and 76.9 μg/dL, respectively (p-values: frailty vs. prefrail, p < 0.0001; prefrail vs. robust, p = 0.0063; frailty vs. robust, p < 0.0001; overall p < 0.0001). For all cases, variables with absolute values of correlation coefficient with frailty score (0–5) ≥ 0.3 were age (rs = 0.3570, p < 0.0001), serum albumin (rs = −0.3212, p < 0.0001), extracellular water to total body water ratio using bioimpedance analysis (rs = 0.4386, p < 0.0001), and serum Zn level (rs = −0.3406, p < 0.0001). In conclusion, decreased serum Zn level in patients with CLDs can be closely associated with the presence of frailty.
Highlights
Frailty refers to a state in which vulnerability to physical stress is increased due to a decrease in physiological function, and it precedes disability [1,2,3]
We investigated the relationship between the serum Zn level and frailty in chronic liver diseases (CLDs) patients in a retrospective manner
The elucidation of the relationship between serum Zn level and frailty in CLDs may be of clinical importance for the better understanding of frailty in CLDs
Summary
Frailty refers to a state in which vulnerability to physical stress is increased due to a decrease in physiological function, and it precedes disability [1,2,3]. It is easy to fall into an outcome such as requiring nursing care or death [1,2,3]. The Japan Geriatric Society defines frailty as an intermediate between health and need of care [4]. Frailty is defined as the presence of three or more of the following phenotypes: body weight (BW) loss, self-reported exhaustion, skeletal muscle functional decline, slow walking speed (WS), and decreased PA [4,5]. Carey et al reported that 6 min walk distance reflecting physical function significantly predicted mortality in liver transplant candidates [7]
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