Serum Zinc Level and non-Protein Respiratory Quotient in Patients with Chronic Liver Diseases

Abstract

We sought to clarify the correlation between non-protein respiratory quotient (npRQ) in indirect calorimetry and serum zinc (Zn) level in chronic liver diseases (CLDs, n = 586, 309 liver cirrhosis (LC) patients, median age = 63 years). Clinical parameters potentially linked to npRQ <0.85 (best cutoff point for the prognosis in LC patients) were also examined in receiver operating characteristic curve (ROC) analyses. The median npRQ was 0.86. The median serum Zn level was 64 μg/dL. The median npRQ in patients with non-LC, Child–Pugh A, Child–Pugh B and Child–Pugh C were 0.89, 0.85, 0.83 and 0.82 (overall p < 0.0001)). The median serum Zn level in patients with npRQ <0.85 (58 μg/dL) was significantly lower than that in patients with npRQ ≥ 0.85 (68 μg/dL) (p < 0.0001). The correlation coefficient (r) between npRQ level and serum Zn level for all cases was 0.40 (p < 0.0001). Similar tendencies were observed in all subgroup analyses. The highest correlation coefficient between serum Zn level and npRQ was found in patients with Child–Pugh C (n = 22, r = 0.69). In ROC analyses for npRQ <0.85, serum Zn level had the highest area under the ROC (AUC) among baseline laboratory parameters (AUC = 0.69). In conclusion, serum Zn level can be helpful for npRQ in patients with CLDs.

Nutritional assessment using subjective global assessment identifies energy malnutrition and predicts mortality in patients with liver cirrhosis

“…Moreover, multivariate analysis revealed that SGA is more closely associated with the npRQ than previously reported markers such as the Child-Pugh and ALBI scores, the branched-chain amino acid-to-tyrosine ratio, and serum zinc levels. [17][18][19][20] In terms of discriminative ability, SGA categories B and C displayed similar sensitivity and higher speci city compared to a FFA >660 μEq/L, leading to higher PPV and NPV for SGA than those observed for FFA. The strong link between SGA and energy malnutrition can be attributed to the components evaluated by the SGA.…”