低锌血症与酪氨酸水平升高、握力低、HCC发生率增加和肝脏疾病进展相关——一项横断面研究

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-03-18 DOI:10.1002/jgh3.70124

Tomoo Kobayashi, Jun Inoue, Yu Tanaka, Mitsuru Yamakawa, Makoto Kurihara, Tomoko Handa, Yutaka Kondo, Akihiro Saitou, Manabu Shiraki, Yasuhiro Kojima, Motoki Ohyauchi, Atsushi Masamune

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引用次数: 0

摘要

背景：慢性肝病（CLD）患者血清锌水平降低，但其对肝脏储备功能、酪氨酸、骨骼肌质量、握力（HGS）和肝细胞癌（HCC）发展的影响尚不清楚。方法对516例CLD患者进行回顾性、横断面分析。将患者分为低锌组（≤80 μg/dL）和高锌组（≥80 μg/dL）。分析血清锌水平与肝脏储备功能（通过改良白蛋白-胆红素[mALBI]等级评估）、酪氨酸、支链氨基酸/酪氨酸比率（BTR）和HCC发展情况。研究了180例血清锌水平与骨骼肌特征（包括肌少症和HGS）的关系。结果酪氨酸水平随着mALBI的加重而显著升高。低锌组患者酪氨酸水平较高（76.9 vs. 67.2 μmol/L, p < 0.001），高酪氨酸水平比例较高（5.3% vs. 1.7%, p < 0.001）， HCC发生率较高（10.5% vs. 3.7%, p < 0.005）。CLD越严重，锌水平越低（81 μg/dL [mALBI 1级]vs. 35.2 μg/dL[3级]，p < 0.001）。HCC患者的酪氨酸水平高于非HCC患者（93.1 μmol/L vs 70.7 μmol/L, p < 0.001）。肌少症患病率组间无差异（56.6%比52.0%,p = 0.344），但低锌患者低HGS发生率更高（61.2%比46.3%,p = 0.032）。在低锌水平的患者亚组（n = 12）中，补充锌可在3个月后降低酪氨酸水平（86.3 μmol/L vs. 73.3 μmol/L, p = 0.017）。结论：低锌血症与酪氨酸水平升高、HGS降低、HCC发生率增加和CLD进展有关。

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Hypozincemia Is Associated With Increased Tyrosine Levels, Low Handgrip Strength, Increased Incidence of HCC, and Liver Disease Progression—A Cross-Sectional Study

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Hypozincemia Is Associated With Increased Tyrosine Levels, Low Handgrip Strength, Increased Incidence of HCC, and Liver Disease Progression—A Cross-Sectional Study

Background

Serum zinc levels decrease in chronic liver disease (CLD), but their effects on liver reserve function, tyrosine, skeletal muscle mass, handgrip strength (HGS), and hepatocellular carcinoma (HCC) development remain poorly understood.

Methods

A retrospective, cross-sectional study was conducted on 516 CLD cases. Patients were divided into a low zinc group (< 80 μg/dL) and a high zinc group (≥ 80 μg/dL). Serum zinc levels were analyzed with liver reserve function (assessed by modified albumin-bilirubin [mALBI] grade), tyrosine, branched-chain amino acid/tyrosine ratio (BTR), and HCC development. In 180 cases, the relationship between serum zinc levels and skeletal muscle characteristics, including sarcopenia and HGS, was investigated.

Results

Tyrosine levels increased significantly with mALBI grade progression. Patients in the low zinc group had higher tyrosine levels (76.9 vs. 67.2 μmol/L, p < 0.001), a greater proportion of high tyrosine levels (5.3% vs. 1.7%, p < 0.001), and more HCC cases (10.5% vs. 3.7%, p < 0.005). Zinc levels were lower with more severe CLD (81 μg/dL [mALBI grade 1] vs. 35.2 μg/dL [grade 3], p < 0.001). Tyrosine levels were higher in HCC patients than in non-HCC patients (93.1 vs. 70.7 μmol/L, p < 0.001). Sarcopenia prevalence did not differ between groups (56.6% vs. 52.0%, p = 0.344), but low HGS was more frequent in low zinc patients (61.2% vs. 46.3%, p = 0.032). In a subset of patients with low zinc levels (n = 12), zinc supplementation reduced tyrosine levels after 3 months (86.3 vs. 73.3 μmol/L, p = 0.017).