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Shigefuku R, Iwasa M, Katayama K, Eguchi A, Kawaguchi T, Shiraishi K, Ito T, Suzuki K, Koreeda C, Ohtake T, Tokumoto Y, Endo R, Kawamura N, Shiraki M, Habu D, Sakai H, Kato A, Nishiguchi S, Moriwaki H, Suzuki K, Takei Y. Hypozincemia is associated with human hepatocarcinogenesis in hepatitis C virus-related liver cirrhosis. Hepatol Res 2019; 49:1127-1135. [PMID: 31240767 DOI: 10.1111/hepr.13388] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/28/2019] [Accepted: 06/05/2019] [Indexed: 02/08/2023]
Abstract
AIM Hypozincemia is associated with the progression of chronic liver diseases, but it is unknown whether hypozincemia promotes human hepatocarcinogenesis. Our aim is to evaluate the serum zinc levels in liver cirrhosis (LC) patients and clarify the relationship between the serum zinc levels and the development of hepatocellular carcinoma (HCC). METHODS Cirrhotic patients without HCC (n = 299) were enrolled from 14 medical institutes in Japan as a multicenter prospective study (No. 2028). Of the 299 patients, 157 were included in the present study based on reliable and consistent serum zinc levels and no history of oral zinc supplementation. Clinical parameters associated with the development of HCC were determined. Furthermore, the cumulative incidence of HCC was analyzed using Kaplan-Meier methods and was calculated using the log-rank test. A Cox regression analysis was utilized for the multivariate analysis to evaluate the predictors of hepatocarcinogenesis. RESULTS Thirty of 157 patients (19.1%) developed HCC during an observation period of 3 years. Serum zinc levels were significantly decreased in hepatitis C virus-related LC (C-LC) patients with HCC (0.0180). The risk factors for incidence of HCC were hypozincemia (0.0014), high α-fetoprotein (0.0080), low branched chain amino acids-to-tyrosine ratio (0.0128), or female sex (0.0228). Hypozincemia (hazard ratio 1.61, 0.0324) was the only significant predictor of hepatocarcinogenesis by multivariate Cox regression analysis. CONCLUSIONS Hypozincemia is associated with hepatocarcinogenesis in C-LC patients.
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Affiliation(s)
- Ryuta Shigefuku
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kazuhiro Katayama
- Department of Hepato-Biliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akiko Eguchi
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Shiraishi
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Toshifumi Ito
- Department of Gastroenterology, JCHO Osaka Hospital, Osaka, Japan
| | - Kazutomo Suzuki
- Department of Gastroenterology, Shuuwa General Hospital, Kasugabe, Japan
| | - Chizu Koreeda
- Liver Disease Center, Kansai Medical University Medical Center, Moriguchi, Japan
| | - Takaaki Ohtake
- Department of Gastroenterology, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Yoshio Tokumoto
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Ryujin Endo
- Division of Medical Fundamentals for Nursing, School of Nursing, Iwate Medical University, Morioka, Japan
| | - Naohiro Kawamura
- Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Makoto Shiraki
- Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Daiki Habu
- Department of Nutritional Medicine, Osaka City University Graduate School of Human Life Science, Osaka, Japan
| | - Hironori Sakai
- Department of Gastroenterology and Hepatology, NHO Beppu Medical Center, Beppu, Japan
| | - Akinobu Kato
- Department of Internal Medicine, Morioka Municipal Hospital, Morioka, Japan
| | - Shuhei Nishiguchi
- Division of Hepatobiliary and Pancreatic Disease, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hisataka Moriwaki
- Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuyuki Suzuki
- Department of Nutritional Science, Morioka University, Takizawa, Japan
| | - Yoshiyuki Takei
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Tsu, Japan
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