Comparison of zinc levels in liver cirrhosis and evaluating the severity using child pugh score

Abstract

Background and Objectives: “Liver cirrhosis represents the final common pathway for chronic liver diseases, characterized by extensive fibrosis and hepatocyte dysfunction. Zinc, an essential micronutrient with critical roles in protein synthesis, enzymatic reactions, and antioxidant defense, has been implicated in liver pathophysiology. However, the relationship between zinc deficiency and cirrhosis severity remains incompletely characterized in the Indian population. This study aimed to evaluate serum zinc levels in patients with liver cirrhosis and correlate them with disease severity as measured by the Child-Pugh classification.” Methods: “This hospital-based cross-sectional study was conducted among 85 patients with cirrhosis of liver attending the outpatient and inpatient departments of BLDE University's Shri BM Patil Medical College Hospital. Detailed clinical evaluation, biochemical investigations including serum zinc levels, and Child-Pugh scoring were performed. Zinc deficiency was defined as serum levels below 51 μg/dL. Statistical analysis included descriptive statistics, chi-square tests, and ANOVA to assess relationships between variables.” Results: The study cohort comprised predominantly middle-aged males (95.3%), with alcoholic etiology (89.4%) being the leading cause of cirrhosis. Advanced disease was common, with 67.1% of patients categorized as Child-Pugh Class C. Zinc deficiency was observed in 97.6% of patients, with mean zinc levels showing a significant progressive decrease from Child-Pugh Class A (50.4±4.31 μg/dL) to Class B (42.32±4.86 μg/dL) to Class C (37.02±3.68 μg/dL) (p<0.001). There was a perfect parallelism between zinc and albumin deficiency (both 97.6%). The mortality rate during the study period was 15.3%. Conclusion: This study demonstrates an extraordinarily high prevalence of zinc deficiency in liver cirrhosis with a significant inverse correlation with disease severity. The progressive decline in zinc levels with worsening Child-Pugh scores suggests that zinc deficiency may be both a marker of advanced disease and potentially a contributor to disease progression. These findings support the incorporation of zinc assessment into the routine evaluation of cirrhotic patients and suggest that zinc supplementation could be considered as an adjunctive therapy, particularly in advanced disease.