# The predictive factors of hypozincemia in patients with chronic liver disease

## TL;DR

This study identifies the ALBI score and serum albumin level as predictors of low zinc levels in patients with chronic liver disease.

## Contribution

The study introduces the ALBI score as a novel predictor for hypozincemia in chronic liver disease patients.

## Key findings

- The ALBI score and serum albumin level are associated with serum zinc levels below 60 µg/dL or 80 µg/dL.
- Cut-off values for predicting hypozincemia are ALBI score ≥ -1.83 and serum albumin ≤ 3.3 g/dL for zinc <60 µg/dL.
- Diagnostic accuracy rates for hypozincemia prediction using ALBI score and albumin level were up to 81.9%.

## Abstract

Patients with chronic liver disease (CLD) often experience hypozincemia. The clinical factors associated with hypozincemia have not been established. We investigated clinical factors that may be useful to predict hypozincemia in patients with CLD. The serum zinc levels CLD patients were measured; Study 1 investigated the predictive factors of hypozincemia, and Study 2 was performed to validate the factors identified in Study 1. Study 1 included 197 participants, of whom 28 and 106 had serum zinc levels <60 µg/dL and <80 µg/dL, respectively. A multivariate analysis revealed that serum zinc levels <60 µg/dL or <80 µg/dL were associated with the albumin–bilirubin (ALBI) score and serum albumin level. A receiver operating characteristic curve analysis revealed that the ALBI score ≥ −1.83 and the serum albumin level ≤3.3 g/dL were the cut-off values for a serum zinc level <60 µg/dL, whereas the ALBI score ≥ −2.44 and the serum albumin level ≤3.6 g/dL were the cut-off values for a serum zinc level <80 µg/dL. In Study 2 (n = 177), the diagnostic accuracy rates for serum zinc <60 µg/dL were 81.9% for the ALBI score and 75.1% for the serum albumin level, and those for serum zinc <80 µg/dL were 70.1% for both parameters. Together these findings indicate that the ALBI score may serve as a predictive factor of hypozincemia in CLD patients.