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We sought to examine the serum zinc (Zn) level and frailty in patients with chronic liver diseases (CLDs, n = 285, 107 liver cirrhosis cases, median age = 66 years). Frailty was defined as a clinical syndrome in which three or more of the following criteria were met (frailty score 3, 4, or 5): unintentional body weight loss, self-reported exhaustion, muscle weakness (grip strength: &lt;26 kg in men and &lt;18 kg in women), slow walking speed (&lt;1.0 m/s), and low physical activity. Robust (frailty score 0), prefrail (frailty score 1 or 2), and frailty were found in 90 (31.6%), 157 (55.1%), and 38 (13.3%), respectively. The median serum Zn levels in patients with frailty, prefrailty, and robust were 59.7 μg/dL, 72.8 μg/dL, and 76.9 μg/dL, respectively ( p -values: frailty vs. prefrail, p &lt; 0.0001; prefrail vs. robust, p = 0.0063; frailty vs. robust, p &lt; 0.0001; overall p &lt; 0.0001). For all cases, variables with absolute values of correlation coefficient with frailty score (0-5) ≥ 0.3 were age ( r s  = 0.3570, p &lt; 0.0001), serum albumin ( r s  = -0.3212, p &lt; 0.0001), extracellular water to total body water ratio using bioimpedance analysis ( r s  = 0.4386, p &lt; 0.0001), and serum Zn level ( r s  = -0.3406, p &lt; 0.0001). In conclusion, decreased serum Zn level in patients with CLDs can be closely associated with the presence of frailty.

Serum Zinc Level Is Associated with Frailty in Chronic Liver Diseases