M KIM1, E KOH1, S SHIN1, C PARK1, S CHUNG1
1Department of Internal Medicine, College of Medicine, The Catholic University Of Korea , Seoul, Republic of Korea
Background and Aims: Zinc (Zn) is an essential trace element regarding cellular metabolism, tissue repair and inflammation. Neutrophil to lymphocyte ratio (NLR) has been reported as measure of systemic inflammation. The purpose of this study is to analyze the association between serum zinc level and NLR as novel inflammation marker in CKD patients.
Methods: Serum zinc concentration and inflammation markers including neutrophil to lymphocyte ratio (NLR) were evaluated in 348 patients with CKD under conservative treatment.
Results: Mean age of all participants was 59.94 year-old. 171 patients of the participants were male (49.1%). Median levels of serum Zn and eGFR were 68.3 ug/L (Interquqrtile range (IQR): 56.93-77.17 ug/L) and 35.20 ml/min/1.73m2 (IQR: 12.56-81.64 ml/min/1.73m2), respectively. According to median value of serum Zn, lower Zn group showed lower eGFR, more albuminuria, higher hs-CRP, NLR and monocyte to lymphocyte ratio (MLR). Serum Zn level showed positive correlation eGFR (r=0.235, P<0.001). On the other hands, serum Zn level negatively correlated with NLR (r=-0.289, P<0.001) and also MLR (r=-0.244, P<0.001). Higher serum zinc level (per 1 µg/L increase) was associated with higher NLR level after adjustment for age, sex, hypertension, diabetes, smoking, serum albumin and eGFR in multivariate binary logistic regression analysis. (HR 0.979, 95% CI: 0.953 to 0.995, P = 0.012).
Conclusions: Serum zinc was independently associated with NLR, a novel inflammation marker. It might be important to maintain optimal serum zinc level to delay progression of CKD with regard to inflammation.
Clinical Fellow, Division of Nephrology
Department of Internal Medicine,
College of Medicine The Catholic University of Korea