Observational studyJournal of gastroenterology2025
Serum zinc levels as predictors of covert hepatic encephalopathy in patients with liver cirrhosis.
Observational study in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Covert hepatic encephalopathy as a multi-organ syndrome: the gut-liver-muscle-brain axis, diagnosis, treatment, and multidisciplinary care.Journal of gastroenterology · 2026Review
- Covert hepatic encephalopathy in cirrhosis: implications for early diagnosis and appropriate management.Clinical journal of gastroenterology · 2026Review
- Letter to the editor to ''Serum zinc levels as predictors of covert hepatic encephalopathy in patients with liver cirrhosis''.Journal of gastroenterology · 2026Article
- Reply to the letter by Liu and Jia.Journal of gastroenterology · 2026Article
- Impaired Gustation in Liver Diseases: A Comprehensive Narrative Literature Review.Acta stomatologica Croatica · 2025Review
- Correlation of Serum Zinc Levels with Hepatic Encephalopathy Severity in Patients with Decompensated Liver Cirrhosis: A Prospective Observational Study from Egypt.Biological trace element research · 2025Observational
- Current management and future perspectives of covert hepatic encephalopathy in Japan: a nationwide survey.Journal of gastroenterology · 2025Article
- Clinical Significance of Marginal Zinc Deficiency as a Predictor of Covert Hepatic Encephalopathy in Patients with Liver Cirrhosis.International journal of molecular sciences · 2025Article
- Benefits of Liver Volume and Serum Zinc Level Assessment for the Screening of Covert Hepatic Encephalopathy in Patients with Child-Pugh Class A Cirrhosis.Diagnostics (Basel, Switzerland) · 2024Article
- Evaluation of Quality of Life and Risk Factors in Patients With Covert Hepatic Encephalopathy Including Those With Hepatocellular Carcinoma.Cancer diagnosis & prognosisArticle
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCovert hepatic encephalopathy (CHE) significantly impacts the quality of life and prognosis in patients with liver cirrhosis. This study aims to analyze the prevalence and risk factors of CHE to identify high-risk patients who would benefit from therapeutic interventions.
methodsThis single-center, retrospective observational study included 126 patients without a history of overt hepatic encephalopathy (OHE). CHE was defined as a score above the age-based cutoff value in the Stroop test. Factors associated with the occurrence of CHE and the subsequent development of OHE were evaluated.
resultsCHE was detected in 47 patients (37.3%). A multiple logistic regression analysis identified serum zinc levels (per + 1 µg/dL, odds ratio 0.95, P = 0.0007) as the only risk factor associated with CHE, with a cutoff value of 60 µg/dL (AUC 0.71, P = 0.0001). Neither blood ammonia levels nor liver function were predictive of CHE. During a median observation period of 211 days, OHE developed in 18 patients (14.3%). The administration of more than 20 mg of furosemide was identified as a risk factor for developing OHE (hazard ratio 23.52, P = 0.0207).
conclusionCirrhotic patients with serum zinc levels below 60 µg/dL exhibit a high risk of developing CHE, regardless of blood ammonia levels. These patients face a significant risk of developing OHE. Therefore, early zinc supplementation is recommended for the prevention of OHE, particularly for those prescribed 20 mg or more of furosemide.
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