Skip to main content
Top
Published in: International Journal of Clinical Oncology 10/2021

01-10-2021 | Billroth I Resection | Original Article

Serum zinc deficiency in patients after gastrectomy for gastric cancer

Authors: Tsutomu Namikawa, Shigeto Shimizu, Keiichiro Yokota, Nobuhisa Tanioka, Jun Iwabu, Masaya Munekage, Sunao Uemura, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki

Published in: International Journal of Clinical Oncology | Issue 10/2021

Login to get access

Abstract

Purpose

Zinc is an essential dietary component for humans and the second most prevalent trace element; however, serum zinc levels after gastrectomy have not been fully elucidated. This study aimed to evaluate the correlation between clinicopathologic features and serum zinc levels in patients who underwent gastrectomy for gastric cancer.

Methods

The study enrolled 617 patients who underwent gastrectomy for gastric cancer at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level < 80 μg/dL.

Results

The median zinc level of the 617 patients was 73 μg/dL (range, 31–144 μg/dL), and serum zinc deficiency was present in 68.6% of patients. Median age was significantly higher in the zinc low level group than in the normal group (69 vs. 66 years, P < 0.001). Albumin was significantly lower in the zinc low level group than in the normal group (3.9 vs. 4.2 g/dL, P < 0.001). C-reactive protein level was significantly higher in the zinc low level group than in the normal group (0.12 vs. 0.10 mg/dL, P = 0.014). The median serum zinc level was significantly lower in the patients who received chemotherapy after gastrectomy than in those who were not received chemotherapy (72 vs. 76 μg/dL, P < 0.001). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.505, P = 0.044). Multivariate analysis showed that serum albumin level was significantly associated with serum zinc level (β = 0.489, P < 0.001).

Conclusions

Serum zinc deficiency was found in 68.6% of postoperative patients who underwent gastrectomy for gastric cancer, which was highly correlated with serum albumin.
Literature
1.
go back to reference Matsuoka T, Yashiro M (2018) Biomarkers of gastric cancer: current topics and future perspective. World J Gastroenterol 24:2818–2832CrossRef Matsuoka T, Yashiro M (2018) Biomarkers of gastric cancer: current topics and future perspective. World J Gastroenterol 24:2818–2832CrossRef
2.
go back to reference Nashimoto A, Akazawa K, Isobe Y et al (2013) Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer 16:1–27CrossRef Nashimoto A, Akazawa K, Isobe Y et al (2013) Gastric cancer treated in 2002 in Japan: 2009 annual report of the JGCA nationwide registry. Gastric Cancer 16:1–27CrossRef
3.
go back to reference Fidler MM, Gupta S, Soerjomataram I et al (2017) Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: a population-based study. Lancet Oncol 18:1579–1589CrossRef Fidler MM, Gupta S, Soerjomataram I et al (2017) Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: a population-based study. Lancet Oncol 18:1579–1589CrossRef
4.
go back to reference Fujiya K, Kawamura T, Omae K et al (2018) Impact of malnutrition after gastrectomy for gastric cancer on long-term survival. Ann Surg Oncol 25:974–983CrossRef Fujiya K, Kawamura T, Omae K et al (2018) Impact of malnutrition after gastrectomy for gastric cancer on long-term survival. Ann Surg Oncol 25:974–983CrossRef
5.
go back to reference Hotz C, Peerson JM, Brown KH (2003) Suggested lower cutoffs of serum zinc concentrations for assessing zinc status: reanalysis of the second National Health and Nutrition Examination Survey data (1976–1980). Am J Clin Nutr 78:756–764CrossRef Hotz C, Peerson JM, Brown KH (2003) Suggested lower cutoffs of serum zinc concentrations for assessing zinc status: reanalysis of the second National Health and Nutrition Examination Survey data (1976–1980). Am J Clin Nutr 78:756–764CrossRef
6.
go back to reference Yang X, Wang H, Huang C et al (2017) Zinc enhances the cellular energy supply to improve cell motility and restore impaired energetic metabolism in a toxic environment induced by OTA. Sci Rep 7:14669CrossRef Yang X, Wang H, Huang C et al (2017) Zinc enhances the cellular energy supply to improve cell motility and restore impaired energetic metabolism in a toxic environment induced by OTA. Sci Rep 7:14669CrossRef
7.
go back to reference Khayyatzadeh SS, Maghsoudi Z, Foroughi M et al (2015) Dietary intake of zinc, serum levels of zinc and risk of gastric cancer: a review of studies. Adv Biomed Res 4:118PubMedPubMedCentral Khayyatzadeh SS, Maghsoudi Z, Foroughi M et al (2015) Dietary intake of zinc, serum levels of zinc and risk of gastric cancer: a review of studies. Adv Biomed Res 4:118PubMedPubMedCentral
8.
go back to reference Ji JH, Shin DG, Kwon Y et al (2012) Clinical correlation between gastric cancer type and serum selenium and zinc levels. J Gastric Cancer 12:217–222CrossRef Ji JH, Shin DG, Kwon Y et al (2012) Clinical correlation between gastric cancer type and serum selenium and zinc levels. J Gastric Cancer 12:217–222CrossRef
9.
go back to reference Japanese Gastric Cancer Association (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef Japanese Gastric Cancer Association (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14:113–123CrossRef
10.
go back to reference Sano T, Aiko T (2011) New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer 14:97–100CrossRef Sano T, Aiko T (2011) New Japanese classifications and treatment guidelines for gastric cancer: revision concepts and major revised points. Gastric Cancer 14:97–100CrossRef
11.
go back to reference Namikawa T, Kitagawa H, Okabayashi T et al (2010) Roux-en-Y reconstruction is superior to Billroth I reconstruction in reducing reflux esophagitis after distal gastrectomy: special relationship with the angle of his. World J Surg 34:1022–1027CrossRef Namikawa T, Kitagawa H, Okabayashi T et al (2010) Roux-en-Y reconstruction is superior to Billroth I reconstruction in reducing reflux esophagitis after distal gastrectomy: special relationship with the angle of his. World J Surg 34:1022–1027CrossRef
12.
go back to reference Namikawa T, Kitagawa H, Okabayashi T et al (2011) Double tract reconstruction after distal gastrectomy for gastric cancer is effective in reducing reflux esophagitis and remnant gastritis with duodenal passage preservation. Langenbecks Arch Surg 396:769–776CrossRef Namikawa T, Kitagawa H, Okabayashi T et al (2011) Double tract reconstruction after distal gastrectomy for gastric cancer is effective in reducing reflux esophagitis and remnant gastritis with duodenal passage preservation. Langenbecks Arch Surg 396:769–776CrossRef
13.
go back to reference Namikawa T, Yokota K, Yamaguchi S et al (2020) Evaluation of systemic inflammatory response and nutritional biomarkers as predictive factors in patients with recurrent gastric cancer. Oncology 98:452–459CrossRef Namikawa T, Yokota K, Yamaguchi S et al (2020) Evaluation of systemic inflammatory response and nutritional biomarkers as predictive factors in patients with recurrent gastric cancer. Oncology 98:452–459CrossRef
14.
go back to reference Li Z, Li S, Ying X et al (2020) The clinical value and usage of inflammatory and nutritional markers in survival prediction for gastric cancer patients with neoadjuvant chemotherapy and D2 lymphadenectomy. Gastric Cancer 23:540–549CrossRef Li Z, Li S, Ying X et al (2020) The clinical value and usage of inflammatory and nutritional markers in survival prediction for gastric cancer patients with neoadjuvant chemotherapy and D2 lymphadenectomy. Gastric Cancer 23:540–549CrossRef
15.
go back to reference Kodama H, Tanaka M, Naito Y et al (2020) Japan’s practical guidelines for zinc deficiency with a particular focus on taste disorders, inflammatory bowel disease, and liver cirrhosis. Int J Mol Sci 21:2941CrossRef Kodama H, Tanaka M, Naito Y et al (2020) Japan’s practical guidelines for zinc deficiency with a particular focus on taste disorders, inflammatory bowel disease, and liver cirrhosis. Int J Mol Sci 21:2941CrossRef
16.
go back to reference Lu HD, Wang ZQ, Pan YR et al (1999) Comparison of serum Zn, Cu and Se contents between healthy people and patients in high, middle and low incidence areas of gastric cancer of Fujian Province. World J Gastroenterol 5:84–86CrossRef Lu HD, Wang ZQ, Pan YR et al (1999) Comparison of serum Zn, Cu and Se contents between healthy people and patients in high, middle and low incidence areas of gastric cancer of Fujian Province. World J Gastroenterol 5:84–86CrossRef
17.
go back to reference Lu J, Stewart AJ, Sadler PJ et al (2008) Albumin as a zinc carrier: properties of its high-affinity zinc-binding site. Biochem Soc Trans 36:1317–1321CrossRef Lu J, Stewart AJ, Sadler PJ et al (2008) Albumin as a zinc carrier: properties of its high-affinity zinc-binding site. Biochem Soc Trans 36:1317–1321CrossRef
18.
go back to reference Tsutsumi R, Ohashi K, Tsutsumi YM et al (2014) Albumin-normalized serum zinc: a clinically useful parameter for detecting taste impairment in patients undergoing dialysis. Nutr Res 34:11–16CrossRef Tsutsumi R, Ohashi K, Tsutsumi YM et al (2014) Albumin-normalized serum zinc: a clinically useful parameter for detecting taste impairment in patients undergoing dialysis. Nutr Res 34:11–16CrossRef
19.
go back to reference Wong CP, Magnusson KR, Ho E (2013) Increased inflammatory response in aged mice is associated with age-related zinc deficiency and zinc transporter dysregulation. J Nutr Biochem 24:353–359CrossRef Wong CP, Magnusson KR, Ho E (2013) Increased inflammatory response in aged mice is associated with age-related zinc deficiency and zinc transporter dysregulation. J Nutr Biochem 24:353–359CrossRef
20.
go back to reference Fukahori M, Shibata M, Hamauchi S et al (2021) A retrospective cohort study to investigate the incidence of cancer-related weight loss during chemotherapy in gastric cancer patients. Support Care Cancer 29:341–348CrossRef Fukahori M, Shibata M, Hamauchi S et al (2021) A retrospective cohort study to investigate the incidence of cancer-related weight loss during chemotherapy in gastric cancer patients. Support Care Cancer 29:341–348CrossRef
21.
go back to reference Yang J, Zhang Z, Zhang Y et al (2019) ZIP4 promotes muscle wasting and cachexia in mice with orthotopic pancreatic tumors by stimulating RAB27B-regulated release of extracellular vesicles from cancer cells. Gastroenterology 156:722–734CrossRef Yang J, Zhang Z, Zhang Y et al (2019) ZIP4 promotes muscle wasting and cachexia in mice with orthotopic pancreatic tumors by stimulating RAB27B-regulated release of extracellular vesicles from cancer cells. Gastroenterology 156:722–734CrossRef
22.
go back to reference Sallé A, Demarsy D, Poirier AL et al (2010) Zinc deficiency: a frequent and underestimated complication after bariatric surgery. Obes Surg 20:1660–1670CrossRef Sallé A, Demarsy D, Poirier AL et al (2010) Zinc deficiency: a frequent and underestimated complication after bariatric surgery. Obes Surg 20:1660–1670CrossRef
23.
go back to reference Ruz M, Carrasco F, Rojas P et al (2011) Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass: a randomized study using 2 supplements. Am J Clin Nutr 94:1004–1011CrossRef Ruz M, Carrasco F, Rojas P et al (2011) Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass: a randomized study using 2 supplements. Am J Clin Nutr 94:1004–1011CrossRef
24.
go back to reference Ruiz-Tovar J, Oller I, Llavero C et al (2014) Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg 80:466–471CrossRef Ruiz-Tovar J, Oller I, Llavero C et al (2014) Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg 80:466–471CrossRef
25.
go back to reference Pech N, Meyer F, Lippert H et al (2012) Complications and nutrient deficiencies two years after sleeve gastrectomy. BMC Surg 12:13CrossRef Pech N, Meyer F, Lippert H et al (2012) Complications and nutrient deficiencies two years after sleeve gastrectomy. BMC Surg 12:13CrossRef
26.
go back to reference Henderson LM, Brewer GJ, Dressman JB et al (1995) Effect of intragastric pH on the absorption of oral zinc acetate and zinc oxide in young healthy volunteers. JPEN J Parenter Enter Nutr 19:393–397CrossRef Henderson LM, Brewer GJ, Dressman JB et al (1995) Effect of intragastric pH on the absorption of oral zinc acetate and zinc oxide in young healthy volunteers. JPEN J Parenter Enter Nutr 19:393–397CrossRef
27.
go back to reference Sempértegui F, Díaz M, Mejía R et al (2007) Low concentrations of zinc in gastric mucosa are associated with increased severity of Helicobacter pylori-induced inflammation. Helicobacter 12:43–48CrossRef Sempértegui F, Díaz M, Mejía R et al (2007) Low concentrations of zinc in gastric mucosa are associated with increased severity of Helicobacter pylori-induced inflammation. Helicobacter 12:43–48CrossRef
28.
go back to reference Olechnowicz J, Tinkov A, Skalny A et al (2018) Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci 68:19–31CrossRef Olechnowicz J, Tinkov A, Skalny A et al (2018) Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci 68:19–31CrossRef
29.
go back to reference Lee DH, Anderson KE, Folsom AR et al (2005) Heme iron, zinc and upper digestive tract cancer: the Iowa Women’s Health Study. Int J Cancer 117:643–647CrossRef Lee DH, Anderson KE, Folsom AR et al (2005) Heme iron, zinc and upper digestive tract cancer: the Iowa Women’s Health Study. Int J Cancer 117:643–647CrossRef
Metadata
Title
Serum zinc deficiency in patients after gastrectomy for gastric cancer
Authors
Tsutomu Namikawa
Shigeto Shimizu
Keiichiro Yokota
Nobuhisa Tanioka
Jun Iwabu
Masaya Munekage
Sunao Uemura
Hiromichi Maeda
Hiroyuki Kitagawa
Michiya Kobayashi
Kazuhiro Hanazaki
Publication date
01-10-2021
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 10/2021
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-021-01978-w

Other articles of this Issue 10/2021

International Journal of Clinical Oncology 10/2021 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine