ASSOCIATION BETWEEN SERUM ZINC AND COGNITIVE FUNCTION IN PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS: THE OSAKA DIALYSIS COMPLICATION STUDY (ODCS)

 

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https://storage.unitedwebnetwork.com/files/1099/1f76ed934dd551eff1398237effcd5fb.pdf
ASSOCIATION BETWEEN SERUM ZINC AND COGNITIVE FUNCTION IN PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS: THE OSAKA DIALYSIS COMPLICATION STUDY (ODCS)

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Fumiyuki
Morioka
Fumiyuki Morioka j21574d@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Metabolism, Endocrinology and Molecular Medicine Osaka Japan *
Shinya Nakatani nakatani-s@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Nephrology Osaka Japan -
Tetsuo Shoji tetsuoshoji@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Metabolism, Endocrinology and Molecular Medicine Osaka Japan - Osaka Metropolitan University Graduate School of Medicine Department of Vascular Medicine Osaka Japan Aijinkai Inoue Hospital Clinical Research Center Suita Japan
Hideki Uedono uedono1217@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Metabolism, Endocrinology and Molecular Medicine Osaka Japan -
Akihiro Tsuda naranotsudadesu@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Metabolism, Endocrinology and Molecular Medicine Osaka Japan -
Katsuhito Mori ktmori@omu.ac.jp Kindai University Nara Hospital Department of Endocrinology, Metabolism, and Diabetes Nara Japan -
Yasuo Imanishi Imanishi0728Yasuo@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Vascular Medicine Osaka Japan - Osaka Metropolitan University Graduate School of Medicine Vascular Science Center for Translational Research Osaka Japan
Tomoaki Morioka moriokatmed@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Metabolism, Endocrinology and Molecular Medicine Osaka Japan -
Masanori Emoto emoto-m@omu.ac.jp Osaka Metropolitan University Graduate School of Medicine Department of Metabolism, Endocrinology and Molecular Medicine Osaka Japan - Osaka Metropolitan University Graduate School of Medicine Department of Nephrology Osaka Japan Osaka Metropolitan University Graduate School of Medicine Vascular Science Center for Translational Research Osaka Japan
 
 
 
 
 
 

Zinc plays a crucial role in neurotransmission, synaptic plasticity, and neurogenesis. Zinc deficiency has been associated with attentional deficits in children and diminished executive functioning in older adults. However, the association between serum zinc and cognitive performance in patients with kidney failure undergoing maintenance hemodialysis remains unclear, although zinc deficiency is highly prevalent in this population. This study aimed to examine the association between serum zinc and cognitive function in patients undergoing maintenance hemodialysis.

In this cross-sectional study, 1207 eligible patients were selected. Cognitive function was assessed by using the Modified Mini-Mental State examination (3MS). The association between serum zinc and 3MS total score was examined by using a linear regression model. The associations between serum zinc and the eight cognitive domains of 3MS were further examined using ordinal logistic regression model. 

In total patients, 3MS score and serum zinc levels were 91 (82-97) points and 68 (61-76) μg/dL, respectively. Serum zinc level was positively associated with 3MS score in unadjusted model (p=0.006). However, the association was no longer significant in adjusted model with 17 potential confounders including serum albumin levels (p=0.794). Because there was a close correlation between serum zinc and albumin levels, we conducted further analyses in which participants were categorized into 2 subgroups by the median serum albumin level (3.7 g/dL). In the lower serum albumin group (N=445), the positive association between serum zinc and 3MS was significant after adjustment for 16 potential confounders (p=0.049). Among the cognitive domains of the 3MS, attention and long-term memory were significantly associated with serum zinc levels in participants with lower serum albumin group, even after adjusted for 16 potential confounders (p=0.013 and 0.049, respectively).

Lower serum zinc was associated with lower cognitive function, especially in attention and long-term memory, in patients undergoing maintenance hemodialysis with lower serum albumin level.

 

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