著者

Kei Moriya Keigo Saeki Norihisa Nishimura Shinya Sato Yasuhiko Sawada Hiroaki Takaya Kosuke Kaji Hideto Kawaratani Tadashi Namisaki Takemi Akahane Hitoshi Yoshiji

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1817-23, (Released:2023-05-17)

参考文献数

50

被引用文献数

2

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Background and Aims Patients with autoimmune hepatitis (AIH) reportedly have an impaired quality of life (QOL), mainly due to depression, even during remission. In addition, hypozincaemia has been demonstrated in patients with chronic liver disease, including AIH, and is known to be related to depression. Corticosteroids are known to cause mental instability. We therefore investigated the longitudinal association between zinc supplementation and changes in the mental status among AIH patients treated with corticosteroids. Patients and Methods This study enrolled 26 patients with serological remission of AIH routinely treated at our facility after excluding 15 patients who either discontinued polaprezinc (150 mg/day) within 24 months or interrupted treatment. Two questionnaires, the Chronic Liver Disease Questionnaire (CLDQ) and SF-36, were adopted to evaluate the QOL before and after zinc supplementation. Results Serum zinc levels were significantly elevated after zinc supplementation (P <0.0001). The CLDQ worry subscale significantly improved after zinc supplementation (P = 0.017), but none of the SF-36 subscales was affected. Multivariate analyses demonstrated that daily prednisolone dosing was inversely related to both the CLDQ worry domain score (P = 0.036) and the SF-36 mental health component (P = 0.031). There was a significant negative correlation between the changes in the daily steroid dose and the CLDQ worry domain scores before and after zinc supplementation (P = 0.006). No serious adverse events occurred during the observation period. Conclusions Zinc supplementation safely and efficiently improved mental impairment, possibly caused by continuous treatment with corticosteroids, in patients with AIH.