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Associations of Whole Blood Zinc Levels with Coronary Artery Calcification and Future Cardiovascular Events in CKD Patients

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Abstract

This study was conducted to compare the differences of the whole blood zinc concentration in patients with chronic kidney disease (CKD) as compared to healthy controls, and to explore the correlations of the whole blood zinc level with coronary artery calcification (CAC) and cardiovascular event (CVE) in CKD patients. A total of 170 CKD patients and 62 healthy controls were recruited. The whole blood zinc concentration was determined in using atomic absorption spectroscopy (AAS) method. The degrees of CAC were evaluated by Agatston score based on computed tomography (CT). Regular follow-up visits were performed to record the incidence of CVE, and risk factors were analyzed by COX proportional hazard model and Kaplan–Meier survival curve. There were statistically significant lower zinc levels in CKD patients than in healthy population. The prevalence of CAC was 58.82% in CKD patients. Correlation analysis showed that dialysis duration, intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), 25-hydroxyvitamin D3 (25(OH)D3), neutrophil–lymphocyte ratio (NLR), total cholesterol (TC), and high-sensitive C-reactive protein (Hs-CRP) were positively correlated with CAC, while albumin (ALB), hemoglobin (Hb), and zinc levels were negatively associated with CAC. Further COX proportional hazard model demonstrated that moderate to severe CAC, NLR, phosphate, 25(OH)D3, iPTH, and high-density lipoprotein (HDL) were associated with an increased risk for CVE, while zinc levels, Hb, and ALB were inversely associated with a reduced risk for CVE. Kaplan–Meier curve showed that low zinc (zinc < 86.62 μmol/L) patients and moderate to severe CAC patients had lower survival respectively. Our study found the lower levels of zinc and higher prevalence of CAC in CKD patients; the low zinc is involved in the high incidence rate of moderate to severe CAC and CVE in CKD patients.

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Data Availability

The data of this study are available from the corresponding author upon reasonable request.

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Funding

This research was funded by the Clinical Research Cultivation Program of the Second Hospital of Anhui Medical University Foundation, grant numbers 2020LCZD01, 2021LCYB14, and the Fundamental Research Cultivation Program of the Second Hospital of Anhui Medical University Foundation, grant numbers 2020GMFY04, 2021GQFY05.

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Authors and Affiliations

  1. Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, People’s Republic of China

    Danfeng Zhang, Yuyu Zhu, Yunfei Wang, Zheng Niu, Wenli Zhou & Deguang Wang

  2. Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei, People’s Republic of China

    Danfeng Zhang, Yuyu Zhu, Yunfei Wang, Zheng Niu, Wenli Zhou & Deguang Wang

  3. Department of Radiology, The Second Hospital of Anhui Medical University, Hefei, People’s Republic of China

    Huan Li

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Contributions

Conceptualization, DZ and DW; methodology, DZ and YW; software, DZ; validation, DZ and DW; formal analysis, DZ and DW; investigation, HL, YW, WZ, and ZN; resources, HL, YW, WZ, and ZN.; data curation, DZ and DW; writing—original draft preparation, DZ; writing—review and editing, DZ and DW; supervision, DW; project administration, DW; funding acquisition, DZ. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Deguang Wang.

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Competing interests

The authors declare no competing interests.

Ethics Approval and Consent to Participate

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee for human research at the Second Hospital of Anhui Medical University (No: YJ-YX2017-004). Written informed consent has been obtained from the patients to publish this paper.

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Not applicable.

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The authors declare no competing interests.

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Danfeng Zhang and Yuvu Zhu are co-first authors for this paper.

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Zhang, D., Zhu, Y., Li, H. et al. Associations of Whole Blood Zinc Levels with Coronary Artery Calcification and Future Cardiovascular Events in CKD Patients. Biol Trace Elem Res 202, 46–55 (2024). https://doi.org/10.1007/s12011-023-03655-7

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  • DOI: https://doi.org/10.1007/s12011-023-03655-7

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