Abstract: Objective To study the relationship between serum zinc level and left ventricular diastolic dysfunction (LVDD) in patients with maintenance hemodialysis (MHD), and to explore the feasibility of serum zinc for early prediction of LVDD in MHD patients.  Methods  This was a single centered and cross-sectional study. A total of 96 MHD patients in the Blood Purification Center of Lianyungang First People's Hospital from Jun 2018 to Dec 2020 were recruited as the research objects. Serum zinc level was measured by flame atomic absorption spectrometry. According to the results of echocardiography, the patients were divided into LVDD group (n=52) and non-LVDD group (n=44). The clinical data, laboratory indexes and echocardiographic parameters were compared between LVDD group and non-LVDD group. The relationship between serum zinc level and other indexes in MHD patients was analyzed by Pearson and Spearman correlation methods. The factors affecting LVDD in MHD patients were analyzed by multivariate logistic regression. The diagnostic value of serum zinc for LVDD in MHD patients was analyzed by ROC.  Results  Serum zinc level in LVDD group was (90.15±10.44) μg/dl, lower than that in non-LVDD group (107.42±11.57) μg/dl, and the difference was statistically significant (t=7.618, P<0.001). Correlation analyses showed that serum zinc level in MHD patients was positively correlated with hemoglobin (r=0.263, P=0.017), and negatively correlated with E/E' (r=-0.447, P<0.001) and left atrial diameter (LAD) (r=-0.243, P=0.028). ROC curve showed that the area under curve (AUC) of serum zinc level in predicting LVDD in MHD patients was 0.817 (95% CI: 0.728~0.892, P=0.015), the predicted cutoff value was 95.85 μg/dL, the sensitivity was 78.44%, and the specificity was 76.02%. Multivariate logistic regression showed that lower serum zinc level was an independent risk factor for LVDD in MHD patients (OR=2.014, 95% CI: 1.414~7.015, P=0.005).  Conclusion  Lower serum zinc level is an independent risk factor for LVDD in MHD patients. Serum zinc may be an effective serological marker for predicting LVDD in MHD patients.

Key words: Maintenance hemodialysis, Serum zinc, Left ventricular diastolic dysfunction, Relevance, Early diagnosis