The role of serum zinc and other factors on the prevalence of muscle cramps in non-alcoholic cirrhotic patients

Background/Aims: To determine the prevalence of muscle cramps in patients with liver cirrhosis and to identify factors associated with their development, especially serum zinc. Method: One hundred cirrhotic patients and 85 healthy subjects were enrolled into the study. True muscle cramp was defined as at least 1 painful leg cramp either occurring at rest or strong enough to waken a patient from sleep, occurring at least once a week persisting for a period of greater than 1 year. Creatinine, calcium, magnesium, sodium, potassium, zinc, glucose, alanine aminotransferase, total bilirubin, and albumin levels were detected in sera. Prothrombine time was measured in cirrhotic patients. Presence or absence of ascite was determined by sonography. Results: True muscle cramps were significantly more common in patients with cirrhosis when compared with the control group (59% vs. 7.1%, respectively, P < 0.00 1). Cramp (+) cirrhotic patients had older age (49.54 +/- 10.09 vs. 55.54 +/- 7.90, respectively; p: 0.001) and higher Child-Pugh scores (7.56 +/- 2.32 vs. 9.02 +/- 2.55, respectively; p: 0.004) when compared with cramp (-) patients. None of the serum related factors such as creatinine, calcium, magnesium, sodium, potassium, zinc, glucose, alanine aminotransferase, total bilirubin, and albumin levels had any statistically significant contribution to the etiology. Conclusion: Muscle cramps are frequent complication of cirrhosis. Neither biochemical characteristics including decreased serum zinc levels nor the use of diuretics explained the greater prevalence of cramps in patients with cirrhosis. We conclude that the detrimental effect of cirrhosis on muscle fibers may be the major factor.