ABSTRACT
The present study aimed to evaluate the effects of low dose zinc [Zn] supplementation on biochemical markers and underlying disease status in non-alcoholic cirrhotic patients. We enrolled 60 cirrhotic patients in a double-blind, placebo-controlled, randomized clinical trial. All patients in the interventional group [n = 30] received long-term, low dose Zn supplementation [50 mg elemental Zn sulfate daily]. The control group [n = 30] received placebo [starch]. Child-Pugh scores and biochemical markers were assessed for both interventional and control groups at the first day and the end of the 90th day of the interventional period. A per-protocol analysis was performed after excluding all participants who did not receive or complete the randomized intervention. The mean differences of quantitative variables between and within groups were evaluated by independent samples t-test and paired-samples t-test, respectively. SPSS version 13.00 was used for statistical analysis. In the initial evaluation, 16 [53.30%] patients from the interventional group had a Child-Pugh score of 5-8 and 14 [46. 70%] had a score of 9-12. In the control group 18 [60.00%] had a Child-Pugh score of 5-8 and 12 [40.00%] scored 9-12. After three months the mean Child-Pugh score in the interventional group showed a significant improvement [from 6.56 +/- 0.21 to 5.72 +/- 0.22, P = 0.001] whereas in the control group despite no significant decline, the mean Child-Pugh score increased slightly [from 6.25 +/- 0.27 to 6.67 +/- 0.31, P = 0.14]. Zn supplementation significantly decreased copper [Cu; P = 0.01] and creatinine [Cr; P < 0.0001] levels. In this study, we determined that low dose Zn supplementation could prevent deterioration of clinical status of cirrhosis and prevent excess Cu accumulation in non-alcoholic cirrhotic patients. Zn supplementation produces metabolic effects and trends towards improvements in liver function, hepatic encephalopathy, and nutritional status
ABSTRACT
To determine the levels of zinc, copper, iron, albumin and zinc to copper ratio in sera of patients in different stages of cirrhosis and to find possible correlation between trace elements and anthropometrics measurements with liver cirrhosis presence and progression. This cross-sectional analytic study was carried out on sixty continuous patients with liver cirrhosis referred to hepatology clinic, Tabriz University of Medical Sciences. The mean of daily calorie and protein intake was determined by Nutrition III software and compared to recommended dietary allowances [RDA], body composition was determined by bioelectrical impedance analysis [BIA] and serum Zn, Cu and Fe levels were determined by atomic absorption spectrophotometery and albumin level of serum was measured by calorimetric method. Among sixty studied patients, 39 were male and 21 were female. 53.8% of male patients were in Child-Pugh class B while 23.8% of female patients were in Child-Pugh class B. The mean energy and protein intake of all patients was lower than RDA values and there was no significant correlation between the mean of protein and energy intake with severity of liver cirrhosis. The serum levels of Zn, Albumin and Zn/Cu ratio in patients with Child-Pugh class B were significantly lower than those with Child-Pugh class A. In general, these results suggested that changes in liver cell pathology compounded by functional impairment may alter the metabolism of trace metals, in particular, zinc