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This study was conducted to determine and compare serum trace metal levels in viral hepatitis-associated chronic liver disease. Of 98 patients aged 43 (+/- 13) [mean (+/- SD)] years, 83 (85%) were seropositive for hepatitis B surface antigen (HBsAg) and 15 (15%) were seropositive for anti-hepatitis C virus (HCV). Twenty-five patients had chronic persistent hepatitis, 32 chronic active hepatitis, 21 post-necrotic cirrhosis, and 20 hepatocellular carcinoma. Determination of fasting serum trace metal levels (zinc, copper, calcium, magnesium, and phosphorus) was performed after the patients had been on a 2-day diet containing 10-12 mg zinc/day. Compared to healthy volunteers (n = 30), serum zinc levels were significantly decreased in patients with chronic active hepatitis, cirrhosis, and hepatocellular carcinoma (P < or = 0.0001), and copper levels were significantly elevated only in patients with hepatocellular carcinoma (P < 0.0001). The overall serum levels of calcium, magnesium, and phosphorus were within normal ranges, and levels of calcium and magnesium correlated with serum zinc (P = 0.01-0.03). Serum zinc levels correlated with bilirubin, albumin, and cholesterol (P = 0.0004 < or = 0.0001), but not with daily urinary zinc excretion. Serum copper levels correlated with alkaline phosphatase and gamma-glutamyltransferase (P = 0.008-0.0001). These results suggested that changes in liver cell pathology compounded by functional impairment may alter the metabolism of trace metals, in particular, zinc and copper. The possible relationship of these changes to the pathogenesis of chronic liver disease is discussed.

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Objectives: To establish a general view of food habits in Thailand, and to make a quantitative assessment of rice dependency of Thai people. Design: Cross-sectional study. Setting: Community. Subjects: 52 non-smoking and non-habitually drinking adult women in Bangkok participated in the study. Methods: The participants offered 24 h food duplicates and peripheral blood samples, and underwent clinical examination including anthropometry. The duplicates were subjected to nutritional evaluation taking advantage of the Thai food composition tables (FCTs), and analyzed for eight nutrient elements by inductively coupled plasma mass spectrometry (ICP-MS). Results: The participants took 1630 kcal from 55 g protein (63% from animal sources), 57 g lipid (mostly from vegetable oil), and 224 g carbohydrate (60% from rice) daily. Nutrient intake at lunch was as large as that at dinner. About a half of the women had insuf®cient energy intake (ie`80% RDA) whereas 4% had an excess ( b 120%). Protein intake was suf®cient in most cases, whereas lipid intake was in excess in more than a half of the women. Ca, Fe, Mg, Zn and possibly P intakes were below the RDA values in many participants. FCT-based estimates agreed well with the ICP-MS measures in cases of Fe and Ca but tended to be greater than the measures by 50% with regard to P. Conclusions: Lunch as substantial as dinner for Thai urbanites. There was a marked dependency on rice as an energy source. Whereas protein intake is generally suf®cient, the intake of Ca (and to a lesser extent Fe) was insuf®cient in a majority of the study participants. Sponsorship: Dai-ichi Mutual Life Insurance, Japan; the Ministry of Health and Welfare, the government of Japan.

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