Low plasma zinc concentrations in pediatric patients with cirrhosis

Abstract

Objective: To determine plasma zinc concentrations in children and adolescents with cirrhosis and to investigate the association between these results and dietary zinc intake, anthropometric data, and severity of liver disease.Methods: Plasma zinc concentration was assessed by atomic absorption spectrophotometry in 30 children and adolescents with cirrhosis (105.0±60.0 months; 22 girls) and 27 without liver disease (122.3±47.3 months, 14 girls). Dietary zinc data were evaluated by 3-day food intake records. Anthropometry measures included height, weight, skinfold thickness, brachial circumference, and upper arm muscle size. Severity of liver disease was classified according to the Child-Pugh, MELD, and PELD criteria. Results:The mean (± standard deviation) plasma zinc concentrations in control subjects and patients were 105.69±19.46 and 75.44±24.45 µg/dL, respectively (p < 0.001). No associations were found between anthropometric measures, dietary zinc intake, and plasma zinc concentration. There was statistical difference related to plasma zinc concentrations between Child-Pugh B + C patients and control subjects (p < 0.001), and concerning PELD, between patients below the cutoff score of 15 and those above (p = 0.002). Conclusions:The prevalence of hypozincemia was 43% for patients with cirrhosis. Although low plasma zinc concentration was associated with more severe liver disease, it was present even in some Child-Pugh A patients. Therefore, zinc supplementation should be considered for cirrhotic children.J Pediatr (Rio J). 2009;85(4):359-364: Zinc, liver cirrhosis, anthropometry, child. ResumoObjetivo: Determinar a concentração plasmática de zinco em crianças e adolescentes cirróticos e investigar a associação entre esses resultados e a ingestão dietética de zinco, os dados antropométricos e a gravidade da doença hepática.Métodos: As concentrações plasmáticas de zinco foram avaliadas por espectrofotometria de absorção atômica em 30 crianças e adolescentes com cirrose (105,0±60,0 meses; 22 meninas) e 27 hígidas e sem doença hepática (122,3±47,3 meses, 14 meninas). Os dados relacionados ao zinco dietético foram avaliados por registro de ingestão alimentar de 3 dias. A antropometria incluiu peso, altura, espessura da dobra cutânea, circunferência braquial e área muscular do braço. A gravidade da doença hepática foi classificada de acordo com os critérios de Child-Pugh, MELD e PELD. Resultados: As concentrações plasmáticas de zinco dos indivíduos controles e dos pacientes foram 105,69±19,46 e 75,44±24,45 µg/dL, respectivamente (p < 0,001). Nenhuma associação foi encontrada entre os índices antropométricos, a ingestão dietética e o zinco plasmático. Houve diferença estatística nas concentrações de zinco plasmático entre pacientes Child-Pugh B+C e controles (p < 0,001), e com relação ao PELD, entre pacientes abaixo e acima do ponto de corte 15 (p = 0,002). Conclusão:A prevalência de hipozincemia foi de 43% para pacientes com cirrose. A baixa concentração plasmática de zinco foi associada com a doença hepát...

An Assay for Determination of Hepatic Zinc by AAS - Comparison of Fresh and Deparaffinized Tissue

“…As well, some interesting studies were published on the importance of zinc related to hepatic diseases. Decreases in plasma (Halifeoglu et al, 2004;Schneider et al, 2009;Pereira et al, 2011) or serum (Hamed et al, 2008, Matsuoka et al, 2009) zinc concentrations have been described in patients with chronic liver diseases. Authors that measured zinc in the liver parenchyma of adults and children with liver cirrhosis found low zinc levels (Milman et al, 1986;Göksu & Özsoylu, 1986;Sharda & Bhandari, 1986;Kollmeier et al, 1992;Adams et al, 1994).…”