Screening for Zinc Deficiency in Patients with Cirrhosis: When Should We Start?

Sengupta, Shreya; Wroblewski, Kristen; Aronsohn, Andrew; Reau, Nancy; Reddy, K. Gautham; Jensen, Donald M.; Te, Helen S.

doi:10.1007/s10620-015-3613-0

Cited by 49 publications

(33 citation statements)

References 29 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A similar study found that serum zinc level was lowered in those with severe cirrhosis than in those with mild cirrhosis in 163 patients. 7 Further, the concentration of serum zinc level decreased with severity of liver disease and found a significant negative correlation between serum zinc and Child score (p<0.001). 5 Therefore, screening for zinc deficiency in these patients with more advanced cirrhosis seems to be warranted as a marker of advanced liver disease.…”

Section: Hbv+hcv 1%mentioning

confidence: 87%

“…It is consistent with that of other studies which showed most of the cirrhosis of liver occurred in male patients. 7,9,10 This may be due to more exposure of alcohol among male patients. This may be due to increased alcohol consumption among male population in Myanmar and it consequently leads to increased number of male cirrhotic patients.…”

Section: Discussionmentioning

confidence: 99%

“…Zinc is also an important cofactor in activation of ornithine transcarbamylase, key enzyme in urea metabolism. 7 This study was aimed to determine the serum zinc level in different stages of cirrhosis based on Child Turcotte Pugh score and to find out the association of serum zinc level and severity of cirrhosis. If they were associated in clinical practice, screening of serum zinc level was a valuable marker for detection of advanced liver disease and zinc supplementation can be considered to reduce further liver damage and prevent advancement of cirrhosis of liver.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon

2019

myanmarhsrj

View full text Add to dashboard Cite

Cirrhosis of liver is one of the common medical problem in daily clinical practice and one of the leading causes of morbidity and mortality. Zinc is an essential trace elements for human and plays in many biological roles in the body. Among them, zinc deficiency is thought to be involved in metabolism of ammonia and causes hyperammonia that worsen hepatic encephalopathy. This study aimed to find out the severity of cirrhosis of liver was by Child Turcotte Pugh score and to investigate the associations between serum zinc level and severity of cirrhosis. A hospital-based cross-sectional descriptive study was performed on 78 patients with different underlying causes of cirrhosis of liver at the Medical Units of Yangon General Hospital and Yangon Specialty Hospital. Among the study population, Child grade A was found to be 28.21%, Child grade B was 30.77% and Child grade C was 41.03%. Regarding result of serum zinc level, 62.8% were low level, 28.2% were within normal level and 8.9% were high level. Mean value of serum zinc level in grade A was 0.68 mg/l, grade B was 0.54 mg/l and grade C was 0.48 mg/l (p=0.00). It was found out that there was a high prevalence of zinc deficiency in severe cirrhotic patients. The zinc level was significantly lowest among patients with Child-Pugh C as compare to those with Child-Pugh B and C. Severity of zinc deficiency should be requested for supplementation therapy in cirrhotic patients as to prevent complications such as hepatic encephalopathy, hepatocellular carcinoma and liver failure. Screening for zinc deficiency may need in these patients with more advanced cirrhosis because it seems to be a marker of advanced liver disease and it can be deducted that awareness of serum zinc level among cirrhotic patients is very important in clinical practice.

show abstract

Section: Hbv+hcv 1%mentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon

2019

myanmarhsrj

View full text Add to dashboard Cite

show abstract

“…In our study, chelating action by L‐dopa used in LCIG treatment is considered to cause zinc deficiency in the cases presented. Comorbidities or underlying conditions that could also cause zinc deficiency include liver disease (Sengupta et al, ), diabetes (Walter et al, ), chronic inflammatory bowel disease (Naber, van den Hamer, Baadenhuysen, & Jansen, ), and renal diseases such as the nephrotic syndrome and malabsorption after the small intestine excision (Makhlough et al, ). The first patient has diabetes mellitus but is unlikely the sole cause for zinc deficiency.…”

Section: Discussionmentioning

confidence: 99%

Proposition of zinc supplementation during levodopa–carbidopa intestinal gel treatment

et al. 2018

View full text Add to dashboard Cite

ObjectivesLevodopa–carbidopa intestinal gel (LCIG) infusion is a useful therapy for the wearing‐off phenomenon of advanced Parkinson's disease (PD) patients. Recently, we found three PD patients that may have had a zinc deficiency after the LCIG infusion, possibly due to the zinc‐chelating action of levodopa. This study aims to evaluate changes in serum zinc levels in three patients that received LCIG treatment and to determine possible remedies for zinc deficiency during treatment.Materials and MethodsWe performed a prospective blood analysis of serum zinc levels before, when possible, and after LCIG treatment in our three PD patients.ResultsThe serum zinc levels of the first patient before treatment and 4 months after beginning LCIG treatment were 69 and 58 μg/dl, respectively. For the second patient, serum zinc levels before treatment and two months after starting LCIG treatment were 87 and 46 μg/dl, respectively. The baseline serum zinc level for the third patient was not examined, but was 48 μg/dl 5 months after starting the LCIG infusion.ConclusionsLevodopa–carbidopa intestinal gel infusion might have caused a zinc deficiency through levodopa zinc chelation. Zinc deficiency with LCIG infusion has not yet been reported, though preventing zinc deficiency may be an important factor in future LCIG treatment strategies.

show abstract

“…Finally, Mohammad M. et al, presented the results of the Zinc Supplementation in Alcoholic Cirrhosis (ZAC) trial [62]; which is based on the fact that zinc deficiency occurs in human subjects with alcoholic cirrhosis (AC) [63] and zinc supplementation attenuates liver injury/inflammation in murine models of ALD [64,65]. In this small single center double blind placebo controlled trial, the authors aimed to determine if low dose zinc supplementation (220 mg/day for 3 months) improves serum biomarkers of liver injury/inflammation and clinical status of patients with AC.…”

Section: Alcoholic Liver Diseasementioning

confidence: 99%

Clinical Trial Watch: Reports from the Liver Meeting®, AASLD, San Francisco, November 2015

Bömmel¹,

Duarte‐Rojo

Altamirano

et al. 2016

Journal of Hepatology

View full text Add to dashboard Cite

Screening for Zinc Deficiency in Patients with Cirrhosis: When Should We Start?

Cited by 49 publications

References 29 publications

Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon

Serum Zinc Levels in Cirrhotic Patients Attending General and Specialty Hospitals, Yangon

Proposition of zinc supplementation during levodopa–carbidopa intestinal gel treatment

Clinical Trial Watch: Reports from the Liver Meeting®, AASLD, San Francisco, November 2015

Contact Info

Product

Resources

About