Serum trace metals in chronic viral hepatitis and hepatocellular carcinoma in Thailand

Abstract

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.

The status of zinc in the development of hepatocellular cancer

“…4,[42][43][44][45] To assess this zinc relationship, one must recognize that homeostatic physiological mechanisms regulate and maintain a constant normal plasma zinc concentration, which is ~12-15 uM in humans. The plasma zinc concentration is maintained basically by the balance of dietary zinc intestinal absorption and assimilation into blood, the distribution of zinc among the tissues of the body, and the "excretion" of zinc out of the body.…”

The Use of Selected Nutrition Supplements and Complementary and Alternative Medicine in Liver Disease

“…Several small studies have evaluated serum zinc levels in patients with chronic viral hepatitis. [69][70][71][72][73][74] The results have been mixed. Three found no significant differences when compared with controls; however, others have demonstrated a signifi-cant decrease in serum zinc levels when compared with controls.…”

“…Three found no significant differences when compared with controls; however, others have demonstrated a signifi-cant decrease in serum zinc levels when compared with controls. [69][70][71][72][73][74] In one of these studies, a significant difference was found only in those patients with cirrhosis. 72 Another of these studies only looked at patients with chronic hepatitis C and demonstrated that, in addition to lower serum zinc levels at baseline, these reductions were exacerbated further following injection of INF-α.…”

Blood micronutrient, oxidative stress, and viral load in patients with chronic hepatitis C

“…The essential micronutrients (Zn, Cu, Fe, and Se) might exacerbate liver disease in case of deficiency, imbalance, or toxicity [5,30] . They are also linked to the process of oxidation during chronic liver damage [6,7,31] . In the present investigation, the levels of Zn and Se in plasma and erythrocytes of HCV-infected patients decreased significantly compared to healthy subjects.…”

“…Decreasing levels of Zn, Se, or increasing Cu levels were also noted in sera of hepatitis cases [31][32][33] . HCV-and HIV-coinfected patients showed markedly lower blood Se levels compared to HIV-infected patients without concomitant HCV infection [34] .…”