Treatment of Liver Disease of the Alcoholic: A Composite Approach

Role of Zinc in the Development/Progression of Alcoholic Liver Disease

“…Zinc deficiency is a well-recognized cause of hypogonadism in experimental animals, and it has been postulated to play a pathogenic role in the human hypogonadism observed in certain disease processes such as regional enteritis, sickle cell disease, uremia, and chronic alcoholism [33, 44–49]. Chronic alcoholics, with or without liver disease, may have hypogonadism [50].…”

“…Zinc deficient animals have reduced basal testosterone levels and depressed weights of testes and other androgen-sensitive organs as well as decreased muscle mass compared to zincsufficient controls [40, 51, 52]. Uncontrolled studies suggested that zinc supplementation may improve the hypogonadism in ALD [33, 49]. Low testosterone may play a role in the sarcopenia frequently observed in chronic ALD, and testosterone therapy has recently been shown to improve sarcopenia in cirrhosis [53].…”

Nutritional Factors in Liver Disease of the Alcoholic

“…A nutritious diet with adequate calories, protein, carbohydrate, lipids, vitamins and minerals appropriately spaced and ingested, with a diary of what is eaten, is desirable to restore normal nutrition, improve liver function and prevent resumption of ethanol intake. Protein repletion is important for liver regeneration; branch chain amino acids have proven helpful in subjects who develop encephalopathy when over 20 grams of protein are given (29). The effectiveness of dietary therapy on liver morphology is best evaluated by determining its influence on hepatic DNA and collagen synthesis by in vitro perfusion of percutaneous biopsies.…”