Zinc and magnesium in liver cirrhosis

Abstract

The Authors determined zinc (Zn) and magnesium (Mg) in the plasma, urine, erythrocytes (RBCs), mono- and polymorphonuclear cells (MNCs and PMNs) of patients with overt alcoholic and non-alcoholic liver cirrhosis. In order to obtain a clearer clinical picture, biochemical and nutritional parameters (retinol, tocopherol, six different carotenoids, creatinine-height index and tricipital skinfold), as well as markers of portal hypertension (spleno-portal size and platelet count) were also evaluated. The plasma levels of Zn and Mg were found to be reduced, as were the urine levels of Mg. Urine Zn, on the other hand, was higher than normal. Plasma Zn correlated inversely, and urine Zn directly, with the severity of the disease, rather than with alcohol consumption or treatment with diuretics. Protein metabolism impairment would appear to affect the plasma transport of Zn rather than its overall availability in the organism; the opposite was found in the case of Mg, the availability of which appeared to be reduced. Determination of the two elements in RBCs, MNCs and PMNs suggested that a true nutritional deficit cannot be demonstrated. MNCs, rather than RBCs or PMNs seem better to reflect tissue status of trace elements.

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

“…Increased portosystemic shunting, surgical or spontaneous, has been also been associated with higher urinary zinc excretion [13]. While diuretic use may potentially increase zinc excretion in the urine, one study did not find a specific correlation between zinc deficiency and diuretic use, beyond its correlation with disease severity [6]. In our study, there was a correlation between serum zinc levels and ascites or diuretic use, but only ascites remained an independent predictor with multivariate analysis.…”

“…Indeed, various mechanisms for zinc deficiency in patients with cirrhosis have been proposed, including decreased dietary intake, decreased intestinal absorption [10,11], decreased portal venous extraction [12,13], and increased urinary losses [3,4,6]. Malnutrition is a common problem in patients with advanced cirrhosis, and dietary zinc deficiency is likely only a part of a more globally inadequate nutritional intake due to anorexia, ascites that limits gastric distension and promotes early satiety, and/or hepatic encephalopathy that impedes adherence to an appropriate diet.…”

“…In studies that measured urinary zinc levels and blood zinc levels, higher urinary zinc excretion has been observed in patients with both alcoholic [3,4] and nonalcoholic [6] cirrhosis. Increased portosystemic shunting, surgical or spontaneous, has been also been associated with higher urinary zinc excretion [13].…”

Effects of Ellagic acid and Hesperetin on Levels of Some Elements in Livers of Aluminum-Induced Rats

“…Levels of Zn in HES-treated group were significantly higher than that in other groups (p<0.05) and there was not any statistical significant difference amongst of C, A, A+HES and A+EA groups (p>0.05). Zn is necessary for proper liver function and Zn deficiency has been related to the pathogenesis of multiple liver diseases [32][33][34][35]. Although liver Zn levels were observed to be increased by HES in HES treated groups, there were no statistically significant changes in EA administered groups.…”

Hepatische Enzephalopathie

“…Als weitere supportive Maßnahme bei HE gilt die prophylaktische Gabe von Zinkpräparaten. Es ist lange bekannt, dass der Gehalt des Körpers an Zink bei Patienten mit Leberzirrhose auch bei normalem Serumspiegel häufig reduziert ist [94,95]. Da Zink ein Kofaktor der Carbamyltransferase ist, welche das Schlüsselenzym der Harnstoffsynthese darstellt, kann eine reduzierte Verfügbarkeit dieses Spurenelements zur verminderten Aktivität des Harnstoffzyklus bei Leberzirrhose beitragen.…”