Zinc sulfate inhibits the enterohepatic cycling of unconjugated bilirubin in subjects with Gilbert’s syndrome

Méndez-Sánchez, Nahúm; Martinez, Mariana; González, Verónica; Roldan-Valadez, Ernesto; Flores, Marina; Uribe, Misael

doi:10.1016/s1665-2681(19)32191-x

Cited by 33 publications

(27 citation statements)

References 20 publications

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“…Similar results on Gunn rats were reported by Vitek et al, where decreased serum bilirubin levels were observed, presumably as a result of inhibition of enterohepatic circulation of bilirubin [9]. The only human study to evaluate the role of zinc salts in jaundice has been carried out in adult Mexican population with Gilbert's disease using a small sample size [10]. This study showed that acute and chronic oral administration of ZnSO 4 decreased serum unconjugated bilirubin levels significantly, most likely by the inhibition of the "normal" enterohepatic cycling of unconjugated bilirubin.…”

Section: Introductionsupporting

confidence: 80%

“…Among compounds having this potential, zinc salts were demonstrated to be promising in both in vitro and in vivo. Only human study on this issue is one by Mendez-Sanchez et al on adult patients of Gilbert syndrome [10]. This study was a small one, enrolling only 20 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Zinc has also been investigated for its role in decreasing the STB levels by inhibiting enterohepatic circulation [8][9][10]. Study by Mendez-Sanchez et al reported that the Zn salts that flocculate at physiological pH adsorb unconjugated bilirubin almost completely from unsaturated micellar bile salt solutions.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Zinc in Reducing Hyperbilirubinemia among At-Risk Neonates: A Randomized, Double-Blind, Placebo-Controlled Trial

et al. 2011

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Section: Introductionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Efficacy of Zinc in Reducing Hyperbilirubinemia among At-Risk Neonates: A Randomized, Double-Blind, Placebo-Controlled Trial

et al. 2011

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“…However, pharmacodynamics may have affected our study. Mendez-Sanchez et al 5 gave single dose oral zinc adult Gilbert's syndrome patients. They showed a significant decrease in bilirubin serum levels in their subjects.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to previous studies [5][6][7] which observed the effect of oral zinc in reducing UCB serum levels based on time measured in days, we measured time in hours. In Rana ' s study 7 in India, oral zinc gluconate was given to subjects starting on the second day of life, whereas, we gave oral zinc soon after the first feeding and observed hyperbilirubinemia based on time in hours and analyzed hyperbilirubinemia duration with zinc and in placebo groups, respectively, that required phototherapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of oral zinc on hyperbilirubinemia in full term neonates

Patton

Rachmadi

Sukadi

2011

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Background Oral zinc has been shown to reduce serum unconjugated bilirubin in animals, adolescents and low birth weight neonates. However, studies in healthy tenn neonates given oral zinc showed no reduction in hyperbilirubinemia based on time measurement in days. In order to improve accuracy, hyperbilirubinemia may be determined based on time measurements in hours.Objective To determine the effect of oral zinc on hyperbiliru-binemia in full term neonates, based on time measurement in hours, rather than days.Methods We conducted a randomized, double-blind clinical trial on healthy term neonates born spontaneously or through elective caesarean section in Hasan Sadikin Hospital from June to July 2010. Subjects were randomized into two groups: those receiving 5 mg of zinc sulphate and those receiving a placebo, sucrose, each twice daily. Serum total bilirubin level was examined at discharge and upon follow􀁂up at day 5 of life. Factors which may be related to hyperbilirubinemia such as maternal age, infants' gender, umbilical cord bilirubin levels and type of feeding, were analyzed by Chi-square test. Hyperbilirubinemia persistence and comparison of survival distributions were analyzed by Kaplan-Meier survival analysis and Logrank test.Results Out of 60 subjects, 26 had hyperbilirubinemia. The mean duration of hyperbilirubinemia in the 15 subjects in the zinc group and 11 in the placebo group were 116.5 hours and 117.3 hours, respectively. There was no significant difference in hyperbilirubinemia duration between the two groups ( P=0.496, 95% CI 111.5 to 122.7). In addition, Chi-square analysis of factors which may be related to hyperbilirubinemia showed no significant difference between the two groups (P > 0.05).Conclusions Oral zinc 5 mg tMce daily made no significant difference in hyperbilirubinemia duration in full tenn neonates despite measuring in hours.

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