Portacaval Shunt As an Experimental Model of Impaired Hepatic Release of Vitamin A in Liver Disease

Schölmerich, Jürgen; Fabian, Matthew J.; Tauber, Rudolf; Löhle, E.; Köttgen, E.; Grün, M; Wietholtz, H.; Baumgartner, Ulrich; Gerok, W.

doi:10.1016/0016-5085(91)70027-u

Cited by 9 publications

(12 citation statements)

References 13 publications

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“…Nutritional advice in patients with cirrhosis requires an individual management regarding the dominating complications of the disease. [2,28,29] [25,26]. Eine Vitamin-D-Malnutrition führt zu einer Demineralisierung des Knochens.…”

Section: Discussionmentioning

confidence: 99%

Ernährung bei Leberzirrhose

et al. 2007

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A sufficient daily energy supply should be guaranteed in patients with liver cirrhosis, which is higher compared to the normal population. Furthermore, the increased turnover of amino acids requires a sufficient protein supplementation. Ascites may benefit from a restriction of daily low-salt fluid intake. Additional substitution of vitamins and trace elements is indicated when symptoms of deficiency are apparent. Associated hepatic osteopathy is a frequent complication of liver cirrhosis. Nutritional advice in patients with cirrhosis requires an individual management regarding the dominating complications of the disease.

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Section: Discussionmentioning

confidence: 99%

Ernährung bei Leberzirrhose

et al. 2007

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“…Bei Zinkmangel sind Seh-, Geschmacks-und Geruchsstörungen, Innenohrschwerhörigkeit, Hodenatrophie, Rückgang der Spermiogenese, Immundefizienz, gestörte Wundheilung und hyperkeratotische Hautveränderungen beschrieben worden [25,26]. …”

Section: Schlüsselwörterunclassified

“…Bei Untersuchungen an Patienten mit Leberzirrhose und portosystemischem Shunt wurde ein Zinkmangel als ursächlich für die verminderte Freisetzung von retinolbildendem Protein (RBP) und Vi-tamin A aus der Leber nachgewiesen [25,26]. Ein Schwerpunkt der Forschung bei Mundschleimhauterkrankungen und oralen Karzinomen ist die Prävention und Therapie mit Retinol und Retinoiden [8,10,11,13,20,32].…”

Section: Diskussionunclassified

“…Er spielt eine nachgewiesene Rolle bei Karzinomen, die durch Dialkylnitrosamine induziert werden, da der mikrosomale Stoffwechsel der Dialkylnitrosamine zinkabhänging ist [2,3]. Als Ursache für den Mangel kommt in der Gruppe PEC der hohe Anteil an Patienten mit langjährigem Alkoholabusus mit darauf zurückzuführender verminderter Zufuhr und verminderter Resorption in Betracht [18,19,26,27,28]. Eine weitere mögliche Ursache ist in einer gestörten Verteilung zu suchen, da bei Patienten mit alkoholischer und nicht alkoholischer Lebererkrankung ein vergrößerter portosystemischer Shunt mit verminderter hepatischer Extraktion vorliegen kann [18].…”

Section: Diskussionunclassified

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Zink- und Vitamin-A-Mangel bei Mundschleimhauterkrankungen

Kleier

Werkmeister

Joos

1998

Mund Kiefer GesichtsChir

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The regeneration of the oral mucosa is zinc- and vitamin A-pathway dependent. Hyperkeratoses, a disturbed immune system and a higher incidence of oral malignancies have been reported in cases of deficiency. In this study, blood samples were taken from 97 patients with oral lichen planus, oral leukoplakia, oral squamous cell carcinoma (OSCC), and a control group. Besides routine blood analysis, serum levels of zinc (Zn), vitamin A (Vit A) and retinol binding protein (RBP) were identified. Mean values in lichen ruber planus were Zn 784 micrograms/l, RBP 5.26 mg/dl and Vit A 656 ng/ml; in leukoplakia Zn 696 micrograms/l, RBP 5.30 mg/dl and Vit A 652 ng/ml; and in OSCC Zn 659 micrograms/l, RBP 5.00 mg/dl and Vit A 617 ng/ml. Patients with lichen ruber planus showed no statistically significant differences, whereas in leukoplakia patients there were statistically lower values for Zn compared to the control group and the lichen ruber planus group (P < 0.05). Patients with oral malignancies showed lower serum levels for Zn, RBP and Vit A. Compared with the control group and the lichen ruber planus group, differences of the serum Zn levels proved to be statistically significant (P < 0.01). In patients with oral leukoplakia and patients with oral carcinoma and Zn deficiency, a substitutional therapy should be considered.

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“…In this study, hepatic hypoperfusion had a greater impact on plasma concentrations of 25-hydroxyvitamin D than reduction in liver mass [13]. Experimental rats in which a portocaval shunt was experimentally created had a 25% decrease in serum vitamin A concentrations compared to sham-operated rats 48 days after surgery [14]. Besides hypoperfusion, some degree of (secondary) liver dysfunction is expected [15].…”

Section: Introductionmentioning

confidence: 99%

Persistent hypercobalaminemia three months after successful gradual attenuation of extrahepatic shunts in dogs: a prospective cohort study

et al. 2022

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Background Deficiencies in vitamin A and D and disorders in the vitamin B complex are often present in people with chronic liver diseases. So far, the serum concentrations of these vitamins have not yet been studied in dogs with congenital extrahepatic portosystemic shunts (EHPSS), who also have some degree of liver dysfunction. The objective was to assess serum vitamin concentrations in dogs with EHPSS from diagnosis to complete closure. A prospective cohort study was performed using ten client-owned dogs with EHPSS, closed after gradual surgical attenuation. Serum concentrations of vitamin A, 25-hydroxyvitamin D, folic acid, cobalamin and methylmalonic acid (MMA) were measured at diagnosis prior to institution of medical therapy, prior to surgery, and three months after gradual attenuation and complete closure of the EHPSS. Results At diagnosis, median serum concentrations of vitamin A, 25-hydroxyvitamin D and folic acid were 18.2 μg/dL (8.8 - 79.5 μg/dL), 51.8 ng/mL (19.4 - 109.0 ng/mL), and 8.1 μg/L (5.2 - 14.5 μg/L), respectively, which increased significantly postoperatively (88.3 μg/dL (51.6 - 182.2 μg/dL, P=0.005), 89.6 ng/mL (49.3 - >150.0 ng/mL, P =0.005), and 14.8 μg/L (11.5 - 17.7 μg/L, P <0.001), respectively). Median serum cobalamin concentrations were 735.5 ng/L (470 - 1388 ng/L) at diagnosis and did not significantly decrease postoperatively (P =0.122). Both at diagnosis and three months postoperatively 7/10 dogs had hypercobalaminemia. Conclusions Serum concentrations of vitamin A, 25-hydroxyvitamin D and folic acid significantly increase after surgical attenuation. Nevertheless, persistent hypercobalaminemia is suggestive of ongoing liver dysfunction, despite successful surgery.

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Portacaval Shunt As an Experimental Model of Impaired Hepatic Release of Vitamin A in Liver Disease

Cited by 9 publications

References 13 publications

Ernährung bei Leberzirrhose

Ernährung bei Leberzirrhose

Zink- und Vitamin-A-Mangel bei Mundschleimhauterkrankungen

Persistent hypercobalaminemia three months after successful gradual attenuation of extrahepatic shunts in dogs: a prospective cohort study

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