Serum Zinc Deficiency and its Relation to Liver Fibrosis in Chronic HCV: a Real-Life Egyptian Study

Abstract

Zinc is essential for the activation of approximately 300 metallo-enzymes. Serum and hepatic zinc is decreased in chronic liver disease patients, and zinc depletion has been suggested to accelerate liver fibrosis. The study was designed to assess Zinc status in chronic HCV Egyptian patients and its relationship to fibrosis stage diagnosed by FibroScan. This was a cross-sectional study on 297 Egyptian patients with naïve chronic HCV. All patients underwent laboratory tests (including assessment of serum Zinc) and liver stiffness measurement (LSM) by Transient Elastography (FibroScan). The study included 170 (57.2%) females and 127 (42.8%) males with a mean age 52.4 ± 10.2 years. Most of the patients had zinc deficiency as the mean zinc level was 55.5 ± 30.7 μg/dl. The FibroScan scores showed that 97 patients had mild to moderate fibrosis (≤F2), while 200 patients had advanced to severe fibrosis (˃F2). Zinc level was significantly lower in patients with ˃F2 than those with ≤F2 (52 ± 30.7 vs 62.5 ± 29.7, p value: 0.005), as the zinc values decreased with the progression of liver fibrosis. Serum zinc level had a negative significant correlation with INR and negative significant correlation with FibroScan score but no correlation to bilirubin, ALT, AST, or albumin. Most of Egyptian chronic liver disease patients had zinc deficiency. Zinc level gets significantly lower with progression of fibrosis. Zinc supplementation is essential before and during antiviral therapy for HCV.

Factors Attenuating Zinc Deficiency Improvement in Direct-Acting Antiviral Agent-Treated Chronic Hepatitis C Virus Infection

“…Baseline Zn was negatively related to the baseline FIB-4 index, which is consistent with previous findings that serum zinc levels were significantly correlated with the degree of liver fibrosis, and that serum zinc levels were significantly lower as liver fibrosis progressed [ 18 ]. In chronic liver diseases, both serum and hepatic zinc levels decrease, promoting liver fibrosis [ 7 , 19 ].…”

Selenium-Dependent Antioxidant Enzymes: Actions and Properties of Selenoproteins

“…An interesting work conducted in 55 days broilers with a Se-deficient diet (0.033 mg Se/kg) and a normal diet (0.2 mg/kg) showed that Se deficiency reduced HSP (HSP40, HSP60, and HSP90) and selenoprotein (selenoprotein K, GPX1, and selenoprotein H) mRNA expression, although the expression levels of selenoprotein Pb, selenoprotein I, selenoprotein N, MSRB1, HSP27, GPX2 and inflammatory factors (TNF-α, COX-2, HO-1 and iNOS) were upregulated. These results also indicated that selenoproteins play different roles in chicken testes [ 182 ]. Huang et al [ 183 ] studied the effect of Se deficiency on selenoprotein expression levels in chicken muscular stomach and a correlation of muscular stomach injuries and selenoproteins was found.…”

Zinc deficiency and advanced liver fibrosis among HIV and hepatitis C co-infected anti-retroviral naïve persons with alcohol use in Russia

“…Our study differed from others as well with regard to demographic characteristics. For example, Omran et al found that lower zinc levels were associated with advanced liver fibrosis in an older cohort (mean age 52) of HCV mono-infected Egyptian patients [31]. The serum zinc level among those with >F2 fibrosis was 0.52 mg/L ± 0.31 mg/L versus 0.63 ± 0.30 mg/L among those with ≤F2 fibrosis.…”