The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial

Mousa, Nasser; Abdel‐Razik, Ahmed; Zaher, Ashraf Ahmed; Hamed, Magdy; Shiha, Gamal; Effat, Narmin; Elbaz, Sherif; Elhelaly, Rania; Hafez, Mohamed Zain Eldeen; El‐Wakeel, Niveen; Eldars, Waleed

doi:10.1177/1756283x16645049

Cited by 38 publications

(51 citation statements)

References 26 publications

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“…5 , 9 , 16 - 19 In one study Mosua N et al found improvement of minimal hepatic encephalopathy in cirrhosis after zinc supplementation. 21 Therefore, it can be proposed that zinc supplementation may reduce hepatic encephalopathy by improving the effectiveness of the urea cycle.…”

Section: Discussionmentioning

confidence: 99%

Zinc level assessment in patients having Viral Cirrhosis

Kamani¹,

Shaikh²

2018

Pak J Med Sci

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Objective:Zinc is a vital trace element and its deficiency in cirrhosis might potentiate the development of hepatic encephalopathy. The objective of this study was to assess the zinc levels in serum of patients having viral cirrhosis and compare it with normal healthy controls.Methods:This study was conducted in Department of Gastroenterology, Liaquat National hospital and medical college, Karachi, Pakistan; from January 2014 to December 2014. Total of 45 patients with the mean age of 52.44±8.7 years were included. The three groups of patients were made including Child Pugh Class Score B (Group-1), Child Pugh Class C (Group-2) and healthy controls (Group-3) having 15 patients in each group. Zinc levels in serum were evaluated by the help of atomic absorption spectrometry (Normal range50-150 µg/dl).Results:Total of 45 subjects was enrolled in this study. Overall prevalence of zinc deficiency was noted in 13(28.9%) patients. Mean value of zinc levels in group 1,2 and 3 were 68.09±20.85, 50.69±15.86 and 92.91±17.18µg/dL respectively. Highly statistical difference was observed in the mean zinc level between three groups p=0.0001. An inverse correlation was observed between Child Pugh Score and the zinc level in serum r=-0.498.Conclusion:Patients suffering from advanced cirrhosis appeared to have lower serum zinc levels. In patients suffering from viral cirrhosis having hepatic encephalopathy, zinc supplementation might improve clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Zinc level assessment in patients having Viral Cirrhosis

Kamani¹,

Shaikh²

2018

Pak J Med Sci

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“…Hyperammonemia plays a major role in the development of brain edema and in evoking changes in cerebral blood flow (CBF) [13]. There are several drugs and clinical trials that could benefit patients with HE and most of them tend to reduce the production and absorption of ammonia from the colon, with the hypothesis that the colon is the primary organ that generates ammonia [14]. Recently, it was recorded that lactulose is the most commonly utilized nonabsorbable disaccharide for prophylaxis of HE [15].…”

Section: Discussionmentioning

confidence: 99%

Curative role of lactulose, L-carnitine, alpha-lipoic acid and combination of L-carnitine and alpha-lipoic acid in a rat model of acute hepatic encephalopathy: Biochemical observations

Saeed¹,

Ahmed²,

Saleh³

et al. 2017

Trop. J. Pharm Res

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“…Zinc is also required for detoxification of ammonia via the urea cycle in the liver and its serum level shows a significant inverse relationship with blood ammonia concentrations in LC patients [108]. Since zinc is closely related to the pathogenesis of HE, several studies have examined the effects of zinc supplementation in patients with HE and hyperammonemia [109][110][111][112]. Our research group has recently performed a prolonged, randomized, placebo-controlled, double-blind trial and found that zinc supplementation for three months is effective and safe in treating hyperammonemia in patients with LC [113].…”

Section: Other Ammonia-lowering Drugsmentioning

confidence: 99%

Therapeutic Strategies and Current Management for Hepatic Encephalopathy in Liver Cirrhosis

Suzuki¹,

Kato²,

Takikawa³

2019

obm hg

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Hepatic encephalopathy (HE) is a neuropsychiatric syndrome with a wide spectrum of symptoms and one of the serious complications seen in patients with acute and chronic liver disease or spontaneous portal-systemic shunting. HE is usually classified into three types according to the underlying cause (A, B, and C). Some recent discussions suggest a fourth type (D) to exclusively include HE patients with acute-on-chronic liver failure. HE has also been classified into coma grades I to IV according to the West Haven criteria, while the International Society for Hepatic Encephalopathy and Nitrogen Metabolism has proposed two distinct categories: covert HE (includes minimal HE, which is identified solely through psychometric or neurological tests and coma grade I) and overt HE (coma grade II-IV). Although modern therapeutic approaches based on clinical evidence have gradually improved the outcomes of cirrhotic patients with HE, recurrent or resistant HE is still common and the prognosis in patients with severe liver dysfunction is still poor. In this article, we discuss the therapeutic strategies and current management, except for liver transplantation and interventional procedures for portal-systemic shunting, in cirrhotic patients with HE.

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The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial

Abstract: Antioxidant and zinc supplementation can improve MHE in patients with liver cirrhosis.

Cited by 38 publications

References 26 publications

Zinc level assessment in patients having Viral Cirrhosis

Zinc level assessment in patients having Viral Cirrhosis

Curative role of lactulose, L-carnitine, alpha-lipoic acid and combination of L-carnitine and alpha-lipoic acid in a rat model of acute hepatic encephalopathy: Biochemical observations

Therapeutic Strategies and Current Management for Hepatic Encephalopathy in Liver Cirrhosis

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