The Role of Micronutrients in the Pathogenesis of Alcohol-Related Liver Disease

Abstract

Aims Chronic alcohol consumption may result in liver injury and chronic liver disease, but other factors are likely to influence disease progression. Malnutrition, specifically micronutrient deficiency, is frequently associated with both alcohol use disorder and chronic liver disease. We hypothesize that micronutrient deficiencies may affect the progression of liver disease in this population. Methods Systematic integrative review of the medical literature; electronic search of MEDLINE 1950–2021; studies investigating role of any micronutrient in the acceleration of alcohol-related liver injury in humans or animals. Studies which specifically related to alcoholic hepatitis were excluded. Outcomes were extracted and recorded in tabulated form and discussed narratively. Results We identified 46 studies investigating the role of micronutrient deficiencies in the pathogenesis of alcohol-related liver disease. Specific micronutrients which were identified included folic acid or related B vitamins (n = 9 studies), Vitamin D (n = 9 studies), magnesium (n = 8 studies), zinc (n = 8 studies) and selenium (n = 12 including one systematic review). Observational evidence suggests a potential role of magnesium deficiency in accelerating alcohol-related liver injury with weak or negative evidence for other micronutrients. Conclusions Magnesium deficiency may increase the risk of alcohol-related liver injury and adverse liver outcomes. However, currently, there is insufficient evidence to support magnesium supplementation except for clinically relevant magnesium deficiency. Long-term prospective cohort studies assessing the impact of micronutrients on liver disease progression in patients with alcohol use disorder are lacking and may help determine whether there is a causal role for micronutrient deficiencies in alcohol-related liver injury.

Multiomics Analysis of PCB126’s Effect on a Mouse Chronic-Binge Alcohol Feeding Model

“…Excessive alcohol consumption has been shown to impact a wealth of molecules such as nucleic acids, 37 , 38 proteins, 21 , 37 cofactors, 37 and various micronutrients. 39 , 40 Thus, it was no major surprise to find that some differences in these molecules that were identified following EtOH exposure, such as Zn, were worsened after PCB126 exposure.…”

“…Quantified hepatic metals by ICP-MS revealed that Co, Mg, and Zn were significantly lower in the group relative to the group. Malnutrition 46 and inadequate micronutrients 39 are critical factors in ALD pathogenesis. Zn deficiency in rodents has shown to promote reduced hepatic glycogen stores 47 and has also been associated with increased steatosis in humans.…”

Recent advancements in Mg-based micromotors for biomedical and environmental applications

“…51 A person deficient in Mg will present with health issues such as cardiometabolic disease, 52 moderate tension-type headaches, 53 and alcohol-related liver injury. 54 Currently, Mg is widely used in bone scaffolds in the body. 55 Mg is not only crucial for bodily functions but also has a very high reactivity: micrometre-scale Mg can easily react with water to produce Mg(OH) 2 and H 2 .…”

Nutrition Therapy in Critically Ill Patients with Liver Disease: A Narrative Review

“…Delayed gastric emptying has been reported in patients with liver disease and has been associated with post-prandial fullness and bloating [13]. These patients suffer from alterations in taste acuity, which has been associated with deficiencies in trace elements including zinc, magnesium, and vitamin A [14,15]. Appetite is also reduced due to increased inflammatory cytokines and alterations in appetite-regulating hormones (i.e., leptin, ghrelin, peptide YY, and cholecystokinin) [16].…”

“…Simultaneously, both a lower taste acuity and some liver-related complications also negatively influence appetite. The latter is related to reduced motility (i.e., gastric emptying and bowel transit time), which may impact appetite and contribute to a reduced nutrient intake [13][14][15][16][17][18][19][20][21].…”