Serum zinc and copper concentrations and ratios in cirrhotic patients: correlation with severity index.

INTRODUCTION: zinc (Zn) and copper (Cu) are essential elements that play an important role in the whole-body metabolism and seems to have a role in the pathogenesis of the liver cirrhosis (LC). OBJECTIVE: the aim of this study is to evaluate the influence on serum Zn and Cu concentrations and Cu/Zn ratios of different factors like cirrhosis, severity index, age, sex, death, and disease complications. METHODS: ninety-three patients with LC were included. The severity index was measured by the Child-Pugh index (CPI). RESULTS: mean serum Cu concentration and Cu/Zn ratio were significantly higher in patients than in healthy controls (p ≤ 0.001). Serum Zn concentrations were reduced with higher cirrhosis severity (specifically low vsmedium severity CPI, p < 0.05). Mean serum Cu concentration was significantly higher in the oldest (> 50 years) versusyoungest (< 30 years) age group. Serum Zn concentrations were lower and Cu/Zn ratios were higher (p < 0.05) in patients that died. Among complications, significantly higher serum Zn concentrations were found in cirrhotic patients with ascites than in those with bacteremia-sepsis. CONCLUSIONS: levels of Zn, Cu and Cu/Zn ratio are affected by the presence of hepatic cirrhosis. Serum Zn concentrations are lower with higher severity of cirrhosis, while those for Cu are increased in cirrhotic patients. We can observe that the presence of elevated Cu/Zn ratios in these patients might be useful in the evaluation of suspected liver cirrhosis.

Serum zinc and copper concentrations and ratios in cirrhotic patients: correlation with severity index / Concentraciones séricas de zinc, cobre y sus cocientes correspondientes en pacientes cirróticos: correlación con el índice de severidad

Introduction: zinc (Zn) and copper (Cu) are essential elements that play an important role in the whole-body metabolism and seems to have a role in the pathogenesis of the liver cirrhosis (LC).Objective: the aim of this study is to evaluate the influence on serum Zn and Cu concentrations and Cu/Zn ratios of different factors like cirrhosis, severity index, age, sex, death, and disease complications. Methods: ninety-three patients with LC were included. The severity index was measured by the Child-Pugh index (CPI).Results: mean serum Cu concentration and Cu/Zn ratio were significantly higher in patients than in healthy controls (p ≤ 0.001). Serum Zn concentrations were reduced with higher cirrhosis severity (specifically low vsmedium severity CPI, p < 0.05). Mean serum Cu concentration was significantly higher in the oldest (> 50 years) versusyoungest (< 30 years) age group. Serum Zn concentrations were lower and Cu/Zn ratios were higher (p < 0.05) in patients that died. Among complications, significantly higher serum Zn concentrations were found in cirrhotic patients with ascites than in those with bacteremia-sepsis. Conclusions: levels of Zn, Cu and Cu/Zn ratio are affected by the presence of hepatic cirrhosis. Serum Zn concentrations are lower with higher severity of cirrhosis, while those for Cu are increased in cirrhotic patients. We can observe that the presence of elevated Cu/Zn ratios in these patients might be useful in the evaluation of suspected liver cirrhosis

Introducción: el zinc (Zn) y el cobre (Cu) son elementos esenciales ya que juegan un papel fundamental en el metabolismo en general y parecen tener implicación en la patogénesis de la cirrosis hepática (CH). Objetivos: el objetivo del presente estudio es evaluar la influencia sobre los niveles séricos de Zn y Cu, y sobre los cocientes entre los niveles de Cu y Zn de diferentes factores como la cirrosis, el índice de severidad, la edad, el sexo, la mortalidad y las complicaciones de la enfermedad. Metodología: noventa y tres pacientes con CH fueron incluidos en el estudio y el grado de severidad se midió utilizando el índice Child-Pugh (ICP). Resultados: las concentraciones séricas de Cu y los cocientes entre los niveles de Cu y Zn se encontraron significativamente aumentados en los pacientes con respecto a los controles sanos (p ≤ 0.001). A mayor grado de severidad cirrótica, se obtuvieron valores medios de Zn significativamente disminuidos (concretamente en los enfermos con ICP bajo frente a los que tenían un ICP medio, p < 0.05). La media de las concentraciones séricas de Cu fue significativamente superior en el grupo de sujetos de mayor edad (> 50 años) con respecto al grupo más joven (< 30 años). En aquellos pacientes que habían sufrido un deceso, las concentraciones séricas de Zn estaban significativamente disminuidas, mientras que los cocientes entre los niveles de Cu y Zn se encontraron elevadas (p < 0.05). En cuanto a las complicaciones de la enfermedad, obtuvimos valores séricos significativamente elevados de Zn en aquellos pacientes cirróticos que padecían ascitis respecto a los que presentaban bacteriemia-sepsis. Conclusiones: los valores de Zn, Cu y los cocientes entre los niveles de Cu y Zn se encuentran afectados en la enfermedad cirrótica. Las concentraciones séricas de Zn son bajas cuando existe un mayor grado de severidad de la cirrosis hepática, mientras que los valores de Cu apararen incrementados en los pacientes con esta enfermedad. Podemos observar que la presencia de valores elevados de los cocientes entre los niveles de Cu y Zn podría ser de utilidad en la evaluación de la posible presencia de la enfermedad

Serum selenium levels in cirrhotic patients are not influenced by the disease severity index.

Selenium (Se) is an antioxidant element that protects against cellular damage by reactive oxygen species. Therefore, total serum Se concentration may reflect protection during the development of cirrhosis, an oxidative stress-related disease. We hypothesized that serum Se levels are diminished in cirrhotic patients due to their enhanced oxidative stress, and serum Se levels are reduced the most in patients with the highest severity of cirrhosis. A case-control study was performed to determine whether cirrhosis is associated with changes in serum Se levels. Blood samples from 30 healthy controls and 93 cirrhotic patients were analyzed for total serum Se by hydride generation atomic absorption spectrometry. The Child-Pugh index score was used to evaluate the severity of liver disease. The mean serum Se concentration was significantly lower in patients vs controls (0.721 ± 0.239 vs 0.926 ± 0.241 µmol/L; P = .001). Mean serum Se levels were not significantly lower in patients with higher severity of cirrhosis (0.691 ± 0.229 vs 0.755 ± 0.255 µmol/L; P = .144). A positive and significant correlation was found between age and serum Se levels in patients (r = 0.277, P = .007). Patients showed significant sex differences in serum Se level (higher in male) and severity index (higher in female). The significantly decreased serum Se level in patients indicates that the Se component of the antioxidant system is severely impaired in cirrhosis. However, serum Se levels were not influenced by the severity of the disease.