Title: Zinc supplementation and amino acid-nitrogen metabolism in patients with advanced cirrhosis
Abstract: HepatologyVolume 23, Issue 5 p. 1084-1092 ArticleFree Access Zinc supplementation and amino acid-nitrogen metabolism in patients with advanced cirrhosis G Marchesini, G Marchesini Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorA Fabbri, A Fabbri Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorG Bianchi, G Bianchi Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorM Brizi, M Brizi Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorM Zoli, M Zoli Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this author G Marchesini, G Marchesini Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorA Fabbri, A Fabbri Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorG Bianchi, G Bianchi Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorM Brizi, M Brizi Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this authorM Zoli, M Zoli Istituto di Clinica Medica Generale, Universita di Bologna, Policlinico S. Orsola, ItalySearch for more papers by this author First published: May 1996 https://doi.org/10.1002/hep.510230523Citations: 138AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Zinc deficiency is common in cirrhosis and has been involved in the altered nitrogen metabolism. In this study, we measured the effects of zinc supplementation on the dynamics of amino acid-derived urea synthesis in cirrhosis with mild or latent encephalopathy. The hepatic conversion of amino acids into urea was studied in eight patients with advanced cirrhosis under controlled conditions of substrate availability (continuous alanine infusion), before and after 3-month oral zinc sulfate supplementation (600 mg/d). Eight more patients, matched for hepatocellular failure and encephalopathy, served as controls. Plasma zinc levels were reduced in all patients and returned to normal after oral zinc. The alanine-stimulated urea nitrogen synthesis rate in relation to α-amino-N concentration–the functional hepatic nitrogen clearance–increased by 25% after zinc supplementation, i.e., more urea was produced at any α-amino-N concentration. Basal and alanine-induced glucagon decreased by 50%, and the ammonia response to alanine decreased by 30%. Psychometric tests improved, as did routine and dynamic liver function tests and the Child- Pugh score. Also, the plasma concentration of lipid peroxides was reduced by zinc. No significant changes were observed in the control group. Our data indicate that long-term oral zinc speeds up the kinetics of urea formation from amino acids and ammonia. Changes in the hormonal drive and/or the antioxidant activity of zinc might be involved in the general improvement in liver function, whereas the beneficial effects on encephalopathy might stem from decreased ammonia. References 1 Bray T, Bettger WJ. The physiological role zinc as an antioxidant. Free Rad Biol Med 1990; 8: 281– 291. 2 Bode JC, Hanisch P, Henning H, Koenig W, Richter FW, Bode C. Hepatic zinc content in patients with various stages of alcoholic liver disease and in patients with chronic active and chronic persistent hepatitis. Hepathology 1988; 8: 1605– 1609. 3 McClain CJ, Marsano L, Burk RF, Bacon B. Trace metals in liver disease. Sem Liver Dis 1991; 11: 321– 339. 4 Van Der Rijt CCD, Schalm SW, Schat H, Foeken K, De Jong G. Overt hepatic encephalopathy precipitated by zinc deficiency. 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Publication Year: 1996
Publication Date: 1996-05-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 167
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