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

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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.

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Abbreviations

Zn:

Zinc

Fe:

Iron

Mn:

Manganese

Cu:

Copper

Th:

T helper

STAT:

Signal transducer and activator of transcription 3

LSM:

Liver stiffness measurement

AUROC:

Area under the receiver-operating characteristics

NAFLD:

Non-alcoholic fatty liver disease

IFN:

Interferon

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Author information

Authors and Affiliations

  1. Hepato-gastroenterology and Endemic Medicine Department, Cairo University, Cairo, Egypt

    Dalia A. Omran, Samar Kamal Darweesh, Mohamed Mahmoud & Ayman Yosry

  2. Medical Biochemistry Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Hanan Fouad

  3. Pharmacology Department, Faculty of Pharmacy, Hail University, Hail, Kingdom of Saudi Arabia

    Hanan Fouad

  4. National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo University, Cairo, Egypt

    Sameh Saif, Azza Fared, Mohamed Hassany & Lamiaa Mobarak

  5. Internal Medicine and Hepatology department, National Liver Institute, Menoufya University, Menoufya Governorate, Egypt

    Mahmoud A. El-Tahawy

Authors
  1. Dalia A. Omran
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  2. Samar Kamal Darweesh
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  3. Hanan Fouad
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  4. Mohamed Mahmoud
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  5. Sameh Saif
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  6. Azza Fared
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  7. Mohamed Hassany
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  9. Mahmoud A. El-Tahawy
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  10. Ayman Yosry
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Corresponding author

Correspondence to Samar Kamal Darweesh.

Ethics declarations

Limitations of the Study

None reported.

Ethics Approval and Consent to Participate

This study was approved by the Department committee (institution review board) and the institution ethics committee. This study was performed in accordance with the ethics guidelines of the 1975 Declaration of Helsinki. Informed consent was obtained from each participant after explanation of diagnostic procedures.

Consent for Publication

Not applicable.

Availability of Data and Material

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Competing Interests

The authors declare that they have no competing interests.

Funding

This work was supported by the Science and Technology Development Fund (STDF), Egypt, that funded this research work; Grant No. 5380, Basic and applied research.

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Omran, D.A., Darweesh, S.K., Fouad, H. et al. Serum Zinc Deficiency and its Relation to Liver Fibrosis in Chronic HCV: a Real-Life Egyptian Study. Biol Trace Elem Res 179, 1–7 (2017). https://doi.org/10.1007/s12011-017-0938-x

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  • DOI: https://doi.org/10.1007/s12011-017-0938-x

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