Abstract
Trace elements are involved in chronic liver diseases because these elements may have a direct hepatic toxicity or may be decreased as a consequence of the impaired liver function, particularly in patients with alcoholic cirrhosis and/or malnutrition. In this study, we determined plasma and erythrocytes trace elements in 50 inpatients with nonalcoholic chronic liver disease (11 with biopsy-proven chronic hepatitis, 39 with cirrhosis [16 in stage A according to Child-Pugh criteria, 23 Child B+C]), and in a control group of 10 healthy subjects by the proton induced x-ray emission method. The relationship between trace element concentration and the extent of liver damage, the nutritional status (by anthropometric evaluations), and various blood markers of oxidative stress—reduced glutathione, total lipoperoxides and malonyldialdehyde—was investigated. We found that cirrhotics had a significant decrease of Fe, Zn, Se, and GSH levels in the plasma and of GSH and Se in the erythrocytes with respect to the control and chronic hepatitis groups. GSH levels were related to the degree of liver damage; a significant direct correlation was observed among Se, Zn, and GSH plasma values and between GSH and Se in the erythrocytes. The trace element decrease was, on the contrary, independent of the degree of liver function impairment and only partially affected by the nutritional status. Data indicate that liver cirrhosis, even if not alcohol related, induces a decrease of Se and Zn and that, in these patients, an oxidative stress is present, as documented by the significant correlation between Se and GSH. The plasma Br level was higher in cirrhotics with respect to the control and chronic hepatitis groups.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
C. J. McClain, L. Marsano, R. F. Burk, and B. Bacon, Trace metals in liver disease, Semin. Liver Dis. 11, 321–339 (1991).
N. Arber, F. M. Konikoff, M. Moshkowitz, M. Baratz, A. Hallak, M. Santo, et al., Increased serum iron and iron saturation without liver iron accumulation distinguish chronic hepatitis C from other chronic liver diseases, Dig. Dis. Sci. 39, 2656–2659 (1994).
P. J. Thuluvath and D. R. Triger, Selenium in chronic liver disease, J. Hepatol. 14, 176–182 (1992).
E. Rocchi, P. Borella, A. Borghi, F. Paolillo, M. Pradelli, F. Farina, and G. Casalgrandi, Zinc and magnesium in liver cirrhosis, Eur. J. Clin. Invest. 24, 149–155 (1994).
T. M. Bray and W. J. Bettger, The physiological role of zinc as an antioxidant, Free Radical Biol. Med. 8, 281–291 (1990).
G. Marchesini, A. Fabbri, G. Bianchi, M. Brizi, and M. Zoli, Zinc supplementation and amino acid-nitrogen metabolism in patients with advanced cirrhosis, Hepatology 23, 1084–1092 (1996).
V. Loomba, G. Pawar, K. L. Dhar, and M. S. Setia, Serum zinc levels in hepatic encephalopathy, Indian J. Gastroenterol. 14, 51–53 (1995).
R. A. Hauser, T. A. Zesiewic, A. S. Rosemurgy, C. Martinez, and C. W. Olanow, Manganese intoxication and chronic liver failure, Ann. Neurol. 36, 871–875 (1994).
C. Loguercio, V. De Girolamo, A. Federico, S. L. Feng, V. Cataldi, C. Del Vecchio Blanco, et al., Trace elements and chronic liver diseases, J. Trace Elements Med. Biol. 11, 158–161 (1997).
R. F. Burk, K. E. Hill, J. A. Awad, J. D. Morrow, T. Kato, and P. R. Lyons, Pathogenesis of diquat-induced liver necrosis in selenium-deficient rats: assessment of the roles of lipid peroxidation and selenoprotein P, Hepatology 21, 561–569 (1995).
C. Loguercio, G. Nardi, G. Prota, C. Del Vecchio Blanco, and M. Coltorti, Decrease of total glutathione and cysteine SH in non-alcoholic cirrhosis, Ital. J. Gastroenterol. 22(1), 13–15 (1990).
C. Loguercio, C. Del Vecchio Blanco, M. Coltorti, and G. Nardi, Alteration of erythrocyte glutathione, cysteine and glutathione-synthetase in alcoholic and nonalcoholic cirrhosis, Scand. J. Clin. Lab. Invest. 52, 207–213 (1992).
S. Moscarella, A. Duchini, and G. Buzzelli, Lipoperoxidation, trace elements and vitamin E in patients with liver cirrhosis, Eur. J. Gastroenterol. Hepatol. 6, 633–636 (1994).
V. Udupi and C. Rice-Evans, Thiol compounds as protective agents in erythrocyte under oxidative stress, Free Radical Res. Commun. 16, 315–323 (1992).
K. Ishak, A. Baptista, and L. Bianchi, Histological grading and staging of chronic hepatitis, J. Hepatol. 22, 696–699 (1995).
R. N. H. Pugh, I. M. Murray-Lyon, J. L. Dawson, M. C. Pietroni, and R. Williams, Transection of the oesophagus for bleeding oesophageal varices, Br. J. Surg. 60, 646–648 (1973).
C. Loguercio, E. Sava, R. Marmo, C. Del Vecchio, and M. Coltorti, Malnutrition in cirrhotic patients: anthropometric measurements as method for the assessment of nutritional status, Br. J. Clin. Pract. 44 (3), 162–165 (1990).
R. Moro, G. Gialanella, Y. X. Zhang, L. Perrone, and R. Di Toro, Trace elements in full term neonate hair, J. Trace Elements Health Dis. 6, 27–31 (1992).
H. L. Bonkovsky, B. F. Banner, and A. L. Rothman, Iron and chronic viral hepatitis, Hepatology 25, 759–768 (1997).
T. Nagamine, H. Takagi, Y. Hashimoto, H. Takayama, R. Shimoda, N. Nomura, et al., The possible role of zinc and metallothionein in the liver on the therapeutic effect of IFN-α to hepatitis C patients, Biol. Trace Element Res. 58, 65–76 (1997)
J. Aaseth, J. Ringstad, H Bell, and Y. Thomassen, Alcohol, trace elements, and liver dysfunction, in Trace Elements in Clinical Medicine, H. Tomita, ed., Springer-Verlag, Tokyo, pp. 79–83 (1990).
R. F. Burk, D. S. Early, K. E. Hill, I. S. Palmer, and M. E. Boeglin, Plasma selenium in patients with cirrhosis, Hepatology 27, 794–798 (1998).
G. Nardi, C. Loguercio, and M. Cipollaro, A fluorimetric assay of gamma-glutamilcysteine synthetase and glutathione synthetase by high performance liquid chromatography, J. Chromatogr. 53, 122–128 (1990).
C. Loguercio, P. Clot, E. Albano, F. Argenzio, A. Grella, V. De Girolamo, et al., Free radicals and not acetaldehyde influence the circulating levels of glutathione after acute or chronic alcohol abuse: in vivo and in vitro studies, Ital. J. Gastroenterol. 29, 168–173 (1997).
C. Loguercio, C. Del Vecchio Blanco, V. De Girolamo, D. Disalvo, G. Nardi, and A. Parente, Ethanol consumption, amino acid and glutathione blood levels in patients with and without chronic liver disease, Alcohol Clin. Exp. Res. 23, 1780–1784 (1999).
N. Milman, J. Laursen, S. Asnaes, and J. Podenphant, Elements in normal and cirrhotic human liver tissue II. Potassium, sulphur, chlorine and bromine measured by X-ray fluorescence spectrometry, Liver 7, 206–210 (1987).
K. H. Ng, D. A. Bradley, and L. M. Looi, Elevated trace element concentrations in malignant breast tissues, Br. J. Radiol. 70, 375–382 (1997).
C. Pramoolsinsap, N. Promvanit, S. Komindr, P. Lerdverasirikul, and S. Srianujata, Serum trace metals in chronic viral hepatitis and hepatocellular carcinoma in Thailand, J. Gastroenterol. 29(5), 610–615 (1994).
M. W. Yu, I. S. Horng, K. H. Hsu, Y. C. Chiang, Y. F. Liaw, and C. J. Chen, Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection, Am. J. Epidemiol. 150, 367–374 (1999).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Loguercio, C., De Girolamo, V., Federico, A. et al. Relationship of blood trace elements to liver damage, Nutritional status, and oxidative stress in chronic nonalcoholic liver disease. Biol Trace Elem Res 81, 245–254 (2001). https://doi.org/10.1385/BTER:81:3:245
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1385/BTER:81:3:245