Hepato-gastroenterology and Endemic Medicine Department, Cairo University, Cairo, Egypt.
Medical Biochemistry Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Biol Trace Elem Res. 2017 Sep;179(1):1-7. doi: 10.1007/s12011-017-0938-x. Epub 2017 Jan 16.
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.
锌对于大约 300 种金属酶的激活至关重要。慢性肝病患者的血清和肝锌降低，锌耗竭被认为会加速肝纤维化。本研究旨在评估埃及慢性 HCV 患者的锌状况及其与 FibroScan 诊断的纤维化分期的关系。这是一项针对 297 例初治慢性 HCV 埃及患者的横断面研究。所有患者均接受实验室检查（包括血清锌评估）和通过瞬时弹性成像（FibroScan）进行肝硬度测量（LSM）。该研究包括 170 名（57.2%）女性和 127 名（42.8%）男性，平均年龄为 52.4±10.2 岁。大多数患者存在锌缺乏，平均锌水平为 55.5±30.7μg/dl。FibroScan 评分显示，97 例患者有轻度至中度纤维化（≤F2），200 例患者有进展性至严重纤维化（＞F2）。＞F2 组患者的锌水平明显低于≤F2 组（52±30.7 vs 62.5±29.7，p 值：0.005），随着肝纤维化的进展，锌值降低。血清锌水平与 INR 呈负显著相关，与 FibroScan 评分呈负显著相关，但与胆红素、ALT、AST 或白蛋白无关。大多数埃及慢性肝病患者存在锌缺乏。锌水平随着纤维化的进展显著降低。在接受 HCV 抗病毒治疗之前和期间，锌的补充是必不可少的。
