TRACE ELEMENTS IN PLASMA AND NUTRITIONAL ASSESSMENT IN PATIENTS WITH COMPENSATED CIRRHOSIS ON A LIVER TRANSPLANT LIST.

Arq Gastroenterol

Departamento Gastrocentro - Ambulatório de transplante de fígado. Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil., Universidade Estadual de Campinas, Departamento Gastrocentro, Ambulatório de transplante de fígado, Universidade Estadual de Campinas, Campinas SP , Brazil.

Published: February 2017

AI Article Synopsis

  • In chronic liver disease, trace element levels in plasma are typically low, but the reasons behind this and its functional impacts are not fully understood.
  • A study on 31 male patients with compensated liver cirrhosis aimed to assess their nutritional status and plasma trace element profiles, correlating these with disease severity.
  • Findings revealed that a significant number of patients were malnourished or overweight, and alterations in trace elements like manganese (Mn), copper (Cu), selenium (Se), calcium (Ca), and magnesium (Mg) were noted, with malnutrition influencing trace element levels more than disease severity did.

Article Abstract

Background: - In chronic liver disease, trace element levels in plasma are usually low. However, the specific cause and functional implications of this abnormality are yet not well understood. These element levels may decrease as a result of abnormal liver function in patients with cirrhosis and/or malnutrition.

Objective: - To evaluate the nutritional status and the profile of trace elements in plasma of patients with cirrhosis on a liver transplant list and to correlate them with disease severity.

Methods: - This cross-sectional study evaluated 31 male patients diagnosed with compensated liver cirrhosis on a waiting list for liver transplant. Nutritional status was objectively evaluated through anthropometry using Mendenhall score and Blackburn classification, subjectively through the Detsky questionnaire and severity of the disease by MELD and CTP score. Trace elements (Zn, Se, Cu, Ca, Fe, Mg and Mn) in plasma were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Statistical analysis was performed using Mann-Whitney test.

Results: - According to the nutritional assessment 19 (61.3%) were malnourished and 12 (38.7%) were overweight. Regarding disease severity 12 (39%) were classified as Child A, 17 (55%), Child B and 2 (6%) Child C, with 46.9% of patients with MELD score >17. The trace element analysis indicated that 31 (100%) had Mn levels above the reference range, 23 (74.2%) low levels of Cu, 29 (93.5%) with deficiency of Se, and 31 (100%) low levels of Ca and Mg. Disease severity did not show statistical difference between the studied trace elements, in contrast to the nutritional status, in which the malnourished group showed higher levels of Mn (P=0.01) and Fe (P=0.01) and low levels of Zn (P=0.03) when compared to the overweight group.

Conclusion: - The results showed that the trace elements in plasma are altered in chronic liver disease; without significant correlation to disease severity, but correlated to nutritional status. Malnutrition is present in the patients studied, nonetheless a new scenario with an increase in the prevalence of overweight was verified regardless of the degree of hepatic decompensation.

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Source
http://dx.doi.org/10.1590/S0004-28032016000200006DOI Listing

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