The Correlation between Serum Zinc Level and Liver Histology in Non-Alcoholic Steatohepatitis

Farid Kosari, Raika Jamali, Tayeb Ramim, Ebrahim Mosavi Jahan Abad, Farid Kosari, Raika Jamali, Tayeb Ramim, Ebrahim Mosavi Jahan Abad

Abstract

Background & objective: The aim of this present study was to assess the relationship between serum zinc levels and liver histopathological findings in non-alcoholic steatohepatitis (NASH) patients.

Methods: This case-control study was performed in consecutively selected NASH patients who had been referred to a general hospital. The control group consisted of age and sex-matched individuals with normal physical examinations, laboratory findings, and liver ultrasounds. Serum zinc level was measured using atomic absorption spectrophotometry. Liver histopathological findings were determined based on non-alcoholic fatty liver activity score.

Results: A cohort of eighty biopsy-proven NASH patients and eighty controls were enrolled in the study. The mean serum zinc level was significantly lower in the NASH group compared with the controls. The mean serum zinc concen- tration was significantly lower in moderate and severe lobular inflammation groups than the mild group. After multiple adjustments for potential contributing variables, serum zinc level was associated with the severity of lobular inflam- mation. Nonetheless, it was not associated with liver steatosis and fibrosis. A serum zinc value of 89 (µg/dl) yielded a sensitivity and specificity of 93% and 86%, respectively, characterizing patients with lobular inflammation of less than two inflammatory foci per high-power field (HPF) from more advanced groups. Furthermore, a value of 79.55 (µg/dl) yielded a sensitivity and specificity of 87% and 100%, respectively, distinguishing those with a lobular inflammation grade of less than four foci per HPF from more advanced cases.

Conclusion: Serum zinc level might be associated with the severity of lobular inflammation in NASH.

Keywords: Fibrosis; Lobular inflammation; Non-alcoholic Fatty Liver Disease Zinc; Oxidative stress.

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
The frequency of liver histology findings in subjects with non-alcoholic steatohepatitis. Steatosis grades (Top), in- flammation grades based on foci of lobular inflammation in high power field (HPF) of microscopic view (Middle), and fibrosis stages (Bottom)
Figure 2
Figure 2
Receiver operating characteristic (ROC) analysis to determine threshold values of serum zinc for differentiating lobular inflammation severity

References

    1. Jamali R. Non-Alcoholic Fatty Liver Disease: Diagnosis and Evaluation of Disease Severity. Thrita. 2013;2:43–51.
    1. Jamali R, Khonsari M, Merat S, Khoshnia M, Jafari E, Bahram Kalhori A, et al. Persistent alanine aminotransferase elevation among the general Iranian population: prevalence and causes. World J Gastroenterol. 2008;14:2867–2871.
    1. Razavizade M, Jamali R, Arj A, Talari H. Serum parameters predict the severity of ultrasonographic findings in non-alcoholic fatty liver disease. Hepatobiliary Pancreat Dis Int. 2012;11:513–520.
    1. Jamali R, Arj A, Razavizade M, Aarabi MH. Prediction of Nonalcoholic Fatty Liver Disease Via a Novel Panel of Serum Adipokines. Medicine (Baltimore) 2016;95:e2630.
    1. Jamali R, Hatami N, Kosari F. The Correlation Between Serum Adipokines and Liver Cell Damage in Non-Alcoholic Fatty Liver Disease. Hepat Mon. 2016;16:e37412.
    1. Jamali R, Razavizade M, Arj A, Aarabi MH. Serum adipokines might predict liver histology findings in non-alcoholic fatty liver disease. World J Gastroenterol. 2016;22:5096–103.
    1. Koruk M, Taysi S, Savas MC, Yilmaz O, Akcay F, KarakokM Oxidative stress and enzymat- ic antioxidant status in patients with nonalcoholic steatohepatitis. Ann Clin Lab Sci. 2004;34:57–62.
    1. He J, Hu B, Shi X, Weidert ER, Lu P, Xu M, et al. Activation of the aryl hydrocarbon receptor sensitizes mice to non- alcoholic steatohepatitis by deactivating mitochondrial sirtuin deacetylase Sirt3. Mol Cell Biol. 2013;33:2047–55.
    1. Stanković MN, Mladenović D, Ninković M, Ethuričić I, Sobajić S, Jorgačević B, et al. The effects of α-lipoic acid on liver oxidative stress and free fatty acid composition in methionine-choline deficient diet-induced NAFLD. J Med Food. 2014;17:254–61.
    1. Takami Y, Uto H, Tamai T, Sato Y, Ishida Y, Morinaga H, et al. Identification of a novel biomarker for oxidative stress induced by hydrogen peroxide in primary human hepatocytes using the 2-nitrobenzenesulfenyl chloride isotope label- ing method. Hepatol Res. 2010;40(4):438–45.
    1. Jamali R, Pourshams A, Amini S, Deyhim MR, Rezvan H, Malekzadeh R. The upper normal limit of serum alanine aminotransferase in Golestan Province, northeast Iran. Arch Iran Med. 2008;11:602–607.
    1. Razavizade M, Jamali R, Arj A, Matini SM, Moraveji A, Taherkhani E. The effect of pioglitazone and metformin on liver function tests, insulin resistance, and liver fat content in nonalcoholic Fatty liver disease: a randomized double blinded clinical trial. Hepat Mon. 2013;13:e9270.
    1. Jamali R, MofidA , Vahedi H, Farzaneh R, Dowlatshahi S. Theeffect of helicobacter pylori eradication on liver fat content in subjects with non-alcoholic Fatty liver disease: a randomized open-label clinical trial. Hepat Mon. 2013;13:e14679.
    1. Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, et al. Nonalcoholic Steatohepatitis Clinical Research Network Design and validation of a histological scoring system for nonalcoholic fatty liver dis- ease. Hepatology. 2005;41:1313–1321.
    1. Yilmaz Y, Yonal O, Eren F, Kurt R, Celikel CA, Ozdogan O, et al. Serum zinc-α2-glycoprotein con- centrations in patients with non-alcoholic fatty liver disease. Clin Chem Lab Med. 2011;49:93–7.
    1. Kolachi NF, Kazi TG, Afridi HI, Kazi N, Kandhro GA, Shah AQ, et al. Distribution of copper, iron, and zinc in biological samples (scalp hair, serum, blood, and urine) of Pakistani viral hepatitis (A-E) patients and controls. Biol Trace Elem Res. 2011;143:116–30.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren