Abstract | OBJECTIVE: To our knowledge, no randomized study has shown whether zinc replacement therapy is effective for hyperammonemia in liver cirrhosis; therefore, we performed a double-blind, placebo-controlled trial to examine efficacy and safety of the zinc replacement therapy. METHODS: Patients with liver cirrhosis and hyperammonemia (at or above the institutional reference value) and hypozincemia (≤65 μg/dL) were enrolled in the outpatient units of the participating institutions and were randomly divided to receive placebo (P group) or zinc acetate preparation at a dose of 3 capsules/d for a total zinc content of 150 mg/d (Z group) by the envelope method. Of the 18 enrolled patients, 6 dropped out; thus, the analyses included 12 patients (5 in the P group and 7 in the Z group). Variations in blood concentrations of zinc and ammonia as well as liver function test results were compared. RESULTS: Blood zinc levels significantly increased in the Z group (P = 0.0037; Friedman test) but not the P group. Blood ammonia levels significantly decreased in the Z group (P = 0.0114; Friedman test) but not the P group. The percent change in blood ammonia level also revealed significant reduction at the eighth week in the Z group (P = 0.0188: Mann-Whitney test). No serious adverse events attributable to the zinc preparation were noted. CONCLUSION: Although this study is preliminary and includes a small sample, it is, to our knowledge, the first randomized controlled trial to show that zinc supplementation for 3 mo seems effective and safe for treating hyperammonemia in liver cirrhosis. Studies with a larger sample size are needed to confirm our findings.
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Authors | Kazuhiro Katayama, Masanori Saito, Takumi Kawaguchi, Ryujin Endo, Kei Sawara, Shuhei Nishiguchi, Akinobu Kato, Hiroshi Kohgo, Kazutomo Suzuki, Isao Sakaida, Yoshiyuki Ueno, Daiki Habu, Toshifumi Ito, Hisataka Moriwaki, Kazuyuki Suzuki |
Journal | Nutrition (Burbank, Los Angeles County, Calif.)
(Nutrition)
2014 Nov-Dec
Vol. 30
Issue 11-12
Pg. 1409-14
ISSN: 1873-1244 [Electronic] United States |
PMID | 25280421
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2014 Elsevier Inc. All rights reserved. |
Chemical References |
- Trace Elements
- Ammonia
- Zinc Acetate
- Zinc
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Topics |
- Aged
- Aged, 80 and over
- Ammonia
(blood)
- Dietary Supplements
- Double-Blind Method
- Female
- Humans
- Hyperammonemia
(blood, drug therapy, etiology)
- Liver Cirrhosis
(blood, complications, drug therapy)
- Male
- Middle Aged
- Trace Elements
(blood, pharmacology, therapeutic use)
- Treatment Outcome
- Zinc
(blood, deficiency, pharmacology, therapeutic use)
- Zinc Acetate
(pharmacology, therapeutic use)
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