Effect of zinc on liver cirrhosis with hyperammonemia: a preliminary randomized, placebo-controlled double-blind trial.

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.

• 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)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Trace Elements
• Ammonia
• Zinc Acetate
• Zinc

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)