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McHutchison, J.G., Dusheiko, G., Shiffman, M.L., Ro-driguez-Torres, M., Sigal, S., Bourliere, M., Berg, T., Gordon, S.C., Campbell, F.M., Therdore, D., Blackman, N., Jenkins, J. and Afdhal, N.H. (2007) TPL102357 Study group, Eltrombopag for thrombocytopenia in pa-tients with cirrhosis associated with hepatitis C. New England Journal of Medicine, 357, 2227-2236. doi:10.1056/NEJMoa073255

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• TITLE: Effect of zinc supplementation in patients with type C liver cirrhosis

  AUTHORS: Kazuhiro Katayama, Mitsuru Sakakibara, Kazuho Imanaka, Kazuyoshi Ohkawa, Takashi Matsunaga, Masafumi Naito, Toshifumi Ito

  KEYWORDS: Hepato-Carcinogenesis; Trace Element; Protein Metabolism

  JOURNAL NAME: Open Journal of Gastroenterology, Vol.1 No.2, November 17, 2011

  ABSTRACT: Zinc is often deficient in patients with liver cirrhosis, and treatment with zinc provides short-term improvement in protein metabolism. However, the long-term effects of zinc have not been fully clarified. The present study aimed to analyze the effect of zinc on the long-term clinical course, especially hepatocarcinogenesis, in type C liver cirrhosis. Am- ong patients with type C liver cirrhosis visiting our hospital between June 1998 and January 2009, th- ose with a serum albumin level ≤3.5 g/dL and a serum zinc level ≤70 μg (1.07 μmol)/dL were selected. Thirty-seven patients were randomly divided into 2 groups: group B (12 g/day branched-chain amino acid granules) and group BZ (same as group B plus 100 mg/day - 600 mg/day zinc sulfate or 150 mg/day - 225 mg/day polaprezinc). Multivariate analysis revealed that the administration of zinc was not a significant determinant, but pretreatment serum zinc levels (hazard ratio [HR], 0.921; 95% confidence interval [CI], 0.853–0.994) and serum zinc levels less than 80 μg (1.22 μmol)/dL 12 months after beginning this study (HR, 6.866; 95% CI, 1.399 - 33.707) were significant determinants of carcinogenesis and death. Serum albumin levels in patients whose serum zinc levels had not increased up to 80 μg/dL by the third year of this study were significantly lower (p = 0.023) than those of patients that had increased up to 80 μg/dL. Conclusions: In type C liver cirrhosis with zinc deficiency, administration of zinc does not improve cancer-free survival. However, serum zinc levels can predict outcomes in patients with type C liver cirrhosis. However, although zinc may play a role in hepatocarcinogenesis, the precise implications remain to be clarified.