Trace element deficiency is highly prevalent and associated with infection and mortality in patients with alcoholic hepatitis.
Level 3 - non-randomized controlled study
Cohort study evaluating prognostic associations across clinical cohorts
PubMed 32573823 · doi:10.1111/apt.15880
What was done
Serum trace element concentrations were measured by inductively coupled plasma mass spectrometry in 302 patients with alcoholic hepatitis, 46 with alcohol-related cirrhosis, and 15 healthy controls pooled from clinical trials, cohort studies, and a biobank. Multivariate logistic regression was used to evaluate associations between trace element levels and the development of infection within 90 days and mortality within 28 and 90 days.
What was found
Zinc deficiency (85%) and selenium deficiency (67%) were more prevalent in alcoholic hepatitis than in alcohol-related cirrhosis (72%, p=0.04 and 37%, p<0.001, respectively). Concentrations of zinc, selenium, copper, and chromium differed significantly between groups. Iron deficiency independently predicted infection within 90 days, while zinc deficiency predicted mortality at 28 and 90 days (effect sizes and confidence intervals were not reported in the abstract).
Why it matters
These findings highlight widespread trace element depletion in alcoholic hepatitis and identify zinc and iron deficiencies as potential prognostic markers and targets for therapeutic supplementation trials.
Limits
The observational design cannot establish whether trace element deficiencies are causal or markers of severe liver failure. Comparator groups were relatively small (n=46 and n=15), and specific effect sizes, odds ratios, and confidence intervals were not provided in the abstract.
Cited by
- supports Between 30% and 50% of people with alcohol use disorder have low zinc status.