Clinical trial: oral zinc in hepatic encephalopathy

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http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04448.x/abstract;jse\

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Clinical trial: oral zinc in hepatic encephalopathy

Y. Takuma1,2, K. Nouso3, Y. Makino2, M. Hayashi4, H. Takahashi2Article first

published online: 3 SEP 2010

DOI: 10.1111/j.1365-2036.2010.04448.x

© 2010 Blackwell Publishing Ltd

Issue

Alimentary Pharmacology & Therapeutics

Early View (Articles online in advance of print)

Summary

Background 

Hepatic encephalopathy has a negative effect on patient health-related quality

of life (HRQOL). Zinc supplementation has been effective with regard to altered

nitrogen metabolism.

Aim 

To investigate the effectiveness of oral zinc supplementation on hepatic

encephalopathy and HRQOL.

Methods 

Seventy-nine cirrhotic patients with hepatic encephalopathy were randomized to

receive 225 mg of polaprezinc in addition to standard therapies of a

protein-restricted diet including branched-chain amino acid and lactulose, or to

continue only standard therapies for 6 months. The change of HRQOL by Short

Form-36, hepatic encephalopathy grade, laboratory parameters, and

neuropsychological (NP) tests were compared at baseline and at 6 months. We also

evaluated via multivariate analysis whether zinc supplementation and clinical

variables correlated with the changes in physical component scale (PCS) and

mental component scale (MCS) between the two visits.

Results 

Zinc supplementation significantly improved the PCS (P = 0.04), but not the MCS

(P = 0.95). Zinc supplementation significantly decreased hepatic encephalopathy

grade and blood ammonia levels (P = 0.03 and P = 0.01), and improved Child-Pugh

score and NP tests compared with standard therapy (P = 0.04 and P = 0.02). In

multivariate analysis, zinc supplementation was significantly associated with

improvement in PCS (P = 0.03), whereas it was not significantly associated with

change in MCS (P = 0.98).

Conclusion 

Zinc supplementation is effective in hepatic encephalopathy and consequently

improves patients HRQOL.