Status of essential trace minerals and oxidative stress in viral hepatitis C patients with nonalcoholic fatty liver disease

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) may be an important factor leading to altered trace mineral homeostasis, thereby accelerating the progression of hepatitis C virus (HCV) infection. Our aim was to determine whether NAFLD influenced the status of certain essential trace minerals and oxidative stress in chronic HCV-infected patients.

Design and methods: Blood biochemical parameters were determined in a group of 30 healthy, non-obese, non-diabetic participants (CNL group), and hepatitis C patients without NAFLD (HCV group, n = 30) and with NAFLD (HCV-NAFLD group, n = 32).

Results: Concentrations of thiobarbituric acid reactive substances (TBARS; a measure of oxidative stress), C-reactive protein (CRP), ferritin, aminotransferases, lipid profiles, and insulin metabolism were markedly abnormal in both patient groups than in CNL subjects. Compared to patients in the HCV group, those with HCV-NAFLD group had lower high-density lipoprotein concentrations, higher low-density lipoprotein and homeostasis model assessment-insulin resistance (HOMA-IR) values, disrupted antioxidant enzyme activities, and elevated TBARS concentrations, as well as decreased plasma concentrations of trace minerals zinc (Zn) and selenium (Se) and increased copper (Cu). The alterations in mineral homeostasis were also linked to TBARS, CRP, ferritin, lipoproteins, and HOMA-IR values in the HCV-NAFLD group.

Conclusions: There is a progressive deterioration in the homeostasis of minerals (Zn, Se, and Cu) in HCV-NAFLD patients, which may reflect greater oxidative stress and inflammation. These results suggest that the disturbance in mineral metabolism by NAFLD has an impact on the effectiveness of treatment for chronic HCV infection.

Keywords: chronic hepatitis C; essential trace minerals; inflammation; nonalcoholic fatty liver disease; oxidative stress.

Figure 1

Plasma concentrations of essential metals (A)Cu, (B)Zn, (C)Se, lipid peroxidation byproduct (D)TBARS, and erythrocyte antioxidant enzymes (E)SOD and (F)GPx activities in HCV-NAFLD patients. Bars are mean (SD) or median (IQR). Values above the box plots are outliers. Bars with different superscripts are significantly different (p < 0.05). HCV-NAFLD = hepatitis C patients with non-alcoholic fatty liver disease. Cu= copper; Zn = zinc; Se = selenium; TBARS = thiobarbituric acid reactive substances; SOD = superoxide dismutase; GPx = glutathione peroxide.