Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;11(9):OC25-OC28.
doi: 10.7860/JCDR/2017/26519.10655. Epub 2017 Sep 1.

Correlation of Trace Elements in Patients of Chronic Liver Disease with Respect to Child- Turcotte- Pugh Scoring System

Amit Agarwal  1 , Shilpa Avarebeel  2 , Narendra S Choudhary  3 , Mohan Goudar  4 , C J Tejaswini  5
Affiliations

Correlation of Trace Elements in Patients of Chronic Liver Disease with Respect to Child- Turcotte- Pugh Scoring System

Amit Agarwal et al. J Clin Diagn Res. 2017 Sep.

Abstract

Introduction: Zinc, copper, manganese and magnesium are essential trace elements whose role in chronic liver disease and its complications is not clear.

Aim: To study the concentration of these elements in patients with Chronic Liver Disease (CLD) with respect to Child-Torcotte-Pugh (CTP) scoring.

Materials and methods: This was an observational study carried out in the Department of Medicine, JSS Hospital, Mysore, India, between October 2013 and October 2015. A total of 75 patients with cirrhosis were prospectively enrolled. Severity of liver disease was assessed based on CTP score and patients were grouped into Class A, B and C. Routine investigations were done and following trace elements were assessed in all-zinc, copper, manganese and magnesium.

Results: The serum concentrations of zinc decreased with severity of liver disease, and the mean difference between different severity classes was statistically significant (p<0.001). There was a significant negative correlation between zinc and CTP Score (r= -0.439; p<0.001). Copper concentration was increased in patients with more severe cirrhosis and mean level difference of copper among the CTP groups were statistically significant (p<0.001). Moreover, copper showed significant positive correlation with CTP Score (r=0.385; p<0.001). The serum levels of manganese were significantly higher in patients with CTP C class in comparison to patients with CTP A and B class (p<0.05); Manganese showed significant positive correlation with CTP Score (r=0.271; p= 0.019). The concentrations of magnesium did not differ significantly between CTP class with the mean level difference not statistically significant.

Conclusion: Increasing liver dysfunction alters the metabolism of trace elements towards excess of copper and deficiency of zinc.

Keywords: Cirrhosis; Copper; Magnesium; Manganese; Zinc.

PubMed Disclaimer

Figures

[Table/Fig-2]:
[Table/Fig-2]:
Spearmen correlation between zinc and CTP Score.
[Table/Fig-3]:
[Table/Fig-3]:
Spearmen correlation between copper and CTP Score.
[Table/Fig-4]:
[Table/Fig-4]:
Spearmen correlation between manganese and CTP Score.
See this image and copyright information in PMC

References

    1. Rashmi RS, Rockey DC. Complications and outcomes in chronic liver disease. J. Current Opinion Gastroent. 2011;27(3):204–09. - PubMed
    1. McClain CJ, Marsano L, Burk RF, Bacon B. Trace metals in liver disease. J. Seminar in liver disease. 1991;11(4):321–34. - PubMed
    1. Worwood M, Taylor DM, Hunt AH. Copper and Manganese concentration in biliary cirrhosis of liver. British Medical Journal. 1986;3:344–46. - PMC - PubMed
    1. Ozsoylu S, Kocak N, Akgun N. Zinc deficiency in cirrhosis. Gut. 1991;32(4):458. - PMC - PubMed
    1. HF Goode, Kelleher J, Walker BE. Relation between zinc status and hepatic functional reserve in patients with liver disease. Gut. 1990;31(6):694–97. - PMC - PubMed

LinkOut - more resources