Malnutrition is normally seen in patients with alcohol-related liver disease. Trace elements such as cobalt, copper, iron, selenium and zinc are crucial for several cellular processes including antioxidant pathways. The prevalence and significance of trace element deficiency in alcoholic hepatitis is not clearly understood.

A study was therefore designed to ascertain the prevalence of trace element deficiency and its association with clinical outcomes among alcoholic hepatitis patients.

Serum was obtained from patients with alcoholic hepatitis, alcohol-related cirrhosis and healthy volunteers. Investigators quantified the trace element concentration using inductively coupled plasma mass spectrometry. The link between trace element levels and development of infection within 90 days and mortality within 28 and 90 days was determined.

Sera were obtained from 302 patients with alcoholic hepatitis, 46 with alcohol-related cirrhosis and 15 healthy controls and were subjected to an evaluation for trace element levels. The prevalence of zinc deficiency was 85% and that of selenium deficiency was 67% in alcoholic hepatitis patients. It was found to be higher in patients with alcoholic hepatitis as compared to patients with alcohol-related cirrhosis (72% and 37%, respectively). Zinc, chromium, copper and selenium were shown to be significantly different between the groups. Iron deficiency predicted infection within 90 days while zinc deficiency appeared to predict mortality within 28 and 90 days.

Trace element deficiency was found to have a high prevalence in patients with alcoholic hepatitis and was associated with infection and mortality. Supplementation with certain trace elements could possibly enhance clinical outcomes in these patients. 

Source: Aliment Pharmacol Ther. 2020 Aug;52(3):537-544.