Relationship of blood trace elements to liver damage, nutritional status, and oxidative stress in chronic nonalcoholic liver disease

Trace elements are involved in chronic liver diseases because these element s may have a direct hepatic toxicity or may be decreased as a consequence o f the impaired liver function, particularly in patients with alcoholic cirr hosis and/or malnutrition. In this study, we determined plasma and erythroc ytes trace elements in 50 inpatients with nonalcoholic chronic liver diseas e (11 with biopsy-proven chronic hepatitis, 39 with cirrhosis [16 in stage A according to Child-Pugh criteria, 23 Child B+C]), and in a control group of 10 healthy subjects by the proton induced x-ray emission method. The rel ationship between trace element concentration and the extent of liver damag e, the nutritional status (by anthropometric evaluations), and various bloo d markers of oxidative stress-reduced glutathione, total lipoperoxides and malonyldialdehyde-was investigated. We found that cirrhotics had a signific ant decrease of Fe, Zn, Se, and GSH levels in the plasma and of GSH and Se in the erythrocytes with respect to the control and chronic hepatitis group s. GSH levels were related to the degree of liver damage; a significant dir ect correlation was observed among Se, Zn, and GSH plasma values and betwee n GSH and Se in the erythrocytes. The trace element decrease was, on the co ntrary, independent of the degree of liver function impairment and only par tially affected by the nutritional status. Data indicate that liver cirrhos is, even if not alcohol related, induces a decrease of Se and Zn and that, in these patients, an oxidative stress is present, as documented by the sig nificant correlation between Se and GSH. The plasma Br level was higher in cirrhotics with respect to the control and chronic hepatitis groups.