ORAL ZINC SUPPLEMENTATION IMPROVES HEPATIC ENCEPHALOPATHY: Results of a Randomised Controlled Trial Management of hepatic encephalopathy with oral zinc supplementation: a long-term treatment. The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial The effect of zinc supplementation on the treatment of chronic hepatitis C patients with interferon and ribavirin. Triple therapy of interferon and ribavirin with zinc supplementation for patients with chronic hepatitis C: a randomized controlled clinical trial. Effect of zinc supplementation on viral response in patients with chronic hepatitis C and Beta thalassemia major, a pilot study. Zinc supplementation prevents the increase of transaminase in chronic hepatitis C patients during combination therapy with pegylated interferon alpha-2b and ribavirin. Zinc supplementation enhances the response to interferon therapy in patients with chronic hepatitis C. Zinc supplementation therapy improves the outcome of patients with chronic hepatitis C Double-blind randomized clinical trial comparing neomycin and placebo in the treatment of exogenous hepatic encephalopathy. Oral Zinc Supplementation Reduces the Erythropoietin Responsiveness Index in Patients on Hemodialysis Preliminary study of combination therapy with interferon-α and zinc in chronic hepatitis C patients with genotype 1b A controlled trial on utility of oral zinc supplementation in acute dehydrating diarrhea in infants. Effects of low dose zinc supplementation on biochemical markers in non-alcoholic cirrhosis: a randomized clinical trial. Randomised controlled trial of zinc supplementation in malnourished Bangladeshi children with acute diarrhoea Effects of zinc and multimineral vitamin supplementation on glycemic and lipid control in adult diabetes Zinc supplementation during pregnancy: zinc concentration of serum and hair from low-income women of Mexican descent. [Tolerance of large doses of oral zinc sulfate]. Effect of hypotensive therapy combined with modified diet or zinc supplementation on biochemical parameters and mineral status in hypertensive patients. Effect of oral zinc supplementation on the growth of preterm infants Zinc and the healing of chronic leg ulcers. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: interactions between iron and zinc. Effects of zinc supplementation on 1- to 5-year old children.
22 cirrhotic patients with chronic encephalopathy were given oral zinc supplementation or placebo in a double-blind r and omised trial . In the group which received zinc acetate 600 mg a day for 7 days , serum zinc had been restored to normal by day 8 . On day 8 hepatic encephalopathy , as assessed by a trailmaking test , was improved in the supplemented group but not in the placebo group . There was also a significant increase in blood urea nitrogen in the supplemented group . Short-term oral zinc supplementation probably improved hepatic encephalopathy by correcting the zinc deficiency that compromises conversion of ammonia to urea . The duration of this improvement requires further investigation OBJECTIVES The effect of long-term oral zinc supplementation , in addition to st and ard therapy ( protein-restricted diet and lactulose ) on recurrent hepatic encephalopathy , was assessed in a double-blind study . METHODS Ninety cirrhotic patients with stable recurrent hepatic encephalopathy , after following a one month period of st and ard therapy , were r and omized to receive oral zinc acetate supplementation ( 600 mg/day ) in addition to st and ard therapy or to continue only st and ard therapy ( a diet containing 0.8 g/kg/day of protein and 90 g/day of lactulose ) for six months . Psychometric tests , NCT ( number correction test ) and PSE ( portal-systemic encephalopathy ) Index , were used to evaluate the degree of hepatic encephalopathy , both at the beginning and the end of each treatment period . RESULTS Oral zinc supplementation in addition to st and ard therapy was able to normalize serum zinc levels .  The patients who never showed clinical signs of hepatic encephalopathy during the trial were 88.6 % in zinc-group and 86 % in only st and ard therapy group . Psychometric tests , NCT and PSE Index , were statistically better than basal values either in zinc-group or in only st and ard therapy group . CONCLUSIONS Final values of psychometric tests were better in zinc-group than only st and ard therapy group but the differences were not statistically significant Background : Minimal hepatic encephalopathy ( MHE ) has a far-reaching impact on quality and function ability in daily life and may progress to overt hepatic encephalopathy . There is a synergistic effect between systemic oxidative stress and ammonia that is implicated in the pathogenesis of hepatic encephalopathy . The aim of this study is to investigate the effectiveness of oral supplementation of antioxidants and zinc gluconate on MHE versus lactulose . Methods : Our study included 58 patients with cirrhosis diagnosed as having MHE by neuropsychometric tests , including  number connection test part A ( NCT-A ) , digit symbol test ( DST ) and block design tests ( BDTs ) . Patients were r and omized to receive 175 mg zinc gluconate , 50,000 IU vitamin A , 500 mg vitamin C and 100 mg vitamin E once daily plus lactulose , dose 30–60 ml/day for 3 months [ group A ( n = 31 ) ] or initiated and maintained on lactulose dose 30–60 ml/day for 3 months [ group B ( n = 27 ) ] . Neuropsychometric tests and laboratory investigations were repeated after 3 months of therapy . Results : Compared with the baseline neuropsychometric tests , a significant improvement was reported in patients with MHE after 3 months of antioxidant and zinc therapy ( group A ) versus patients with lactulose therapy ( group B ) ( NCT-A , p < 0.001 ; DST , p = 0.006 ; BDT , p < 0.001 ) . Antioxidant and zinc supplementation significantly decreased arterial ammonia level , alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) ( p < 0.001 ) and improved Child – Pugh score in MHE after 3 months of therapy ( p= 0.024 ) . Conclusion : Antioxidant and zinc supplementation can improve MHE in patients with liver cirrhosis OBJECTIVES To evaluate the effects of zinc supplementation on serum zinc and copper levels , and the severity of adverse reactions and virologic responses in chronic hepatitis C patients undergoing interferon (IFN)/ribavirin therapy . DESIGN AND METHODS Forty subjects were r and omly assigned to receive IFN-alpha-2a/ribavirin with or without zinc gluconate for 24 weeks , then a period of 6 months for follow-up . Twenty healthy controls were also enrolled in the study . Blood sample s were collected at different time points during therapy and at 6 months after the completion of therapy and were analyzed for zinc and copper levels . The adverse reactions and the virologic responses were also examined accordingly . RESULTS Serum zinc levels were significantly lower in chronic hepatitis C patients than in healthy controls and further depressed by IFN/ribavirin treatment . However , serum zinc levels in patients were remediable by zinc supplements . No apparent difference was seen in virologic responses between subjects with or without zinc supplements , but certain adverse side effects associated with the zinc therapy were significantly decreased . CONCLUSIONS Zinc supplementation may be a complementary therapy in chronic hepatitis C patients to increase the tolerance to IFN-alpha-2a and ribavirin AIM To study the therapeutic effect of interferon ( IFN ) and ribavirin with zinc supplement on patients with chronic hepatitis C viral ( HCV ) infection . METHODS A total of 102 patients confirmed histologically to have chronic HCV infection with genotype 1b and more than 100 KIU/mL of HCV were r and omly assigned to each arm of the study and each received 10 million units of pegylated interferon ( IFN-alpha-2b ) daily for 4 wk followed by the same dose every other day for 20 wk plus ribavirin ( 600 or 800 mg/d depending on body weight ) , with or without polaprezinc ( 150 mg/d ) orally for 24 wk . The primary endpoint was sustained virological response ( SVR ) defined as negative HCV-RNA in the serum 6 mo after treatment . RESULTS There were no differences in the clinical background between the two groups except for more females in the dual therapy group than in the other group ( P<0.05 ) . SVR was observed in 33.3 % of the triple therapy group and 33.3 % of the dual therapy group . The side effects were almost the same in both groups except for gastrointestinal symptoms , which were less in the triple therapy group ( P=0.019 ) . CONCLUSION Considered together , triple therapy of zinc plus IFN and ribavirin for HCV infection patients with genotype 1b and high viral load is not better than dual therapy except for lower incidence of gastrointestinal side effects INTRODUCTION Zinc deficiency has been reported in patients with both hepatitis C and beta thalassemia major .  Zinc supplementation in addition to antiviral therapy of chronic hepatitis C has been accompanied by some success in patients with chronic hepatitis C. OBJECTIVE The aim of the present pilot study is to determine the effect of 30 mg elemental zinc on biochemical and virological response in a population of patients with chronic hepatitis C with beta thalassemia major . MATERIAL S AND METHODS A prospect i ve , double blind , placebo controlled trial included 40 patients being treated with Pegylated interferon Alfa ( Peg IFN-α ) and ribavirin .  Biochemical and virological parameters and plasma zinc levels were determined before starting treatment . Patients were r and omly selected to receive either zinc or a placebo in addition to Peg IFN-α and ribavirin for a period of one year . AST , ALT , sustained viral response ( SVR ) , and zinc levels were measured after treatment . Of the original 40 eligible patients , eight withdrawn from the study and 32 patients completed the study ; 16 in the zinc group and 16 in the placebo group . Analysis of the data shows that there is no difference between the two groups in AST , ALT , SVR or zinc level following one year of treatment ( p=0.224 , p=0.616 , p=0.670 , p=0.999 , respectively ) . CONCLUSION The results of this study indicate that using 30 mg/day elemental zinc did not significantly improve the outcome of treatment in thalassemia patients with chronic hepatitis C. In future studies , we recommend trying higher doses zinc in patients with hepatitis C who had beta thalassemia major We investigated the effects of zinc supplementation on clinical observations in chronic hepatitis C patients receiving pegylated interferon ( PEG-IFN ) alpha-2b plus ribavirin combination therapy . Patients were r and omly allocated to receive 150 mg polaprezinc ( zinc group , n=11 ) or no supplement ( control group , n=12 ) daily in addition to PEG-IFN alpha-2b plus ribavirin therapy and 300 mg vitamin E and 600 mg vitamin C supplementation daily for 48 wk . Among the patients who continued treatment , the serum alanine aminotransferase ( ALT ) level at 12 wk in the zinc group was significantly lower than that in the control group . All patients in the zinc group ( 9/9 ) and 67 % ( 8/12 ) of the control patients at 24 wk , and all patients in the zinc group ( 7/7 ) and 60 % ( 6/10 ) of the control patients at 48 wk showed a decrease in serum ALT levels to within the normal range ( 7 - 44 U/L ) . HCV RNA disappeared in all patients ( 7/7 ) in the zinc group and in 8 of 10 control patients at 48 wk . Polaprezinc supplementation decreased plasma thiobarbituric acid reactive substances and prevented the decrease of polyunsaturated fatty acids of erythrocyte membrane phospholipids . No significant differences were observed in the dosage of medicines or other clinical data during the treatment . These observations indicate that polaprezinc supplementation may have induced some antioxidative functions in the liver which result ed in reduced hepatocyte injury during PEG-IFN alpha-2b plus ribavirin therapy We evaluated the synergistic effect of zinc supplementation on the response to interferon ( IFN ) therapy  in patients with intractable chronic hepatitis C in a pilot study using natural IFN-alpha with or without zinc . No clinical differences were observed between patients treated with IFN alone ( n=40 ) and IFN with polaprezinc ( IFN + Zn , n=35 ) . All patients were positive for HCV genotype Ib and had more than 105 copies of the virus/mL serum .  Ten million units of natural IFN-alpha was administered daily for 4 weeks followed by the same dose every other day for 20 weeks . In the IFN + Zn group , patients received an additional dose of 150 mg/day polaprezinc orally throughout the 24-week IFN course . No additional side-effects of polaprezinc  were noted but four out of 40 IFN alone treatment and three out of 35 IFN + Zn group withdrew because of side-effects . Complete response ( CR ) was defined as negative HCV RNA in the serum on PCR and normal aminotransferase level 6 months after therapy . Incomplete response ( IR ) was normal liver enzyme and positive serum HCV RNA . Both of them were evaluated at the 6 months after the completion of the treatment . Patients with higher levels of serum HCV ( more than 5 x 105 copies/mL ) had little response in both treatment groups . Patients with moderate amount of HCV ( 105 to 4.99 x 105/mL ) showed high response rates in combination group ( CR : 11/27 , 40.7 % ; CR + IR 15/27 , 64.3 % ) , better than IFN alone ( CR : 2/15 , 18.2 % ; CR + IR : 2/15 , 18.2 % ) . Serum zinc levels were higher in patients with IFN + Zn group than in the IFN group . Our results indicate that zinc supplementation enhances the response to interferon therapy  in patients with intractable chronic hepatitis We administered zinc supplementation therapy over three years to patients with chronic hepatitis C and reported and that the aspartate aminotransferase ( AST ) and alanine aminotaransferase ( ALT ) levels decreased , and platelet counts increased , significantly in the group with increased serum zinc concentrations . We are continuing this treatment to clarify the long-term consequences and report here the changes in serum zinc concentrations over seven years and compare the cumulative incidence of hepatocellular carcinoma ( HCC ) . We administered polaprezinc to 32 patients , r and omly selected for zinc therapy ( treatment group ) , while another 30 formed the control group . We measured the serum zinc and albumin concentrations and conducted a prospect i ve study to determine long-term outcomes . The changes and rates of change of serum zinc concentrations after seven years were 76.7 ± 18.2 µg/dl and + 0.302 ± 0.30 % in the treatment group and 56.7 ± 12.4 µg/dl and + 0.033 ± 0.21 % in the control group and had increased significantly ( p = 0.0002 , p = 0.0036 ) . Progression of liver disease seemed to vary , depending on serum albumin concentrations . In the group with baseline serum albumin concentrations of 4.0 g/dl or more , the change and rate of change of serum zinc concentrations increased significantly , and the cumulative incidence of HCC tended to decrease , in the treated group . According to multivariate analysis , the factors that contribute to a reduction in the incidence of HCC are  zinc therapy ( risk ratio : 0.113 , 95 % CI : 0.015–0.870 , p = 0.0362 ) , and platelet counts ( 0.766 , 0.594–0.989 , 0.0409 ) . Zinc supplementation therapy seems to improve liver pathology and reduce the incidence of HCC Hepatic encephalopathy due to cirrhosis is frequently precipitated by exogenous factors , and the effectiveness of a specific treatment with neomycin sulfate has so far not been su bmi tted to clinical trials . Over a period of five years , 102 cirrhotic patients developed hepatic encephalopathy at admission or during hospitalization , and 39 were r and omized for treatment with either neomycin sulfate or placebo .  Exclusion criteria were : 1 . current usage of specific treatment for hepatic encephalopathy , 2 . chronic hepatic encephalopathy and 3 . multiple organ failure syndrome associated with hepatic encephalopathy . The group of excluded patients ( n = 63 ) was compared with the r and omized group ( n = 39 ) , and no statistical differences were found regarding sex and age distributions , Child-Pugh classification , etiology of cirrhosis , percipitating factors and grade of hepatic encephalopathy . These same parameters were also comparable among the 20 patients who received active neomycin and the 19 who were treated with placebo . The therapy for hepatic encephalopathy consisted in the control of precipitating factors associated with 6 g of neomycin sulfate " per os " or placebo .  Therapeutic failure and death by the fifth day of treatment , occurred in four patients ( 10.2 % ) , two in each of the r and omized groups . The time elapsed between the initiation of the therapeutic procedure and regression to grade zero of hepatic encephalopathy was 39.11 + /- 23.04 hours for the group of active neomycin , and 49.47 + /- 21.92 hours for the placebo group , but this difference did not achieve statistical significance Background : In hemodialysis ( HD ) patients , zinc depletion caused by inadequate intake , malabsorption , and removal by HD treatment leads to erythropoiesis-stimulating agent ( ESA ) hyporesponsiveness . This study investigated the effects of zinc supplementation in HD patients with zinc deficiency on changes in the erythropoietin responsiveness index ( ERI ) . Methods : Patients on HD with low serum zinc levels ( < 65 μg/dL ) were r and omly assigned to two groups : The polaprezinc group ( who received daily polaprezinc , containing 34 mg/day of zinc ) ( n = 35 ) and the control group ( no supplementation ) ( n = 35 ) for 12 months . All the 70 patients had been taking epoetin alpha as treatment for renal anemia .  ERI was measured with the following equation : Weekly ESA dose (units)/dry weight (kg)/hemoglobin ( g/dL ) . Results : There were no significant changes in hemoglobin levels within groups or between the control and polaprezinc groups during the study period . Although reticulocyte counts were increased immediately after zinc supplementation , this change was transient . Serum zinc levels were significantly increased and serum copper levels were significantly decreased in the polaprezinc group after three months ; this persisted throughout the study period . Although there was no significant change in the serum iron or transferrin saturation levels in the polaprezinc group during the study period , serum ferritin levels significantly decreased following polaprezinc treatment . Further , in the polaprezinc  group , ESA dosage and ERI were significantly decreased at 10 months and nine months , respectively , as compared with the baseline value . Multiple stepwise regression analysis revealed that the change in the serum zinc level was an independent predictor of lowered ERI . Conclusions : Zinc supplementation  reduces ERI in patients undergoing HD and may be a novel therapeutic strategy for patients with renal anemia and low serum zinc levels We have evaluated the efficacy of  interferon-α ( IFN-α ) plus zinc therapy  in hepatitis C patients with genotype 1b , poor responders for IFN alone . Ten patients were injected with 10 MU of IFN-α every day for 4 wk , followed by three times a week for 20 wk ( control group ) . Nine patients took 300 mg of zinc sulfate a day orally during IFN-α therapy ( zinc sulfate group ) , and 15 patients took IFN-α and 150 mg of polaprezinc ( polaprezinc group).On the d 8 of IFN therapy , circadian zinc levels in serum elevated significantly in the polaprezinc group compared to the zinc sulfate group or control group . Serum ALT levels normalized in 73.3 % of the polaprezinc group , 55.6 % of the zinc sulfate group , and 40.0 % of the control group at 6 mo after the end of IFN therapy . Sustained eradication for the hepatitis C virus RNA judged at the end of the 6-mo follow-up period was higher in the polaprezinc group than in the zinc sulfate group ( 53.3 % vs 11.1 % , p<0.05 ) or the control group ( 20.0 % ) . No clinical side effects of zinc were observed at the dose used . The data suggest that polaprezinc is expected to increase the therapeutic response of IFN-α for chronic hepatitis C with genotype 1b A controlled , r and omized trial was conducted in 50 infants with acute dehydrating diarrhea to evaluate the effect of oral zinc supplementation in acute diarrhea . After completion of rehydration , 25 infants in Group A received oral zinc sulfate ( 20 mg elemental zinc twice daily ) and an equal number in Group B were given placebo ( glucose ) . Both groups were comparable with respect to various initial characteristics including nutritional status , diarrheal disease , serum alkaline phosphatase , and serum and rectal mucosal zinc content . During therapy all the assessed parameters of zinc status ( serum alkaline phosphatase and serum and rectal zinc ) recorded significant elevation and reduction in Groups A and B , respectively . At recovery the zinc status of Group A was significantly better and was nearer that of healthy controls . The diarrheal duration and frequency in the zinc-supplemented group were lower , but the differences were not significant ( 0.05 less than p less than 0.1 ) . However , when only subjects with relatively severe initial zinc depletion ( rectal zinc lower than the 15th percentile of healthy controls ; 11 in Group A and 14 in Group B ) were considered , the diarrheal duration and frequency were significantly ( p less than 0.05 and p less than 0.01 , respectively ) lower in the zinc-supplemented cases . Weight gain in both groups was similar . It is concluded that oral zinc administration in acute diarrhea can replenish body zinc status and this may shorten the diarrheal duration and frequency in children with relatively severe zinc depletion BACKGROUND The present study aim ed to evaluate the effects of low dose zinc ( Zn ) supplementation on biochemical markers and underlying disease status in non-alcoholic cirrhotic patients . METHODS We enrolled 60 cirrhotic patients in a double-blind ,  placebo-controlled  , r and omized clinical trial . All patients in the interventional group ( n = 30 ) received long-term , low dose Zn supplementation ( 50 mg elemental Zn sulfate daily ) . The control group ( n = 30 ) received placebo ( starch ) .  Child-Pugh scores and biochemical markers were assessed for both interventional and control groups at the first day and the end of the 90th day of the interventional period . A per- protocol analysis was performed after excluding all participants who did not receive or complete the r and omized intervention . The mean differences of quantitative variables between and within groups were evaluated by independent sample s t-test and paired- sample s t-test , respectively . SPSS version 13.00 was used for statistical analysis . RESULTS In the initial evaluation , 16 ( 53.30 % ) patients from the interventional group had a Child-Pugh score of 5 - 8 and 14 ( 46 . 70 % ) had a score of 9 - 12 . In the control group 18 ( 60.00 % ) had a Child-Pugh score of 5 - 8 and 12 ( 40.00 % ) scored 9 - 12 . After three months the mean Child-Pugh score in the interventional group showed a significant improvement ( from 6.56 ± 0.21 to 5.72 ± 0.22 , P = 0.001 ) whereas in the control group despite no significant decline , the mean Child-Pugh score increased slightly ( from 6.25 ± 0.27 to 6.67 ± 0.31 , P = 0.14 ) . Zn supplementation significantly decreased copper ( Cu ; P = 0.01 ) and creatinine ( Cr ; P < 0.0001 ) levels . CONCLUSION In this study , we determined that low dose Zn supplementation could prevent deterioration of clinical status of cirrhosis and prevent excess Cu accumulation in non-alcoholic cirrhotic patients . Zn supplementation produces metabolic effects and trends towards improvements in liver function , hepatic encephalopathy , and nutritional status . Registration ID in I RCT : I RCT 201106122017N4 OBJECTIVE To evaluate the impact of zinc supplementation on the clinical course , stool weight , duration of diarrhoea , changes in serum zinc , and body weight gain of children with acute diarrhoea . DESIGN R and omised double blind controlled trial . Children were assigned to receive zinc ( 20 mg elemental zinc per day ) containing multivitamins or control group ( zinc-free multivitamins ) daily in three divided doses for two weeks . SETTING A diarrhoeal disease hospital in Dhaka , Bangladesh . PATIENTS 111 children , 3 to 24 months old , below 76 % median weight for age of the National Center for Health Statistics st and ard with acute diarrhoea . Children with severe infection and /or oedema were excluded . MAIN OUTCOME MEASURES Total diarrhoeal stool output , duration of diarrhoea , rate of weight gain , and changes in serum zinc levels after supplementation . RESULTS Stool output was 28 % less and duration 14 % shorter in the zinc supplemented group than placebo ( p = 0.06 ) . There were reductions in median total diarrhoeal stool output among zinc supplemented subjects who were shorter ( less than 95 % height for age ) , 239 v 326 g/kg ( p < 0.04 ) , and who had a lower initial serum zinc ( < 14 mmol/l ) , 279 v 329 g/kg ( p < 0.05 ) ; a shortening of mean time to recovery occurred ( 4.7v 6.2 days , p < 0.04 ) in those with lower serum zinc . There was an increase in mean serum zinc in the zinc supplemented group ( + 2.4 v −0.3 μmol/l , p < 0.001 ) during two weeks of supplementation , and better mean weight gain ( 120 v 30 g , p < 0.03 ) at the time of discharge from hospital . CONCLUSIONS Zinc supplementation is a simple , acceptable , and affordable strategy which should be considered in the management of acute diarrhoea and in prevention of growth faltering in children specially those who are malnourished . Key messages 20 mg of daily zinc supplementation reduced diarrhoeal stool in shorter children Zinc reduced diarrhoeal stool in those with low serum zinc Zinc reduced duration of diarrhoea in children with low serum zinc Zinc increased body weight of children during acute diarrhoeal episode Malnourished children are likely to benefit more from zinc Aims : To evaluate the effects of zinc with or without other antioxidants on blood glucose , lipid profile , and serum creatinine in adult diabetics on long-term follow-up . Material s and methods : Patients ( n = 96 ) were r and omly allocated to three groups : group A ( n = 29 ) was supplemented with oral zinc sulfate ( 22 mg/day ) and multivitamin/mineral ( zinc+MVM ) preparation ; group B ( n = 31 ) was given the same preparation without zinc ( MVM ) ; and group C ( n = 36 ) was given a matching placebo for a period of 4 months in a single-blinded study . Blood sample s were taken at baseline and after 4 months of supplementation to assess blood glucose ( fasting and postpr and ial ) and glycosylated hemoglobin ( HbA1C% ) and serum levels of zinc , creatinine , and lipids . Results : The zinc+MVM group had a mean change of fasting blood sugar −0.33 mmol/L ( st and ard error of the mean 0.21 mmol/L ) and was significant ( P = 0.05 ) when compared with the other two groups ( mean change in the MVM group + 0.19 ( 0.31 ) mmol/L and + 0.43 ( 0.23 ) mmol/L in the control group , respectively ) . The HbA1C% level reduced significantly , irrespective of the baseline level , in zinc+MVM-supplemented individuals . In the other two groups , the change of HbA1C% level was not significant . Serum lipid levels reduced significantly in the zinc+MVM and MVM groups . Conclusions : Zinc+MVM supplementation showed beneficial effects in the metabolic control of adult diabetics in addition to elevating their serum zinc level . Zinc supplementation  improved glycemic control measured by HbA1C% and fasting and postpr and ial glucose . Furthermore , zinc supplementation  lowered serum cholesterol and cholesterol/high-density lipoprotein ratio The effect of zinc supplementation on concentrations of zinc in hair and serum of 213 pregnant Hispanic women attending a clinic in Los Angeles was assessed using a r and om , double-blind experiment . Both the treatment ( T ) and control ( C ) groups received similar vitamin and mineral supplements except that 20 mg zinc was added to the supplements for the treatment group . Nutrient intakes were calculated from 24-h recalls . The initial mean dietary  zinc intake of both groups was about 50 % of the Recommended Dietary Allowance ( 9 + /- 5 mg ) . Initially there were no significant differences between the two groups in mean zinc levels in serum ( 66 + /- 11 micrograms/dl , C , and 65 + /- 12 micrograms/dl , T ) or in hair ( 184 + /- 41 micrograms/g , C , and 175 + /- 38 micrograms/g , T ) . Zinc supplementation did not alter mean zinc levels in serum or hair but significantly ( p less than 0.05 ) reduced the number of low serum zinc values ( less than or equal to 53.3 micrograms/dl ) toward the end of pregnancy . Although serum zinc levels do decline in pregnancy , our results suggest that severely depressed levels ( less than or equal to 50 to 55 micrograms/dl ) indicate inadequate zinc status The toxicity of oral zinc was investigated in patients hospitalized for chronic leg ulcers .  Untoward effects were monitored by reference to clinical tolerance , hematological , hepatic and renal parameters , and serum concentrations of copper and iron . The investigation was conducted by comparing two groups of patients who initially did not differ significantly with regard to ulcer area , hemoglobin , leukocytes , copper , iron and zinc .  Both groups had serum zinc concentrations in the lower normal range . One group was treated with 3 daily doses of 220 mg oral zinc sulfate and the other with placebo , and hence , untoward effects of zinc should have become manifest in the zinc-treated group . This was not the case . Therefore , oral zinc appears to be well tolerated clinical ly and does not cause hematological , renal or hepatic toxicity . In view of the increasing interest in and range of indications for zinc , particularly in conditions associated with cellular immunological hyporeactivity , this finding is a prerequisite for the institution of clinical zinc therapy BACKGROUND Hypotensive therapy leads to a number of trace elements metabolism disturbances . Zinc balance is frequently affected by antihypertensive treatment . AIM To evaluate the effect of a hypotensive treatment , modified diet and zinc supplementation on mineral status and selected biochemical parameters in newly diagnosed hypertensive patients on monotherapy . METHODS In the first stage , arterial hypertension in ninety-eight human subjects was diagnosed . In the second stage , antihypertensive monopharmacotherapy was implemented . In the third stage , patients were r and omized into three groups and continued antihypertensive monotherapy : group D received an optimal-mineral-content diet , group S received zinc supplementation , and group C had no changes in diet or zinc supplementation . Iron , zinc , and copper concentrations in serum , erythrocytes , urine , and hair were determined . Lipids , glucose , ceruloplasmin , ferritin , albumin , C-reactive protein ( CRP ) , tumor necrosis factor α ( TNF-α ) , nitric oxide ( NO ) , superoxide dismutase ( SOD ) and catalase ( CAT ) were assayed in serum . RESULTS Antihypertensive monotherapy decreased zinc concentration in serum and erythrocytes and increased the level of zinc in urine , decreased CAT and SOD activity , TNF-α concentration in serum , and increased the level of NO in the serum . Zinc supply led to an increase in zinc concentration in serum , erythrocytes , and hair ( in group S only ) . In the groups with higher zinc intake , decreased glucose concentration in the serum was observed . Significant correlation was seen between the zinc and glucose serum concentrations . CONCLUSION Hypotensive drugs disturb zinc status in newly diagnosed hypertensive patients .  Antihypertensive monotherapy combined with increased zinc supply in the diet or supplementation favorably modify zinc homeostasis and regulate glucose status without blood pressure affecting in patients with hypertension Objective To compare the effect of oral zinc supplementation on growth of  preterm infants . Design R and omized controlled trial . Setting Dhaka Shisu Hospital ( Tertiary care hospital).Subjects100 appropriate for date preterm infants weighing between 1000 to 2500 g were r and omized to receive zinc and multivitamin supplement ( Group I ; n=50 ) or only multivitamin supplement ( Group II).InterventionZinc supplementation was given 2mg/kg/day for 6 weeks along with multivitamin in Group I and only multivitamin to Group II . Primary outcome variableIncrement of weight and length . Results At enrollment , serum zinc ( 62.1±12.4μg/dL in Group I and 63.1±14.6μg/dL in Group II ) and hemoglobin levels ( 14.9±2.4g/dL in Group I and 14.4±1.7g/dL in Group II ) were almost similar in both groups . Serum zinc levels were in lower limit of normal range . After supplementation , serum zinc and hemoglobin levels were significantly higher in Group I ( 105±16.5μg/dL ) than Group II ( 82.2±17.4μg/dL ) ( P<0.05 ) . Weight , length and head circumference were comparable in both groups at enrollment . Significant differences in weight gain and increment in length were found in first and second follow up between two groups but OFC increments were not significant ( P>0.05 ) . Reduction of morbidity was apparent in zinc supplemented group . No serious adverse effect was noted related to supplementation therapy . Conclusion Zinc supplementation for preterm low birth weight babies is found effective to enhance the growth in early months of life Summary An objective method of determining the healing rate in patients with chronic leg ulcers has been used in forty patients to date . Almost all patients showed improvement on a regimen of cleanliness and external support . The serum zinc levels of twenty-four of the patients ranged from 39 to 219 μg per cent , but there was no correlation between the healing rate and the serum level . The addition of supplemental oral zinc to the therapeutic regime did not acclerate the healing rate in any patient BACKGROUND Combined supplementation with iron and zinc during infancy may be effective in preventing deficiencies of these micronutrients , but knowledge of their potential interactions when given together is insufficient . OBJECTIVE The goal was to compare the effect in infants of combined supplementation with iron and zinc  and of supplementation with single micronutrients on  iron and zinc status . DESIGN Indonesian infants ( n = 680 ) were r and omly assigned to daily supplementation with 10 mg Fe ( Fe group ) , 10 mg Zn ( Zn group ) , 10 mg Fe + 10 mg Zn ( Fe+Zn group ) , or placebo from 6 to 12 mo of age . Venous blood sample s were collected at the start and end of the study . Five hundred forty-nine infants completed the supplementation and had both baseline and follow-up blood sample s available for analysis . RESULTS Baseline prevalences of anemia , iron deficiency anemia ( anemia and low serum ferritin ) , and low serum zinc ( < 10.7 micromol/L ) were 41 % , 8 % , and 78 % , respectively . After supplementation , the Fe group had higher hemoglobin ( 119.4 compared with 115.3 g/L ; P < 0.05 ) and serum ferritin ( 46.5 compared with 32.3 microg/L ; P < 0.05 ) values than did the Fe+Zn group , indicating an effect of zinc on iron absorption . The Zn group had higher serum zinc ( 11.58 compared with 9.06 micromol/L ; P < 0.05 ) than did the placebo group . There was a dose effect on serum ferritin in the Fe and Fe+Zn groups , but at different levels . There was a significant dose effect on serum zinc in the Zn group , whereas no dose effect was found in the Fe+Zn group beyond 7 mg Zn/d . CONCLUSION Supplementation with iron and zinc was less efficacious than were single supplements in improving iron and zinc status , with evidence of an interaction between iron and zinc when the combined supplement was given OBJECTIVE To assess the impact of zinc supplementation on nutritional and biochemical parameters among children aged 12 to 59 months . METHODS A blinded r and omized clinical trial was carried out with 58 children aged 12 to 59 months included in the Programa Governamental de Combate a Carências Nutricionais ( National Child Nutritional Program ) , which provided them with 2 kg of  iron-fortified milk . The supplementation group ( n = 28 ) received 10 mg/day of zinc sulfate for four months , and the control group ( n = 30 ) received placebo . The following parameters were used to assess the nutritional status : weight-for-height and height-for-age expressed as z scores , according to National Center for Health Statistics ( NCHS ) st and ards , biochemical measurements of serum iron and serum zinc , and hemoglobin and hematocrit levels . RESULTS Zinc supplementation did not have a remarkable influence on anthropometric parameters . Baseline serum zinc levels were low in both groups . After supplementation , variations in mean hemoglobin ( p = 0.002 ) , hematocrit ( p = 0.001 ) , serum zinc ( p = 0.023 ) , and serum iron ( p = 0.013 ) levels significantly increased in the zinc supplementation group . CONCLUSION Zinc supplementation improved hemoglobin response and normalized serum zinc concentration . The results show the importance of establishing policies for nutritional care that can tackle zinc deficiency as well
Conclusion Oral zinc supplementation improved performance on the number connection test , but no evidence about other clinical or biochemical outcomes was available
Background and aim Because low serum zinc levels precipitate hepatic encephalopathy , zinc supplementation is considered a potential therapeutic option .
The aim of this study was to assess the effects of oral zinc supplementation in the treatment of hepatic encephalopathy .