Clinical trials assessing zinc supplementation in liver diseases do not show benefits in terms of clinical improvement or disease halting .
There are possible benefits of zinc supplementation on hepatic encephalopathy , however , this is based on limited evidence .
INTRODUCTION AND OBJECTIVES Zinc deficiency has been associated with poor prognosis in chronic liver disease .
This systematic review and meta- analysis aim ed to evaluate the role of zinc supplementation in the management of chronic liver diseases .
The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial
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
Clinical trials assessing zinc supplementation in liver diseases do not show benefits in terms of clinical improvement or disease halting .
There are possible benefits of zinc supplementation on hepatic encephalopathy , however , this is based on limited evidence .
INTRODUCTION AND OBJECTIVES Zinc deficiency has been associated with poor prognosis in chronic liver disease .
This systematic review and meta- analysis aim ed to evaluate the role of zinc supplementation in the management of chronic liver diseases .