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Serum concentration levels of magnesium, copper, and zinc in patients with post-viral liver cirrhosis

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      Abstract

      Abstract. Liver cirrhosis and chronic liver failure are leading causes of morbidity and mortality, caused by excessive viral hepatitis (B or C), alcohol consumption, or nonalcoholic fatty liver disease. Aim: The aim of this study was to evaluate serum concentrations of magnesium, copper, and zinc in post-viral liver cirrhosis patients. Materials and methods: This study was conducted in the Emergency Department (ED) and included 32 patients with post-viral liver cirrhosis with variceal bleeding, 32 patients with post-viral liver cirrhosis without variceal bleeding, and 35 patients without cirrhosis which served as control group. Serum concentrations of zinc, copper, and magnesium were determined using atomic absorption spectrophotometry. Statistical analyses were performed using Pearson’s correlation test and ANOVA test. Results: The serum levels of magnesium (11.490 ± 2.94 mg/L) and zinc (0.7959 ± 0.39 mg/L) were significantly decreased (p < 0.05) in postviral cirrhotic patients with variceal bleeding and without variceal bleeding compared with control group. Also, the mean serum concentration of copper (1.7519 ± 0.78 mg/L) was significantly increased (p < 0.05) in patients with postviral liver cirrhosis. The mean difference of magnesium (8.722 mg/L) using the Child-Pugh score in postviral liver cirrhotic patients with variceal bleeding was statistically significant (p < 0.05). Conclusion: There are significant differences between total magnesium, zinc, and copper serum concentrations between postviral cirrhotic patients with variceal bleeding compared to cirrhotic patients without variceal bleeding and control group.


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      Selenium, selenoproteins and human health: a review.

      Selenium is of fundamental importance to human health. It is an essential component of several major metabolic pathways, including thyroid hormone metabolism, antioxidant defence systems, and immune function. The decline in blood selenium concentration in the UK and other European Union countries has therefore several potential public health implications, particularly in relation to the chronic disease prevalence of the Western world such as cancer and cardiovascular disease. Ten years have elapsed since recommended dietary intakes of selenium were introduced on the basis of blood glutathione peroxidase activity. Since then 30 new selenoproteins have been identified, of which 15 have been purified to allow characterisation of their biological function. The long term health implications in relation to declining selenium intakes have not yet been thoroughly examined, yet the implicit importance of selenium to human health is recognised universally. Selenium is incorporated as selenocysteine at the active site of a wide range of selenoproteins. The four glutathione peroxidase enzymes (classical GPx1, gastrointestinal GPx2, plasma GPx3, phospholipid hydroperoxide GPx4)) which represent a major class of functionally important selenoproteins, were the first to be characterised. Thioredoxin reductase (TR) is a recently identified seleno-cysteine containing enzyme which catalyzes the NADPH dependent reduction of thioredoxin and therefore plays a regulatory role in its metabolic activity. Approximately 60% of Se in plasma is incorporated in selenoprotein P which contains 10 Se atoms per molecule as selenocysteine, and may serve as a transport protein for Se. However, selenoprotein-P is also expressed in many tissues which suggests that although it may facilitate whole body Se distribution, this may not be its sole function. A second major class of selenoproteins are the iodothyronine deiodinase enzymes which catalyse the 5'5-mono-deiodination of the prohormone thyroxine (T4) to the active thyroid hormone 3,3'5-triiodothyronine (T3). Sperm capsule selenoprotein is localised in the mid-peice portion of spermatozoa where it stabilises the integrity of the sperm flagella. Se intake effects tissue concentrations of selenoprotein W which is reported to be necessary for muscle metabolism. It is of great concern that the health implications of the decline in Se status in the UK over the past two decades have not been systematically investigated. It is well recognised that dietary selenium is important for a healthy immune response. There is also evidence that Se has a protective effect against some forms of cancer; that it may enhance male fertility; decrease cardiovascular disease mortality, and regulate the inflammatory mediators in asthma. The potential influence of Se on these chronic diseases within the European population are important considerations when assessing Se requirement.
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        The value of the chloride: sodium ratio in differentiating the aetiology of metabolic acidosis.

        Stewart's physicochemical approach to acid-base balance defines the aetiology of a metabolic acidosis by quantifying anions of tissue acids (TA), which consist of unmeasured anions (UMA) and/or lactate. We hypothesised that an increase in TA during metabolic acidosis would lead to a compensatory fall in the plasma chloride (Cl) relative to sodium (Cl:Na ratio) in order to preserve electro-neutrality. Thus, the Cl:Na ratio could be used as a simple alternative to the anion gap in identifying raised TA. Two hundred and eighty two consecutive patients who were admitted to our Paediatric Intensive Care were enrolled in the study. We obtained 540 samples (admission n = 282, 24 h n = 258) for analysis of blood chemistry, lactate and quantification of TA and UMA. Samples were subgrouped into those with metabolic acidosis (standard bicarbonate 3 mEq/l). Metabolic acidosis occurred in 46% of samples, of which 52.3% (120/230) had increased UMA. The dominant component of TA was UMA rather than lactate, and these two components did not always rise in tandem. Our hypothesis of relative hypochloraemia was supported by a lower Cl:Na ratio (P 0.79) excluded TA (PPV 81%, LR 4.5). Base deficit (BD) and lactate performed poorly. In metabolic acidosis due to TA, plasma Cl concentration decreases relative to sodium. The Cl:Na ratio is a simple alternative to the AG for detecting TA in this setting.
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          A comparison of the measurement of sodium and potassium by flame photometry and ion-selective electrode.

           Randall Worth (1985)
          Although sodium and potassium have been the most commonly assayed analytes by clinical chemists for many years there have been fewer analytical principles used routinely than for most other analytes. The introduction of the direct-reading ion-selective electrode has led to a re-examination of the basic concepts of the methods involved, and this in turn to a reassessment of the interpretation of the measurement of sodium in certain clinical situations. As a result there is a case for all clinical chemistry laboratories having access to a direct-reading ion-selective electrode for sodium estimation.
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            Author and article information

            Journal
            Trace Elements and Electrolytes
            TE
            Dustri-Verlgag Dr. Karl Feistle
            0946-2104
            2018
            April 01 2018
            : 35
            : 04
            : 67-72
            10.5414/TEX01449
            © 2018
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