Zinc supplementation therapy improves the outcome of patients with chronic hepatitis C Effect of zinc on liver cirrhosis with hyperammonemia: a preliminary randomized, placebo-controlled double-blind trial. Effect of zinc supplementation on viral response in patients with chronic hepatitis C and Beta thalassemia major, a pilot study. Zinc supplementation in alcoholic cirrhosis. A double-blind clinical trial. ORAL ZINC SUPPLEMENTATION IMPROVES HEPATIC ENCEPHALOPATHY: Results of a Randomised Controlled Trial Zinc distribution in blood components, inflammatory status, and clinical indexes of disease activity during zinc supplementation in inflammatory rheumatic diseases. The role of antioxidants and zinc in minimal hepatic encephalopathy: a randomized trial Zinc supplementation is associated with improved neurologic recovery rate and visceral protein levels of patients with severe closed head injury. Regression of Nonalcoholic Fatty Liver Disease with Zinc and Selenium Co-supplementation after Disease Progression in Rats Zinc deficiency: a reversible complication of uremia. Zinc as an adjunct to the treatment of severe pneumonia in Ecuadorian children: a randomized controlled trial. Effects of low dose zinc supplementation on biochemical markers in non-alcoholic cirrhosis: a randomized clinical trial. Effect of zinc supplementation on body mass index and serum levels of zinc and leptin in pediatric hemodialysis patients Effect of zinc supplementation on growth and body composition in children with sickle cell disease. Zinc supplementation prevents the increase of transaminase in chronic hepatitis C patients during combination therapy with pegylated interferon alpha-2b and ribavirin. Effect of zinc supplementation on incidence of infections and hospital admissions in sickle cell disease (SCD) Zinc Deficiency: Descriptive Epidemiology and Morbidity among Preschool Children in Peri-urban Population in Delhi, India
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 OBJECTIVE To our knowledge , no r and omized study has shown whether zinc replacement therapy is effective for hyperammonemia in liver cirrhosis ; therefore , we performed a double-blind , placebo-controlled trial to examine efficacy and safety of the zinc replacement therapy . METHODS Patients with liver cirrhosis and hyperammonemia ( at or above the institutional reference value ) and hypozincemia ( ≤65 μg/dL ) were enrolled in the outpatient units of the participating institutions and were r and omly divided to receive placebo ( P group ) or zinc acetate preparation at a dose of 3 capsules/d for a total zinc content of 150 mg/d ( Z group ) by the envelope method . Of the 18 enrolled patients , 6 dropped out ; thus , the analyses included 12 patients ( 5 in the P group and 7 in the Z group ) . Variations in blood concentrations of zinc and ammonia as well as liver function test results were compared . RESULTS Blood zinc levels significantly increased in the Z group ( P = 0.0037 ; Friedman test ) but not the P group . Blood ammonia levels significantly decreased in the Z group ( P = 0.0114 ; Friedman test ) but not the P group . The percent change in blood ammonia level also revealed significant reduction at the eighth week in the Z group ( P = 0.0188 : Mann-Whitney test ) . No serious adverse events attributable to the zinc preparation were noted . CONCLUSION Although this study is preliminary and includes a small sample , it is , to our knowledge , the first r and omized controlled trial to show that zinc supplementation for 3 mo seems effective and safe for treating hyperammonemia in liver cirrhosis . Studies with a larger sample size are needed to confirm our findings 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 A double-blind clinical trial with zinc sulfate , 0.2 g three times daily , and a placebo was performed in 30 patients with biopsy-proven alcoholic liver cirrhosis . The disease was in a stable phase , and none of the patients showed evidence of a decompensated liver function . Parameters of liver function , taste acuity , dark adaptation and of zinc and vitamin A metabolism were followed for six weeks . In the zinc-treated group of 16 patients , serum zinc rose from a normal mean value of 13.3 to 17.4 mumol/l , whereas the mean serum vitamin A level remained practically unaltered within the normal range , 1.89 at the entry and 1.83 mumol/l at the end of the study . Plasma prothrombin and serum alkaline phosphatase levels of the zinc group increased and serum bilirubin and serum carotene decreased significantly . The dark adaptation did not change , but the taste function was significantly improved during zinc treatment . The results indicate that zinc supplementation causes alleviation of certain abnormalities of cirrhotics , which deserves further attention 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 The effects of zinc supplementation on zinc status and on clinical and biological indicators of inflammation were investigated in 18 patients with chronic inflammatory rheumatic diseases and in 9 healthy control subjects . Patients with mild and recent onset disease were assigned to a 60-d trial to receive either 45 mg Zn ( as gluconate)/d or a placebo , while control subjects received the zinc supplement .  Baseline mean plasma zinc of the patients was low whereas mononuclear cell zinc content was elevated , suggesting a redistribution of the element related to the inflammatory process rather than to a zinc-deficient state . Zinc supplementation increased plasma zinc to a similar extent in patients and in control subjects , which suggested no impairment of zinc intestinal absorption as a result of the inflammatory process . On the contrary , erythrocyte and leukocyte zinc concentrations were not modified in the two groups examined . No beneficial effect of zinc treatment could be demonstrated on either clinical or inflammation indexes 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 Sixty-eight patients were entered into a r and omized , prospect i ve , double-blinded controlled trial of supplemental zinc versus st and ard zinc therapy to study the effects of zinc supplementation on neurologic recovery and nutritional/metabolic status after severe closed head injury . One month after injury , the mortality rates in the  st and ard zinc group and the zinc-supplemented group were 26 and 12 % , respectively . Glasgow Coma Scale ( GCS ) scores of the zinc-supplemented group exceeded the adjusted mean GCS score of the st and ard group at day 28 ( p = 0.03 ) . Mean motor GCS score levels of the zinc-supplemented group were significantly higher on days 15 and 21 than those of the control group ( p = 0.005 , p = 0.02 ) . This trend continued on day 28 of the study ( p = 0.09 ) . The groups did not differ in serum zinc concentration , weight , energy expenditure , or total urinary nitrogen excretion after hospital admission . Mean 24-h urine zinc levels were significantly higher in the zinc-supplemented group at days 2 ( p = 0.0001 ) and 10 ( p = 0.01 ) after injury . Mean serum prealbumin concentrations were significantly higher in the zinc-supplemented group ( p = 0.003 ) at 3 weeks after injury . A similar pattern was found for mean serum retinol binding protein level ( p = 0.01 ) . A significantly larger number of patients in the st and ard zinc group had craniotomies for evacuation of hematoma ; thus a bias may have been present . The results of this study indicate that zinc supplementation during the immediate postinjury period is associated with improved rate of neurologic recovery and visceral protein concentrations for patients with severe closed head injury Background : Studies have shown that zinc and selenium deficiency is common in nonalcoholic fatty liver disease ( NAFLD ) . However , the effects of zinc and selenium co-supplementation before and /or after disease progression on NAFLD are not clear enough . The aim of this study was to compare the effects of zinc and selenium co-supplementation before and /or after disease progression on NAFLD prognosis . Material s and Methods : Forty male Sprague – Dawley rats ( 197±4 g ) were r and omly assigned to 4 dietary groups : normal-fat diet ( NFD ; receiving 9 % of calories as fat ) , high-fat diet ( HFD ; receiving 82 % of calories as fat ) , supplementation before disease progression ( S+HFD ) , and supplementation after disease progression ( HFD+S ) . The diets were implemented over a 20-week period in all the groups . Biochemical and histologic parameters were compared between the 4 groups , and between-group comparisons were also carried out . Results : There were significant differences in the average food dietary intake ( P<0.001 ) , weight ( P<0.001 ) , fasting blood sugar ( P=0.005 ) , triglyceride ( P<0.001 ) , total cholesterol ( P<0.001 ) , low-density lipoprotein cholesterol ( P=0.002 ) , high-density lipoprotein cholesterol ( P=0.001 ) , alanine aminotransferase ( P<0.001 ) , and aspartate aminotransferase ( P<0.001 ) between the 4 dietary groups . Serum triglyceride and total cholesterol were significantly lower in the HFD+S Group than in the S+HFD Group ( P<0.001 and P=0.003 , respectively ) . Fat accumulation was significantly reduced in the HFD+S Group ( P<0.001 ) . Conclusion : Zinc and selenium co-supplementation after disease progression improved biochemical and histologic parameters in an experimental model of NAFLD Subnormal plasma zinc levels and decreased zinc concentration in hair and leucocytes as well as increased plasma ammonia and ribonuclease activity in dialyzed and nondialyzed uremic patients indicate that zinc metabolism is abnormal in uremia and is not corrected by dialysis . The effect of oral supplementation with zinc acetate  ( 12 patients ) or placebo  ( 12 patients ) on the above biochemical parameters in hemodialysis patients was determined as a part of a double-blind study . The zinc-supplemented , but not the placebo , group demonstrated significant increases in mean ( + /- SD ) , plasma zinc ( 80 + /- 9 to 110 + /- 14 , micrograms/dl ) , leucocyte zinc ( 56 + /- 13 to 1098 + /- 18 , micrograms/10(10 ) cells ) , hair zinc ( 140 + /- 12 to 190 + /- 16 micrograms/g ) , and decreases in plasma ammonia ( 76 + /- 10 to 40 + /- 6 micrograms/dl ) and plasma ribonuclease activity ( 1.49 + /- 0.08 to 0.78 + /- 0.10 , OD/min/ml ) . Abnormalities of taste and sexual function improved significantly in patients receiving zinc but not in those on placebo therapy . These improvements in biochemical as well as clinical parameters confirm and extend our earlier observations of improvement in taste and sexual function after zinc supplementation . Together , they suggest that zinc deficiency is a complicating feature of uremia and can be corrected by oral zinc supplementation BACKGROUND Studies of zinc as an adjunct to treatment of severe pneumonia in children have shown mixed results , possibly because of poor information on zinc status and respiratory pathogens . OBJECTIVE We evaluated the effect of zinc given with st and ard antimicrobial treatment on the duration of respiratory signs in children with severe pneumonia . Zinc status and pathogens were assessed . DESIGN Children aged 2 - 59 mo with severe pneumonia who were admitted to the main children 's hospital in Quito , Ecuador , were given st and ard antibiotics and r and omly allocated to receive zinc supplements twice daily or a placebo . Measurements included anthropometric variables , breastfeeding , hemoglobin , plasma zinc , and common bacteria/viral respiratory pathogens . The primary outcome was time to resolution of respiratory signs . The secondary outcome was treatment failure . RESULTS We enrolled 225 children in each group . There was no difference between groups in time to resolution of respiratory signs or treatment failure ; pathogens were not associated with outcomes . Tachypnea and hypoxemia resolved faster in older children ( P = 0.0001 ) than in younger ones . Higher basal zinc concentration ( P = 0.011 ) and better height-for-age z score ( HAZ ) ( P = 0.044 ) were associated with faster resolution of chest indrawing . Better weight-for-height z score ( WHZ ) ( P = 0.031 ) and HAZ ( P = 0.048 ) were associated with faster resolution of tachypnea . Increased C-reactive protein was associated with a longer duration of tachypnea ( P = 0.044 ) . CONCLUSIONS Zinc did not affect time to pneumonia resolution or treatment failure , nor did type of respiratory pathogens affect outcomes . Higher basal zinc and better HAZ and WHZ were associated with reduced time to resolution of respiratory signs . These results suggest the need for prevention of chronic zinc deficiency and improvement of general nutritional status among Ecuadorian children 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 Introduction Zinc is an essential trace element for human nutrition , and its deficiency is associated with anorexia , poor food efficiency , growth retardation , and impaired neurological and immune systems . The zinc-deficiency rate is particularly high in many disease states , such as with end-stage renal disease patients undertaking hemodialysis . The aim of this study was to determine the effect of zinc supplementation on body mass index ( BMI ) and serum levels of zinc and leptin in pediatric hemodialysis patients . Patients and methods This was a prospect i ve clinical trial study in which 60 hemodialysis patients were r and omly divided into two groups : group I received 50–100 mg zinc sulfate ( equivalent to 11–22 mg elemental zinc ) according to age , sex , and nutritional status of the child ; and group II received placebo ( cornstarch ) twice daily for 90 days . Anthropometric measurements were taken , and serum zinc and leptin levels were determined by colorimetric test with 5-Br-3′-phosphoadenosine-5′-phosphosulfate and enzyme-linked immunosorbent assay , respectively , at days 0 and 90 of the study . Results Zinc supplementation result ed in a significant increase in mean serum zinc level and BMI . Serum leptin decreased significantly after supplementation in children under hemodialysis . A significant negative correlation was observed between serum zinc and leptin levels as a result of zinc supplementation . Conclusion There was an increase in serum zinc level and BMI and decreased serum leptin  after zinc supplementation in children under hemodialysis BACKGROUND Poor growth and delayed maturation in children with sickle cell disease ( SCD ) may be due , in part , to mild zinc deficiency . OBJECTIVE The objective was to determine the effects of zinc supplementation on growth and body composition in children with SCD . DESIGN Forty-two prepubertal children ( 20 girls and 22 boys ) aged 4 - 10 y with SCD-SS were r and omly assigned to receive 10 mg elemental Zn/d in cherry syrup ( zinc group ) or cherry syrup alone ( control group ) . The 2 groups were stratified by sex and initial height status . Dietary intakes were evaluated and anthropometric , high-precision knee-height , and plasma zinc measurements were made at baseline and at 3 , 6 , and 12 mo . Body composition was determined every 6 mo with dual-energy X-ray absorptiometry , and z scores for anthropometric variables were computed from national reference data . Longitudinal-mixed-effects analysis was used to test for differences between the groups over the 12-mo observation period . RESULTS Thirty-eight children completed the study . No significant differences were observed at baseline . After 12 mo , the zinc group had significantly greater mean ( + /- SE ) increases in height ( 0.66 + /- 0.29 cm/y ) , sitting height ( 0.97 + /- 0.40 cm/y ) , knee height ( 3.8 + /- 1.2 mm/y ) , and arm circumference z scores ( 0.27 + /- 0.12 cm/y ) . Height-for-age and weight-for-age z scores decreased significantly by 0.11 + /- 0.04 and 0.13 + /- 0.05 , respectively , in the control group but did not change significantly in the zinc group . CONCLUSIONS Prepubertal children with SCD-SS may have zinc deficiency and may benefit from zinc supplementation to improve linear growth and weight gain 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 Zinc deficiency is a common nutritional problem in adult sickle‐cell disease ( SCD ) patients . Hyperzincuria and increased requirement of zinc due to continued hemolysis in SCD are probable bases for zinc deficiency in these patients . Zinc deficiency affects adversely T‐helper1 ( TH1 ) functions and cell mediated immunity and interleukin (IL)‐2 production is decreased in zinc deficient subjects . We hypothesized that zinc supplementation will improve T‐helper1 function and decrease incidence of infections in patients with SCD . We tested this hypothesis in 32 SCD subjects who were divided in three groups ( Grs A , B , and C ) . Grs A ( n = 11 ) and B ( n = 10 ) were zinc deficient based on cellular zinc criteria and Gr C ( n = 11 ) were zinc sufficient . Gr A subjects were observed for 1 year ( baseline ) , following which they received zinc acetate ( 50 to 75 mg of elemental zinc orally daily ) for 3 years . Gr B subjects were observed for 1 year ( baseline ) , following which they received placebo for 1 year and then switched to zinc supplementation ( 50 to 75 mg of elemental zinc orally daily ) for 2 years . Gr C subjects did not receive any intervention inasmuch as they were zinc sufficient . Prolonged zinc supplementation result ed in an increase in lymphocyte and granulocyte zinc ( P = 0.0001 ) , and an increase in interleukin‐2 production ( P = 0.0001 ) , decreased incidence of documented bacteriologically positive infections ( P = 0.0026 ) , decreased number of hospitalizations and decreased number of vaso‐occlusive pain crisis ( P = 0.0001 ) . The predominant pathogens isolated were staphylococci and streptococci involving the respiratory tract and aerobic gram‐negative bacteria , particularly Escherichia coli , involving the urinary tract . Further confirmation of our observations will require prospect i ve studies of zinc supplementation in a larger number of SCD patients . Am . J. Hematol . 61:194–202 , 1999 . © 1999 Wiley‐Liss , Community-based data relating to factors influencing zinc deficiency among preschool children in India are inadequate . Data of a large , double-blinded , r and omized , controlled zinc-supplementation trial were used for assessing the descriptive epidemiology of zinc deficiency among children aged 6–35 months ( n=940 ) . In total , 609 children were followed up for 120 days for information on morbidity . Of these children , 116 from the  control group belonging to the upper and the lower 25th quartile of plasma zinc status at baseline were selected for assessing the association of zinc deficiency with prospect i ve morbidity . At baseline , demographic , socioeconomic and dietary information was collected , and anthropometric measurements and levels of plasma zinc were assessed . At baseline , 73.3 % of the children were zinc-deficient ( plasma zinc < 70 µg/dL ) , of which 33.8 % had levels of plasma zinc below 60 µg/dL. A significantly higher risk of morbidity was prevalent among the subjects with lower plasma zinc compared to those with higher levels of plasma zinc
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 .