Rabab Farhan Thajeel, Dhiaa H Al-Baldawi and Wassan A Najim
Background: Trace elements have a major role as oxidant and antioxidants, promoting and protecting from tissue damage respectively. As the liver has a pivotal role in trace elements metabolism and consequently their bioavailability. Child-Pugh score is used to assess liver disease severity as the patients classified into group A, B and C according to five parameters: total serum bilirubin, ascites, encephalopathy, pro-thrombin time and serum albumin.
Objective: We aim to measure serum level of trace elements in patients with chronic liver disease (zinc, copper, iron, total iron binding capacity and ferritin) and highlight its association with gender, age and child Pughscore. Patient and methods: An analytical cross section study was done in Baghdad Medical City from the first of February 2014 to the thirtieth of September 2014. Two hundred cases, one hundred patients with chronic liver disease and one hundred control group with age ranging from 1 month to 13 years. Data including age and sex for all patients’groups were recorded. Blood samples were taken from all patients and the control group members who were enrolled in study to investigate the serum level of (zinc, copper, iron, total iron binding capacity and ferritin). All patients were assessed for severity of ascites, the presence of hepatic encephalopathy and sent for total serum bilirubin level, prothrombin time, international normalized ratio (INR) and serum albumin for assessing Child Pugh-score classification to divide patient in 3 classes (A, B and C).
Results: Serum zinc and total iron binding capacity were lower in the patients than in the control group, while serum copper, iron and ferritin were higher in the patients than the control but with no statistical significance. Also, the serum zinc and total iron binding capacity decrease as Child Pugh-score increase in severity, on the other hand serum copper, iron and ferritin increase as the Child Pughscore increases in severity but with no statistical significance. Regarding age and gender, there were no statistical significance between their categories and the study parameters.
Conclusion: These results encourage inclusion of serum zinc, copper, iron, total iron binding capacity and ferritin as biomarkers for monitoring the severity of the liver damage during assessment of children with chronic liver diseases. We also recommend avoiding excess iron and copper intake in those patients, whereas zinc supplementation should be encouraged.
