Journal of 1. Trace Elements Med. BioI. Vol. II, pp. 158-161 (1997) Trace Elements In Medicine and Biology Clinical Note © 1997 by Gustav Fischer Verlag Trace Elements and Chronic Liver Diseases C. LOGUERCIO,V. DE GIROLAMO, A.FEDERICO A., S.L. FENG*I, V. CATALDI**, C. DEL VECCHIO BLANCO and G. GIALANELLA* Cattedra di Gastroenterologia, Seconda Universita di Napoli, *Dipartimento di Scienze Fisiche, Universita di Napoli Federico II, ** Prima Medicina Ospedale Ascalesi, Napoli, Italia Summary The relationships between chronic liver diseases and trace element (TE) contents are debated. Particularly. no defined data are available about the TE levels in viral liver disease patients with or without malnutrition. In this study we evaluated blood and plasma levels of various trace elements in patients with HCY-related chronic liver disease, at different stages of liver damage (8 patients with chronic hepatitis and 32 with liver cirrhosis) with or without malnutrition. We also studied 10 healthy volunteers as control group. We found that cirrhotic subjects had a significant decrease of blood levels ofZn and Se, independently on the nutritional status, whereas plasma levels of Fe were significantly reduced only in malnourished cirrhotic patients. Our data indicate that liver impairment is the main cause of the blood decrease of Se and Zn levels in patients with non alcoholic liver disease, whereas the malnutrition affects Fe levels only. Keywords: Selenium, Zinc, liver diseases. Introduction During the last years, mineral concentrations in pa- tients with chronic liver disease have been extensively in- vestigated (I). In fact, liver regulates the metabolic path- way and transport of trace elements (TE), and conse- quently their bioavailability, tissue distribution and even- tual toxicity. Abnormalities of blood levels were found for copper in primary biliary cirrhosis (2), for iron in pri- mary or secondary hemocromatosis and in HCY-related chronic hepatitis (3), for magnesium, manganese, chro- mium, selenium and zinc in different types of chronic liv- er diseases (4-8). The alterations of these last trace ele- ments were related primarily to malnutrition associated Reprint requests to: Dr. G. Gialanella, Dipartimento di Scienze Fisiche, Universita di Napoli Federico II, Mostra d'Oltremare Pad. 20,1-80125 Napoli, Italy (gialanella@napoli.infn.it). 'Permanent address: Institute of High Energy Physics Academia Sinica, Beijing, China with liver disease, particularly in alcoholic patients. However, methods to evaluate trace element levels, and significance of their alterations in patients with different types of chronic liver diseases, are presently under de- bate. In the present study, we investigated the relationship between minerals and chronic liver diseases at different degrees of liver impairment, and in presence or absence of malnutrition. We elected to use the proton-induced x- ray emission (PIXE) technique to determine blood TE levels in patients. Patients and Methods After informed consent and approval of Ethic Com- mittee of our Department, we studied 50 patients, includ- ing controls and biopsy-proven chronic active hepatitis patients, with or without cirrhosis and alteration of nutri-