Involvement of essential trace elements in the pathogenesis of NASH: comparison of their involvement in NASH with that in HCV-related chronic liver disease

Essential trace elements are involved in the pathogenesis of the chronic liver disease such as hepatic inflammation, steatosis and fibrosis. We investigate the roles of essential trace elements in the pathogenesis of nonalcoholic steatohepatitis (NASH) and compared those in NASH with those in HCV-related chronic liver disease (CLD-C). Serum zinc (Zn), selenium (Se), copper (Cu) and ferritin levels were measured in twenty-six NASH patients and 66 CLD-C patients. The correlations between these essential trace elements levels in their sera and biochemical or pathological parameters were examined in both the NASH and CLD-C patients. Serum ferritin levels were significantly correlated with serum ALT levels and the HOMA-IR values in both the NASH and CLD-C groups. Serum Zn and Se levels were significantly associated with serum albumin levels, and inversely associated with the stages of hepatic fibrosis in both groups. Serum Se levels were closely correlated with the grades of hepatic steatosis in the NASH patients, whereas serum ferritin levels were positively correlated, and serum Zn levels were inversely correlated with the grades in the CLD-C patients. Serum Zn levels were inversely associated with the HOMA-IR values in the both groups, although serum Se was also negatively associated with the HOMA-IR values only in the CLD-C patients. These results indicate that the mechanisms to evoke insulin resistance and hepatic steatosis may be slightly different between NASH and CLD-C patients.