{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T21:00:56Z","timestamp":1785445256584,"version":"3.56.0"},"reference-count":122,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with cirrhosis are prone to malnutrition and a range of micronutrient deficiencies, which carry adverse health effects and the potential to worsen liver\u2010specific outcomes. Clinicians may rely heavily on serum or plasma concentrations of micronutrients for information regarding nutritional status. However, these values can be skewed due to factors such as inflammation as well as the underlying liver dysfunction, affecting the accuracy of interpretation and posing concern for overtreatment. This review summarizes the risk factors for vitamin and mineral deficiencies in patients with cirrhosis, describes the challenges associated with micronutrient assessment, and discusses considerations for initiating micronutrient replacement therapy.<\/jats:p>","DOI":"10.1002\/ncp.70124","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T10:42:16Z","timestamp":1776854536000},"page":"1061-1075","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Micronutrient deficiencies in hepatic cirrhosis: Navigating challenges to assessment and implications for clinical management: A narrative review"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0136-0617","authenticated-orcid":false,"given":"Holly","family":"Estes\u2010Doetsch","sequence":"first","affiliation":[{"name":"School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University Columbus Ohio USA"},{"name":"Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wellner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Ziegler","sequence":"additional","affiliation":[{"name":"Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"issue":"12","key":"e_1_2_9_2_1","first-page":"759","article-title":"Cirrhosis: diagnosis and management","volume":"100","author":"Smith A","year":"2019","journal-title":"Am Fam Physician"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1060073"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/85.5.1257"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2009.02135.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-28032006000400005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2022.02.015"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.32049"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.06.024"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16010035"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13093170"},{"issue":"3","key":"e_1_2_9_12_1","first-page":"220","article-title":"Relationships between nutrition, alcohol use, and liver disease","volume":"27","author":"Lieber CS","year":"2003","journal-title":"Alcohol Res Health"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000999"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10924"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.023812"},{"issue":"2","key":"e_1_2_9_16_1","first-page":"113","article-title":"C\u2010reactive protein and bacterial infection in cirrhosis","volume":"27","author":"Pieri G","year":"2014","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rap\/rkad045"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8111926"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533615573054"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/236268"},{"issue":"5","key":"e_1_2_9_21_1","article-title":"Nutritional deficiencies and clinical practices in decompensated cirrhotics with hepatic encephalopathy","volume":"14","author":"Panchani NN","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102842"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0012.7192"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.115.229708"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/69.5.931"},{"issue":"2","key":"e_1_2_9_26_1","first-page":"S13","article-title":"Transport and metabolism of vitamin A","volume":"52","author":"Blomhoff R","year":"1994","journal-title":"Nutr Res"},{"issue":"3","key":"e_1_2_9_27_1","first-page":"126","article-title":"The multifaceted nature of retinoid transport and metabolism","volume":"3","author":"Li Y","year":"2014","journal-title":"Hepatobiliary Surg Nutr"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607102026003184"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-88-5-622"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6457.1484"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2014.10.016"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533612455827"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2010.01072.x"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114511002145"},{"issue":"2","key":"e_1_2_9_35_1","first-page":"237","article-title":"Prevalence of fat\u2010soluble vitamin (A, D, and E) and zinc deficiency in patients with cirrhosis being assessed for liver transplantation","volume":"80","author":"Teriaky A","year":"2017","journal-title":"Acta Gastro\u2010Enterol Belg"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/40.6.1281"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.179176"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2021.101023"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000001982"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/ICB.0000000000000031"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-247856"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/11206721211027416"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090704"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10633-013-9403-0"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.5527\/wjn.v11.i3.96"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(91)90672-8"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840010412"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chembiol.2013.12.016"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu5010111"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20102555"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12113302"},{"issue":"3","key":"e_1_2_9_53_1","first-page":"297","article-title":"Vitamin D deficiency in patients with liver cirrhosis","volume":"29","author":"Konstantakis C","year":"2016","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14647"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-019-04104-x"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13061874"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12866"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23646"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.04.033"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu8050278"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03179812"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1177\/000456328602300505"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840090403"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/41.1.66"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0026-0495(99)90015-X"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1053\/meta.2002.32016"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.1177\/014860710302700171"},{"issue":"1","key":"e_1_2_9_68_1","first-page":"39","article-title":"Reduced concentration of hepatic alpha\u2010tocopherol in patients with alcoholic liver cirrhosis","volume":"27","author":"Bell H","year":"1992","journal-title":"Alcohol Alcohol"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840170606"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2011.06746.x"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000323"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820974917"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1995.10718493"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.14536"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2018.01.009"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2017.09.007"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11011-008-9129-y"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109186"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.12522"},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10474"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.31"},{"issue":"3","key":"e_1_2_9_82_1","first-page":"272","article-title":"Association of liver cirrhosis severity with anemia: does it matter?","volume":"33","author":"Singh S","year":"2020","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.1067\/mlc.2001.119106"},{"key":"e_1_2_9_84_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10018-1466"},{"key":"e_1_2_9_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biochi.2012.11.004"},{"key":"e_1_2_9_86_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.444"},{"key":"e_1_2_9_87_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1998.10718752"},{"key":"e_1_2_9_88_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.110.009613"},{"issue":"6","key":"e_1_2_9_89_1","first-page":"384","article-title":"Vitamin B12 deficiency: recognition and management","volume":"96","author":"Langan RC","year":"2017","journal-title":"Am Fam Physician"},{"issue":"1","key":"e_1_2_9_90_1","first-page":"31","article-title":"Falsely elevated serum vitamin B12 levels were associated with the severity and prognosis of chronic viral liver disease","volume":"60","author":"Sugihara T","year":"2017","journal-title":"Yonago Acta Med"},{"key":"e_1_2_9_91_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/63.2.220"},{"key":"e_1_2_9_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2009.11.012"},{"key":"e_1_2_9_93_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/38.4.493"},{"key":"e_1_2_9_94_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-020-01042-2"},{"key":"e_1_2_9_95_1","doi-asserted-by":"publisher","DOI":"10.5604\/16652681.1184191"},{"key":"e_1_2_9_96_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533615570376"},{"key":"e_1_2_9_97_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365513.2022.2064764"},{"key":"e_1_2_9_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2021.100549"},{"key":"e_1_2_9_99_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.1057156"},{"key":"e_1_2_9_100_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nutres.2019.11.009"},{"key":"e_1_2_9_101_1","doi-asserted-by":"publisher","DOI":"10.3164\/jcbn.19-99"},{"key":"e_1_2_9_102_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1979.tb06065.x"},{"issue":"1","key":"e_1_2_9_103_1","first-page":"15","article-title":"Taste alterations in liver cirrhosis: are they related to zinc deficiency?","volume":"6","author":"Sturniolo GC","year":"1992","journal-title":"J Trace Elem Electrolytes Health Dis"},{"key":"e_1_2_9_104_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/68.2.435S"},{"key":"e_1_2_9_105_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27210"},{"key":"e_1_2_9_106_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-019-0461-3"},{"key":"e_1_2_9_107_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2019.08.011"},{"key":"e_1_2_9_108_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-018-3407-5"},{"issue":"8","key":"e_1_2_9_109_1","first-page":"472","article-title":"Effects of low dose zinc supplementation on biochemical markers in non\u2010alcoholic cirrhosis: a randomized clinical trial","volume":"15","author":"Somi MH","year":"2012","journal-title":"Arch Iran Med"},{"key":"e_1_2_9_110_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10328"},{"key":"e_1_2_9_111_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2016.02.006"},{"key":"e_1_2_9_112_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e32834b2b1b"},{"key":"e_1_2_9_113_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2008.01050.x"},{"key":"e_1_2_9_114_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13041249"},{"key":"e_1_2_9_115_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10215097"},{"key":"e_1_2_9_116_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1393"},{"key":"e_1_2_9_117_1","doi-asserted-by":"publisher","DOI":"10.1039\/C3MT00185G"},{"key":"e_1_2_9_118_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1983.10719930"},{"key":"e_1_2_9_119_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01309514"},{"key":"e_1_2_9_120_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520510023495"},{"key":"e_1_2_9_121_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510270322"},{"key":"e_1_2_9_122_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.115.110932"},{"key":"e_1_2_9_123_1","doi-asserted-by":"publisher","DOI":"10.1002\/ncp.10451"}],"container-title":["Nutrition in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.70124","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ncp.70124","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.70124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T20:36:14Z","timestamp":1785443774000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ncp.70124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":122,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ncp.70124"],"URL":"https:\/\/doi.org\/10.1002\/ncp.70124","archive":["Portico"],"relation":{},"ISSN":["0884-5336","1941-2452"],"issn-type":[{"value":"0884-5336","type":"print"},{"value":"1941-2452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"assertion":[{"value":"2025-12-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}