{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:28:42Z","timestamp":1790231322354,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T00:00:00Z","timestamp":1592870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Plymouth Hospitals Charity"},{"name":"NIHR Health Technology Assessment Board"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Malnutrition is common in patients with alcohol\u2010related liver disease and is associated with outcome in patients with alcoholic hepatitis. Trace elements (cobalt, copper, iron, selenium and zinc) are micronutrients essential for many cellular processes including antioxidant pathways. The prevalence and relevance of trace element deficiency is unknown in alcoholic hepatitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the prevalence of trace element deficiency and its association with clinical outcomes in patients with alcoholic hepatitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum was obtained from patients with alcoholic hepatitis, alcohol\u2010related cirrhosis and healthy volunteers as part of clinical trials, cohort studies and a biobank. Trace element concentration was measured by inductively coupled plasma mass spectrometry. Association of trace element levels with development of infection within 90\u00a0days and mortality within 28 and 90\u00a0days was evaluated by multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sera from 302 patients with alcoholic hepatitis, 46 with alcohol\u2010related cirrhosis and 15 healthy controls were analysed for trace element concentration. The prevalence of zinc deficiency (85%) and selenium deficiency (67%) in alcoholic hepatitis was higher than in alcohol\u2010related cirrhosis (72% [p=0.04] and 37% [p&lt;0.001], respectively). Zinc, selenium, copper and chromium were significantly different between groups. Iron deficiency was a predictor of development of infection within 90\u00a0days. Zinc deficiency was a predictor of mortality within 28 and 90\u00a0days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Trace element deficiency in patients with alcoholic hepatitis is highly prevalent and associated with infection and mortality. Supplementation with selected trace elements may improve clinical outcomes in this patient group but further insight is required of their biological and clinical effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15880","type":"journal-article","created":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T09:12:25Z","timestamp":1592903545000},"page":"537-544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Trace element deficiency is highly prevalent and associated with infection and mortality in patients with alcoholic hepatitis"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0523-0193","authenticated-orcid":false,"given":"Ashwin","family":"Dhanda","sequence":"first","affiliation":[{"name":"Faculty of Health University of Plymouth Plymouth UK"},{"name":"South West Liver Unit University Hospitals Plymouth NHS Trust Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-7100","authenticated-orcid":false,"given":"Stephen","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Vergis","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1532-8992","authenticated-orcid":false,"given":"Doyo","family":"Enki","sequence":"additional","affiliation":[{"name":"Research Design Service \u2013 East Midlands University of Nottingham Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4373-4904","authenticated-orcid":false,"given":"Andrew","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Chemistry University of Plymouth Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3589-6671","authenticated-orcid":false,"given":"Robert","family":"Clough","sequence":"additional","affiliation":[{"name":"Department of Chemistry University of Plymouth Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1152-0568","authenticated-orcid":false,"given":"Matthew","family":"Cramp","sequence":"additional","affiliation":[{"name":"Faculty of Health University of Plymouth Plymouth UK"},{"name":"South West Liver Unit University Hospitals Plymouth NHS Trust Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8218-192X","authenticated-orcid":false,"given":"Mark","family":"Thursz","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,23]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Trace Elements in Human Nutrition and Health","author":"World Health Organization","year":"1996"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.18388\/abp.2003_3638"},{"key":"e_1_2_7_4_1","first-page":"5464373","article-title":"Nutritional aspects of essential trace elements in oral health and disease: an extensive review","volume":"2016","author":"Bhattacharya PT","year":"2016","journal-title":"Scientifica (Cairo)"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/71.2.621s"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-017-0701-x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533612469027"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v9.i5.263"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(84)90776-9"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1995.tb01560.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.12.038"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hepres.2004.10.009"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph13060582"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-015-0237-3"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.115.110932"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-015-3613-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26142"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01309514"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1412278"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta191020"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.1976.tb00505.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.5604\/16652681.1184191"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-017-0132-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1021\/pr050361j"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-7500-8_12"},{"key":"e_1_2_7_26_1","first-page":"119","article-title":"Zinc and vitamin A deficiency in liver cirrhosis","volume":"30","author":"Scholmerich J","year":"1983","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2006.099929"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(87)80069-7"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnutbio.2018.05.003"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840080622"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-5561-1_14"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.1999.10718843"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2008.10719741"},{"key":"e_1_2_7_34_1","first-page":"794A","article-title":"Zinc sulfate for alcoholic cirrhosis (ZAC) clinical trial \u2010 interim analysis of liver injury\/inflammation biomarkers","volume":"60","author":"Mohammad M","year":"2014","journal-title":"Hepatology"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000492"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.21668"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-5890(03)00152-4"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature03104"},{"key":"e_1_2_7_39_1","first-page":"490","article-title":"[Alcohol\u2010induced toxic hepatitis\u2013a \"free radical\" associated disease. Lowering fatality by adjuvant antioxidant therapy]","volume":"48","author":"Wenzel G","year":"1993","journal-title":"Z Gesamte Inn Med"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.03.027"},{"key":"e_1_2_7_41_1","volume-title":"AMA Manual of Style: A Guide for Authors and Editors","author":"Iverson C","year":"2007"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.15880","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.15880","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T16:58:47Z","timestamp":1693933127000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.15880"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,23]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/apt.15880"],"URL":"https:\/\/doi.org\/10.1111\/apt.15880","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,23]]},"assertion":[{"value":"2020-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-05-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}