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We evaluated the efficacy and safety of treatment with zinc acetate hydrate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 97 patients with cirrhosis complicated by hypozincemia were treated with zinc acetate hydrate, and their serum zinc normalization rates; factors contributing to normalization; changes in blood ammonia levels; branched\u2010chain amino acids\u2010to\u2010tyrosine ratios; levels of albumin, hemoglobin, alkaline phosphatase, serum copper, and iron; incidence of adverse events; improvement in subjective symptoms; and serum zinc levels taken at 3\u00a0months post\u2010treatment were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cumulative serum zinc normalization rates, when normalization was defined as achievement of a serum zinc level\u2009\u226580\u00a0\u03bcg\/dL, after 2, 4, and 6\u00a0months of treatment were 64.9%, 80.3%, and 82.5%, respectively. Multivariate analysis identified an albumin level of \u22653.3\u00a0g\/dL and branched\u2010chain amino acids to tyrosine ratio of \u22653.46 as factors contributing to zinc normalization within 3\u00a0months of treatment. Treatment resulted in a significant decrease in blood ammonia and serum copper levels, and significant increases in branched\u2010chain amino acids\u2010to\u2010tyrosine ratios and alkaline phosphatase levels. Seven (7.2%) patients prematurely discontinued treatment due to hypocupremia. By the end of treatment, subjective symptoms had resolved in 46.2% of patients. By 3\u00a0months post\u2010treatment, serum zinc levels had reverted to levels close to those at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment with zinc acetate hydrate resulted in normalization of serum zinc levels at a high rate. The main reasons for discontinuation of treatment included hypocupremia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13461","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T01:35:02Z","timestamp":1573781702000},"page":"488-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Evaluation of treatment with zinc acetate hydrate in patients with liver cirrhosis complicated by zinc deficiency"],"prefix":"10.1111","volume":"50","author":[{"given":"Itaru","family":"Ozeki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Nakajima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirokazu","family":"Suii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoji","family":"Tatsumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakatsu","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Arakawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuaki","family":"Kuwata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joji","family":"Toyota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyasu","family":"Karino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,22]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"93","article-title":"Zinc an overview","volume":"11","author":"Prasad AS","year":"1995","journal-title":"Nutrition"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.biochem.70.1.313"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0092-8674(00)00077-5"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrm1499"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12263-014-0436-0"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/130.5.1447S"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/130.5.1509S"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1079\/BJN19940063"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533611433534"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nu.05.070185.002013"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2012.04.004"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.1976.tb00505.x"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009-8981(86)90082-3"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10010088"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(91)90290-2"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(84)92567-4"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510230523"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.13388"},{"key":"e_1_2_5_20_1","first-page":"178","article-title":"Zinc supplementation therapy improves the outcome of patients with chronic hepatitis C","volume":"51","author":"Matsumura H","year":"2012","journal-title":"J Clin Biochem Nutr"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10121955"},{"key":"e_1_2_5_22_1","first-page":"1","article-title":"Effects of Zinc Acetate on Serum Zinc Concentrations in Chronic Liver Diseases: a Multicenter, Double\u2010Blind, Randomized, Placebo\u2010Controlled Trial and a Dose Adjustment Trial","author":"Katayama K","year":"2019","journal-title":"Biol Trace Elem Res"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20506"},{"key":"e_1_2_5_24_1","unstructured":"National Cancer Institute Division of Cancer Treated and Diagnosis.Cancer Therapy Evaluation Program. 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