Zinc metabolism in alcoholic liver disease

Alterations in zinc metabolism or zinc deficiency frequently occur in patients with alcoholic liver disease. Potential manifestations of zinc deficiency include skin lesions, hypogonadism, impaired night vision, impaired immune function, anorexia, altered protein metabolism, diarrhea, and depressed mental function. Because of the variety of ways in which zinc deficiency may present in alcoholic liver disease, clinicians must maintain a high index of suspicion for this nutrient deficiency when caring for these patients. Not only may zinc deficiency occur with alcoholic liver disease, but there also may be altered zinc metabolism. Recent data from alcoholic hepatitis patients demonstrate increased serum levels of the monokine interleukin 1, which is known to cause hypozincemia and an internal redistribution of zinc. This monokine has a host of metabolic functions other than its effect on mineral metabolism that have relevance for alcoholic liver disease such as fever production, neutrophilia, and muscle catabolism. We suggest that the patient with alcoholic liver disease frequently has problems with either zinc deficiency or altered zinc metabolism and the potential implications of this are discussed.