Estimation of Blood Manganese (Trace Element) Levels in Patients of Hepatitis C, Cirrhosis and Hepatocellular Carcinoma

Abstract

Objective

To determine the levels of manganese (Mn) trace element in patients with cirrhosis, hepatitis C, and hepatocellular carcinoma (HCC).

Methodology

Samples were collected from patients at tertiary care hospitals in Pakistan over a period of two years. In total, 90 patients who were diagnosed with hepatitis C virus infection (HCV), cirrhosis and hepatocellular carcinoma (HCC) were selected. Blood manganese (Mn) levels were quantified using atomic absorption spectrometer in the three groups and mean with standard deviation of Mn was calculated. Moreover, frequency and percentage of different variables was calculated. Analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) was used for comparing manganese mean levels within the study groups. P value less than 0.05 was considered statistically significant.

Results

In cirrhotic patients there is no change in the mean concentration of manganese in the body (mean±SD, 0.01±0.015) compared to normal reference values; while, the mean concentration of manganese is high in patients with hepatitis C (mean±SD, 0.32±0.66) and in patients with hepatocellular carcinoma (mean±SD, 0.36±0.65) (p=0.02, ANOVA). When Tukey’s HSD is applied, a statistically significant change in the Mn level is found between cirrhosis and HCC patients (p-value=0.03).

Conclusion

High levels of manganese can compensate the loss of superoxide dismutase (SOD) in the patient body by protecting against oxidative stress. Present study suggests that manganese has differential levels in HCV, cirrhosis and HCC. Thus, the evaluation of blood manganese levels may be performed periodically in chronic liver diseases to assess the potential progression of liver diseases. 

Keywords

Hepatocellular carcinoma, cirrhosis, hepatitis C virus, manganese