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Distribution of Serum Zinc Between Albumin and α2‐Macroglobulin in Patients with Decompensated Hepatic Cirrhosis

Lower concentrations of total serum zinc (540 ± 111 μg/1, mean ± SEM)., and of albumin‐bound serum zinc (295 ± 113 μg/1) and a higher concentration of a2‐macroglobulin‐bound zinc (245 ± 69 μg/1) were found in 25 patients with decompensated hepatic cirrhosis, compared to 28 healthy subjects (835 ± 91; 679 ± 83; 156 ± 27 μg/1 respectively). Levels of total and albumin‐bound zinc were significantly and positively correlated with serum albumin levels. Higher levels of α2‐macroglobulin‐bound zinc were associated with higher levels of α2‐macroglobulin in these patients (2.8 ± 0.8 g/1) compared to normals (2.3 ± 0.6). Hence, not only do decompensated cirrhotics exhibit a lower serum zinc level but a greater proportion of this zinc is associated with the tightly bound, and presumably metabolically more inert, serum fraction. This situation exaggerates the zinc deficiency state of the severe cirrhotic.