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Table 1 Characteristics of the selected randomized controlled trials

From: Zinc supplementation in patients with cirrhosis and hepatic encephalopathy: a systematic review and meta-analysis

Author, Year Trial design Country N (M:F) Agea (yrs) Etiology of cirrhosis (V/A/other) HE grade (MHE/I/II) Serum zinc levelsa (ug/dL) CP scorea,b/ classification Intervention Comparison Treatment duration (days)
Reding, 1984 [14] Randomized, double-blind, placebo-controlled Belgium Z: 10 (8:2) Z: 52.1 ± 9.9 0/22/0 0/22/0 Z: 60.3 ± 17.9 Z: A/B/C = 1/8/1 Zinc acetate 600 mg/d Placebo 7
C: 12 (7:5) C: 52.7 ± 13.4 C: 64.5 ± 21 C: A/B/C = 1/9/2
Riggio, 1991 [15] Double-blind crossover trial Italy 10:5 47–71 6/5/4 3/10/2 29.9 ± 8.4 ND Zinc sulfate 600 mg/d Placebo 10
Bresci, 1993 [13] Randomized, double-blind, placebo-controlled Italy Z: 46 (33:13) Z: 51 ± 9 50/30/10 ≤ grade I Z: 50 ± 6 Z: A/B/C = 0/30/16 Zinc acetate 600 mg/d and lactulose Lactulose 90 g/d 180
C: 44 (23:21) C: 49 ± 9 C: 52 ± 5 C: A/B/C = 0/35/9
Hayashi, 2007 [26] Randomized, double-blind, placebo-controlled Japan Z: 19 (10:9) Z: 66.0 ± 9.9 38/0/2 ND Z: 58.4 ± 9.2 ND Zinc sulfate 200 or 600 mg/dc and BCAA granules BCAA granules 150–180
C: 21 (13:8) C: 65.1 ± 11.3 C: 60.2 ± 9
Takuma, 2010 [28] Randomized, unblinded, placebo-controlled Japan Z: 39 (17:22) Z: 66.5 ± 5.7 58/13/8 0/49/30 Z: 48.9 ± 9.3 Z: A/B/C = 8/23/8 Polaprezinc 225 mg/dd and standard therapye Standard therapye 30–60 mL/d 180
C: 40 (23:17) C: 66.5 ± 7.4 C: 51.6 ± 13.3 C: A/B/C = 7/26/7
Katayama, 2014 [27] Randomized, double-blind, placebo-controlled Japan Z: 7 (3:4) Z: 64.3 ± 7.1 ND ≤ grade 1 Z: 55.1 ± 8.1 ND Zinc acetate 150 mg/d Placebo 90
C: 5 (4:1) C: 73.6 ± 8.4 C: 51.8 ± 8.3 ND
Mousa, 2016 [17] Randomized, double-blind, placebo-controlled Egypt Z: 31 (16/14) Z: 54.5 ± 9.6 57/0/3 58/0/0 Z: 49.6 ± 11.2 Z: A/B/C = 6/22/3 Zinc gluconate 175 mg/d, Vit. A 50,000 IU, Vit. C 500 mg, Vit. E 100 mg, and lactulose Lactulose 30–60 ml twice to three times a day 90
C: 27 (15/12) C: 55.8 ± 9.2 C: 46.9 ± 10.5 C: A/B/C = 4/20/3
  1. M male, F female, N number, CP Child-Pugh, Z zinc supplementation, d day, C control, ND no data, HE hepatic encephalopathy, MHE minimal hepatic encephalopathy, V viral, A alcoholic, BZL blood zinc level, BCAA Branched-chain amino acids
  2. aData reported as the mean ± standard deviation
  3. bCirrhosis staging reported as A: < 7; B: 7–9; and C: > 9
  4. cThe zinc sulfate dose was 600 mg/d when serum zinc levels of < 50 μg/dL and was 200 mg/d when zinc levels of 50–70 μg/dL
  5. dPolaprezinc was composed of zinc 51 mg and L-carnosine 174 mg
  6. eStandard therapy contained BCAA granules and lactulose 30–60 mL/d