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Zinc deficiency in children with cholestatic liver diseases could affect growth and immunity. Zinc supplementation is one of the strategies to prevent the consequences of zinc deficiency in children. We aimed to study the effect of zinc supplementation on the growth of these children. Fifty-five infants and children (0.5–10 years) with cholestatic liver diseases enrolled from pediatrics hepatology clinic, Cairo University Hospital: 27 post-Kasai, 7 with Alagille syndrome, and 21 with progressive familial intrahepatic cholestasis. Serum zinc, insulin-like growth factor 1 (IGF-1), and anthropometric measurements are measured at enrollment and 4 months after zinc supplementation and in 30 healthy children with matched age and sex. Serum zinc was measured by atomic absorption spectrometry. The mean initial serum zinc (± SD) in cholestatic and healthy control group was 1251 ± 558 and 1461 ± 506 ug/l, respectively (P > 0.05). Meanwhile, serum IGF1 median (IQR; range) in patients and control was 54 (118;10:780) ng/ml and 250 (387;55:635) ng/ml, respectively (p < 0.001). No statistically significant difference was found between post-Kasai patients and other cholestatic diseases. Children supplemented with zinc had their serum zinc 2223 ± 1042 ug/l (P < 0.001) and IGF1 median (IQR; range) 346 (370;50:825) ng/ml (P < 0.001). In addition, among anthropometric variables, height (length) Z-score and percentile were significantly improved (P < 0.01). As compared with the baseline, zinc supplementation had significantly elevated serum zinc levels and IGF1 and improved growth in children with cholestatic liver diseases. Thus, zinc supplementation is beneficial for growth in children with cholestatic liver diseases.

Zinc status in infants and children with cholestatic liver diseases and its effect on growth