الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Liver disease is a major health problem in Egypt. Cirrhosis is the most common cause of non-malignancy related death among patients with diseases of the digestive tract. The most important defense mechanisms are associated with the activity of antioxidative enzymes, among which glutathione peroxidase (GSH-Px), belonging to so-called free radical scavengers’ should be mentioned.
Selenium, regarded as a bioelement, is present in GSH-Px. Involved in numerous redox reactions; it belongs to the factors protecting the organism form oxidative shock. Selenium deficiency induces some pathological conditions such as liver necrosis. Selenium deficiency has been also involved in the pathogenesis of chronic hepatitis B and C.
The aim of this research is to study the level of serum Selenium in patients with chronic liver diseases compared to healthy controls and the relationship of serum Selenium to the severity of liver disease.
Our study included 80 adult patients with chronic liver diseases. The patients were categorized to four groups; fifteen patients with chronic hepatitis C (group I), fifteen patients with chronic hepatitis B (group II), thirty patients with liver cirrhosis (group III) and twenty patients with HCC (group IV). All groups were compared with 20 healthy control subjects.
We found that the level of serum selenium decreased significantly from (chronic hepatitis C, chronic hepatitis B and liver cirrhosis) when compared with healthy controls. Patients with HCC had the lowest selenium concentration when compared to other groups.
It was also found that serum selenium concentrations significantly decreased from Child group A to Child group C. Since the decrease in serum Selenium level was related to the increasing severity of the liver cirrhosis so we may suggest that the assessment of serum selenium concentration may be important prognostic method for evaluation and complementary treatment for patients with chronic liver diseases.
In conclusion serum selenium levels were significantly lower in patients with chronic liver disease than in healthy control group. Also, Serum Selenium levels significantly decreased in relation to the progression of chronic liver disease. Patients with HCC had the lowest serum Selenium concentration that might correlate with the pathophysiology of HCC. chronic hepatitis C and B, liver cirrhosis and HCC were independent predictors of selenium deficiency.
RECOMMENDATIONS
1) Follow up of patients with chronic liver diseases with or without early cirrhosis by serial measurement of serum selenium level.
2) Early introduction of selenium supplements as a part of treatment of patients with chronic liver diseases.
3) Introduction of selenium supplementations in patients with HCC as an aiding factor in their therapeutic procedures.
4) Further studies are needed to study the effect of selenium supplementations in progression of chronic liver disease.