Does the death knell toll for phlebotomy in NAFLD?

Ryan, John D.; Marjot, Thomas; Cobbold, Jeremy

doi:10.1002/hep.28029

Cited by 3 publications

(2 citation statements)

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“…This was not confirmed by a recent Australian study from Adams et al, who failed to find any improvement in both insulin resistance and steatosis in phlebotomized NAFLD patients. However, as stressed by Ryan et al, only a few patients had increased hepatic iron in this study.…”

contrasting

confidence: 42%

Metabolic and hepatic effects of bloodletting in dysmetabolic iron overload syndrome: A randomized controlled study in 274 patients

et al. 2016

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contrasting

confidence: 42%

Metabolic and hepatic effects of bloodletting in dysmetabolic iron overload syndrome: A randomized controlled study in 274 patients

et al. 2016

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“…Some smaller studies have associated phlebotomy with improvements in hepatic functional parameters (Valenti et al 2007 ; Valenti et al 2014 ; Sumida et al 2006 ), but in other studies the benefit of phlebotomy in NAFLD was small or nonexistent (Adams et al 2015 ; Murali et al 2017 ; Beaton et al 2013 ). While the debate continues (Garg et al 2013 ; Ryan et al 2015 ), some national guidelines are embracing the possibilities of phlebotomy in NAFLD, while cautioning that any official recommendation about the use of phlebotomy should be taken into account only after we obtain confident results from large and long-term trials (Watanabe et al 2015 ). The biggest question to be resolved by these trials will be to find out that if phlebotomy is beneficial in NAFLD, then, is this benefit reserved to a subset of patients or to a much larger group of patients.…”

Section: Discussionmentioning

confidence: 99%

Low hepcidin in liver fibrosis and cirrhosis; a tale of progressive disorder and a case for a new biochemical marker

Vela

2018

Mol Med

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Liver fibrosis is a precursor of liver cirrhosis, which is associated with increased mortality. Though liver biopsy remains the gold standard for the diagnosis of fibrosis, noninvasive biochemical methods are cost-effective, practical and are not linked with major risks of complications. In this respect, serum hepcidin, has emerged as a new marker of fibrosis and cirrhosis. In this review the discussion uncovers molecular links between hepcidin disturbance and liver fibrosis/cirrhosis. The discussion also expands on clinical studies that suggest that hepcidin can potentially be used as a biochemical parameter of fibrosis/cirrhosis and target of therapeutic strategies to treat liver diseases. The debatable issues such as the complicated nature of hepcidin disturbance in non-alcoholic liver disease, serum levels of hepcidin in acute hepatitis C virus infection, cause of hepcidin disturbance in autoimmune hepatitis and hepatic insulin resistance are discussed, with potential solutions unveiled in order to be studied by future research.

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Outcome of Phlebotomy on Improvement of Liver Enzymes and Steatosis in Non-Alcoholic Fatty Liver Disease: A Randomized, Controlled Trial

Hormati

Khanyabi

Ahmadpour

et al. 2022

J Adv Med Biomed Res

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10.30699/jambs.30.143.493Background & Objective: Iron overload in the liver can potentially induce nonalcoholic fatty liver disease (NAFLD). In this study, we sought to evaluate the phlebotomy in NAFLD, and compare it with modified life style. Materials & Methods:This randomized, single-blind, clinical trial was carried out to evaluate the efficacy of phlebotomy on liver enzymes and steatosis in NAFLD patients. Forty patients diagnosed with NAFLD were enrolled in the study. Patients were randomized into two groups, including twenty patients in the first group who were under daily consumption of 800 IU vitamin E with modified lifestyle, and the second group who administrated 400 ml phlebotomy at the baseline and fifth month of study alongside the modified lifestyle. Transient elastography (TE) was used to evaluate liver transaminases, hemoglobin, ferritin levels, and liver stiffness prior to and following the intervention. Chi-square and paired t-tests were used to analyze the data, using SPSS v18. Results:In each group, there were 14 men and 6 women. There was no statistically significant difference in demographic features. After the intervention, the mean liver stiffness of the control group increased from 10.38±2.65 kPa before the treatment to 11.40±6.58 kPa, which was not significantly different (P=0.463). The liver stiffness was 11.29±4.71 kPa in the intervention group before the treatment, which was reduced to 8.10±2.36 kPa after the treatment; however, the difference between pre and posttreatment values was statistically significant (P = 0.009). Before and after the treatment, there were no significant differences in the levels of liver enzymes between the two groups. Conclusion:Phlebotomy is a useful treatment for NAFLD patients, and decreased liver stiffness as cirrhosis complication.

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Does the death knell toll for phlebotomy in NAFLD?

Abstract: We are concerned that Wu et al. do not seem to have fully understood that the genetic analyses we report demonstrate a causal link between interleukin (IL)22RA2 alleles and severe fibrosis in hepatitis C virus (HCV) and schistosome infections. In this study,

Cited by 3 publications

References 5 publications

Metabolic and hepatic effects of bloodletting in dysmetabolic iron overload syndrome: A randomized controlled study in 274 patients

Metabolic and hepatic effects of bloodletting in dysmetabolic iron overload syndrome: A randomized controlled study in 274 patients

Low hepcidin in liver fibrosis and cirrhosis; a tale of progressive disorder and a case for a new biochemical marker

Outcome of Phlebotomy on Improvement of Liver Enzymes and Steatosis in Non-Alcoholic Fatty Liver Disease: A Randomized, Controlled Trial

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