Outcome of phlebotomy for treating nonalcoholic fatty liver disease: A systematic review and meta-analysis

Jaruvongvanich, Veeravich; Riangwiwat, Tanawan; Sanguankeo, Anawin; Upala, Sikarin

doi:10.4103/1319-3767.195551

Cited by 13 publications

(8 citation statements)

References 44 publications

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“…However, in patients without HFE hemochromatosis and solely MAFLD, the data are limited. Phlebotomy has been observed in studies to significantly decrease insulin resistance and increase levels of alanine transaminase and triglycerides [ 100 ]. While phlebotomy might be an effective way to reduce iron storage in the liver of MAFLD patients, there is no significant correlation between serum ferritin levels and inflammation or erythrocyte sedimentation rate [ 101 ].…”

Section: Review and Discussionmentioning

confidence: 99%

Metabolic Dysfunction-Associated Steatohepatitis and Progression to Hepatocellular Carcinoma: A Literature Review

Ghazanfar,

Javed,

Qasim

et al. 2024

Cancers

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The prevalence of metabolic-associated fatty liver disease (MAFLD) is increasing globally due to factors such as urbanization, obesity, poor nutrition, sedentary lifestyles, healthcare accessibility, diagnostic advancements, and genetic influences. Research on MAFLD and HCC risk factors, pathogenesis, and biomarkers has been conducted through a narrative review of relevant studies, with a focus on PubMed and Web of Science databases and exclusion criteria based on article availability and language. Steatosis marks the early stage of MASH advancement, commonly associated with factors of metabolic syndrome such as obesity and type 2 diabetes. Various mechanisms, including heightened lipolysis, hepatic lipogenesis, and consumption of high-calorie diets, contribute to the accumulation of lipids in the liver. Insulin resistance is pivotal in the development of steatosis, as it leads to the release of free fatty acids from adipose tissue. Natural compounds hold promise in regulating lipid metabolism and inflammation to combat these conditions. Liver fibrosis serves as a significant predictor of MASH progression and HCC development, underscoring the need to target fibrosis in treatment approaches. Risk factors for MASH-associated HCC encompass advanced liver fibrosis, older age, male gender, metabolic syndrome, genetic predispositions, and dietary habits, emphasizing the requirement for efficient surveillance and diagnostic measures. Considering these factors, it is important for further studies to determine the biochemical impact of these risk factors in order to establish targeted therapies that can prevent the development of HCC or reduce progression of MASH, indirectly decreasing the risk of HCC.

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Section: Review and Discussionmentioning

confidence: 99%

Metabolic Dysfunction-Associated Steatohepatitis and Progression to Hepatocellular Carcinoma: A Literature Review

Ghazanfar,

Javed,

Qasim

et al. 2024

Cancers

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“…The adverse effects of iron overload on metabolic health are reflective of symptoms observed in those with hemochromatosis, which is associated with impaired functioning of the liver, pancreas, heart and endocrine organs due to iron-induced cellular damage [ 69 ]. Reduced plasma ferritin concentrations have been associated with a decreased risk of type 2 diabetes mellitus [ 70 ] and improvements in lipid profile [ 71 ], indicating that consideration of iron status is an important factor in the treatment of obesity associated metabolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Risk of Iron Overload in Obesity and Implications in Metabolic Health

et al. 2021

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Excessive adiposity is associated with several metabolic perturbations including disturbances in iron homeostasis. Increased systemic inflammation in obesity stimulates expression of the iron regulatory hormone hepcidin, which can result in a maldistribution of bodily iron, which may be implicated in metabolic dysfunction. This study aimed to investigate the effect of adiposity and any associated inflammation on iron homeostasis and the potential implications of dysregulated iron metabolism on metabolic health. Analyses are based on a subsample from the cross-sectional Irish National Adult Nutrition Survey (2008–2010) (n = 1120). Ferritin status and risk of iron overload were determined based on established WHO ferritin ranges. Participants were classed as having a healthy % body fat or as having overfat or obesity based on age- and gender-specific % body fat ranges as determined by bioelectrical impedance. Biomarkers of iron status were examined in association with measures of body composition, serum adipocytokines and markers of metabolic health. Excessive % body fat was significantly associated with increased serum hepcidin and ferritin and an increased prevalence of severe risk of iron overload amongst males independent of dietary iron intake. Elevated serum ferritin displayed significant positive associations with serum triglycerides and markers of glucose metabolism, with an increased but non-significant presentation of metabolic risk factors amongst participants with overfat and obesity at severe risk of iron overload. Increased adiposity is associated with dysregulations in iron homeostasis, presenting as increased serum hepcidin, elevated serum ferritin and an increased risk of iron overload, with potential implications in impairments in metabolic health.

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“…The experiment was approved by the Institutional Animal Care and Use Committee (code no. [21][22][23][24][25][26][27][28][29][30][31][32][33] and was performed according to the Guidelines for Animal Experimentation of Osaka Metropolitan University.…”

Section: Coagulation Studymentioning

confidence: 99%

“…In fact, iron depletion by phlebotomy improves biochemical and/or histological outcomes in patients with chronic HCV infection, 31,53 ALD, 47 and NAFLD. 28,32,47 However, another study suggests that phlebotomy does not improve pathology of NAFLD. 3 The role of iron overload in CLD progression is still debated.…”

Section: Introductionmentioning

confidence: 99%

Difference in the Mechanism of Iron Overload–Enhanced Acute Hepatotoxicity Induced by Thioacetamide and Carbon Tetrachloride in Rats

Inai,

Izawa,

Kamei

et al. 2024

Toxicol Pathol

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Iron overload has been recognized as a risk factor for liver disease; however, little is known about its pathological role in the modification of liver injury. The purpose of this study is to investigate the influence of iron overload on liver injury induced by two hepatotoxicants with different pathogenesis in rats. Rats were fed a control (Cont), 0.8% high-iron (0.8% Fe), or 1% high-iron diet (1% Fe) for 4 weeks and were then administered with saline, thioacetamide (TAA), or carbon tetrachloride (CCl4). Hepatic and systemic iron overload were seen in the 0.8% and 1% Fe groups. Twenty-four hours after administration, hepatocellular necrosis induced by TAA and hepatocellular necrosis, degeneration, and vacuolation induced by CCl4, as well as serum transaminase values, were exacerbated in the 0.8% and 1% Fe groups compared to the Cont group. On the other hand, microvesicular vacuolation induced by CCl4 was decreased in 0.8% and 1% Fe groups. Hepatocellular DNA damage was increased by iron overload in both models, whereas a synergistic effect of oxidative stress by excess iron and hepatotoxicant was only present in the CCl4 model. The data showed that dietary iron overload exacerbates TAA- and CCl4-induced acute liver injury with different mechanisms.

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Outcome of phlebotomy for treating nonalcoholic fatty liver disease: A systematic review and meta-analysis

Cited by 13 publications

References 44 publications

Metabolic Dysfunction-Associated Steatohepatitis and Progression to Hepatocellular Carcinoma: A Literature Review

Metabolic Dysfunction-Associated Steatohepatitis and Progression to Hepatocellular Carcinoma: A Literature Review

Risk of Iron Overload in Obesity and Implications in Metabolic Health

Difference in the Mechanism of Iron Overload–Enhanced Acute Hepatotoxicity Induced by Thioacetamide and Carbon Tetrachloride in Rats

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