Serum Markers of Iron Metabolism in Chronic Liver Diseases

Abstract

BACKGROUND:Disorders in the metabolism of iron in the direction of iron overload are observed not only in primary hemochromatosis but also in some chronic liver diseases other aetiology. Elevation of serum iron, ferritin and transferrin saturation is reported in nonalcoholic fatty liver disease and alcohol, chronic hepatitis C and liver cirrhosis.AIM:Aim of the study was to evaluate and compare the frequency of the iron serum markers in patients with various chronic liver diseases.MATERIAL AND METHODS:The study included a total of 246 persons -186 patients with chronic liver disease without cirrhosis (-115 men, women -71; average age of 50.41 ± 12.85, from 23 to 77 years) and 60 healthy controls (-30 men, women -30, middle-aged 50.50 ± 11.31, from 29 to 83 years). Medical history, physical examination and demographic data including height, weight, laboratory and instrumental studies were performed.RESULTS:The highest incidence of elevated serum iron, transferrin saturation and ferritin and decreased serum hepcidin found in cases of alcoholic liver disease (ALD), nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC).CONCLUSION:Finally, analysis of the changes in serum markers of iron metabolism shows that the difference between healthy and sick with liver disease is primarily due to changes in alcoholic and nonalcoholic fatty liver disease, particularly steatohepatitis, and chronic hepatitis C.

Review article: iron disturbances in chronic liver diseases other than haemochromatosis – pathogenic, prognostic, and therapeutic implications

“…Most studies have described low serum hepcidin levels in patients with chronic hepatitis C, and the hepcidin response has been inappropriate for the associated findings of elevated serum iron concentration, hyperferritinemia, and increased transferrin saturation . The mRNA for hepcidin has been decreased in the liver tissue of these patients, and suppression of the transcriptional activity of the HAMP gene has been proposed as a basis for the iron overload .…”

Serum iron, Magnesium, Copper, and Manganese Levels in Alcoholism: A Systematic Review

“…Ferritin levels below 30 μg/L are an indicator of iron deficiency. Other serum markers of iron stores include transferrin–iron saturation [TS] and serum iron levels themselves [13,14,15]. All of the abovementioned markers are higher in people who consume mild or moderate amounts of alcohol compared to those in nondrinkers [16].…”

Quantitative HBsAg titers in relation to disease progression and serum markers of iron metabolism among chronic hepatitis B patients

“…Past studies revealed significantly higher levels of serum iron in persistent HBV carriers than those with clearance of the viral infection and higher serum transferrin saturation and ferritin concentrations and increased liver iron deposition in patients with HBV-related liver disease [12,[18][19][20]. Increase in serum Fe levels has also been associated with increased risk of progression of steatosis to more severe liver pathologies, such as steatohepatitis, fibrosis, and HCC [21][22][23].…”

“…Many indices of iron metabolism such as hepatic iron, serum levels of iron, ferritin, and transferrin saturation have been used as diagnostic tools in detecting iron overload as a risk factor for liver fibrosis and disease progression [11][12][13][14]. However, prevalence and clinical significance of disturbed iron metabolism in patients with HBV-related cirrhosis remain still inconclusive [3,11,12,15].…”