The serum hepcidin:ferritin ratio is a potential biomarker for cirrhosis

Tan, Terrence; Crawford, Darrell H. G.; Franklin, Michael E.; Jaskowski, L.; Macdonald, Graeme A.; Jonsson, Julie R.; Watson, Melanie; Taylor, Paul J.; Fletcher, Linda M.

doi:10.1111/j.1478-3231.2012.02828.x

Cited by 61 publications

(62 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A significant reverse association was found between hepcidin:ferritin ratio and NAFLD that was observed only in women (OR adjusted 0.412, 95% CI 0.215-0.788). A few studies have focused on the relationship between hepcidin:ferritin ratio and NAFLD risk, and our findings were indirectly supported by several studies that revealed a reverse correlation between hepcidin:ferritin ratio and alcoholic liver disease, chronic liver disease, and liver steatosis degree [29][30][31]. Nevertheless, more studies are needed to confirm the association, and potential mechanisms need exploring.…”

Section: Discussion/conclusionsupporting

confidence: 69%

Circulating Iron Levels Interaction with Central Obesity on the Risk of Nonalcoholic Fatty Liver Disease: A Case–Control Study in Southeast China

et al. 2019

View full text Add to dashboard Cite

Objectives: We aimed to evaluate the associations between body iron stores and the risk of nonalcoholic fatty liver disease (NAFLD) in a Chinese population and explore whether this effect may be modified by other factors. Methods: A 1: 1 frequency-matched case–control study was conducted, including 482 NAFLD cases and 490 gender- and age-matched controls. Serum levels of ferritin, hepcidin, and C-reactive protein were measured. Results: Multivariate logistic regression analysis showed that hepcidin was not associated with NAFLD risk; however, elevated serum ferritin was significantly associated with increased risk of NAFLD (adjusted OR 1.619, 95% CI 1.158–2.267), and hepcidin:ferritin ratio was significantly associated with decreased risk of NAFLD (OR_adjusted 0.702, 95% CI 0.501–0.984). When stratified by gender, a significant association was found between elevated serum ferritin and hepcidin:ferritin ratio and NAFLD only for women (OR_adjusted 2.131, 95% CI 1.151–3.944 and OR_adjusted 0.414, 95% CI 0.219–0.781, respectively). A significant multiplicative interaction between central obesity and elevated serum hepcidin was observed (p < 0.05). Conclusions: Elevated serum ferritin and hepcidin:ferritin ratio are associated with NAFLD in a Chinese population. Although serum hepcidin is not associated with NAFLD, it may augment the risk effect of central obesity on NAFLD.

show abstract

Section: Discussion/conclusionsupporting

confidence: 69%

Circulating Iron Levels Interaction with Central Obesity on the Risk of Nonalcoholic Fatty Liver Disease: A Case–Control Study in Southeast China

et al. 2019

View full text Add to dashboard Cite

show abstract

“…When hepcidin production is enhanced, such as in patients with inflammation and chronic kidney disease, iron absorption decreases (14). On the contrary, when hepcidin production is suppressed, such as patients with liver damage, the iron absorption rate rises inappropriately (15). Hence, even when iron absorption is inhibited by PPIs, the hepcidinferroportin system provides negative feedback, thereby enhancing iron absorption.…”

Section: Discussionmentioning

confidence: 99%

Iron-deficiency Anemia Caused by a Proton Pump Inhibitor

Hashimoto¹,

Matsuda²,

Chonan³

2014

Intern. Med.

View full text Add to dashboard Cite

A 59-year-old man was orally administered rabeprazole, a proton pump inhibitor (PPI), for gastroesophageal reflux disease, after which he gradually developed iron-deficiency anemia. The anemia did not improve following the administration of ferrous fumarate, and endoscopic screening of the entire gastrointestinal tract, including the small intestine, did not reveal any findings indicating the cause of the anemia. The patient was then switched from rabeprazole to famotidine and the anemia was cured within three months. There is much debate as to whether the long-term use of PPIs causes iron-deficiency. However, this case strongly suggests that PPIs can induce iron-deficiency anemia.

show abstract

“…Recently, Tan et al showed that serum hepcidin/ferritin ratio could be used as a potential biomarker for cirrhosis. 29 To understand the mechanism of iron regulation in ACLF patients with MOF, we estimated the ratios of the iron-regulating proteins to that of the circulating hepcidin (central iron regulator). The iron/hepcidin and ferritin/hepcidin ratios were significantly higher in ACLF-MOF patients, as compared to cirrhosis and controls.…”

Section: Discussionmentioning

confidence: 99%

Dysregulated iron homeostasis is strongly associated with multiorgan failure and early mortality in acute‐on‐chronic liver failure

et al. 2015

View full text Add to dashboard Cite

Acute-on-chronic liver failure (ACLF) is an ailment with high incidence of multiorgan failure (MOF) and consequent mortality. Dysregulated iron homeostasis and macrophage dysfunction are linked to increased incidence of MOF. We investigated whether a panel of circulating iron-regulating proteins are associated with development of MOF and can predict 15-or 30-day mortality in ACLF patients. One hundred twenty patients with ACLF, 20 patients with compensated cirrhosis, and 20 healthy controls were studied. Relative protein expression profiling was performed in the derivative cohort and confirmed in the validation cohort. A panel of iron regulators and indices were determined. Multiparametric flow cytometry for quantitation of labile iron pool (LIP) was performed. Validation studies confirmed lower serum transferrin (Tf) and ceruloplasmin levels in ACLF and ACLF-MOF, compared to patients with cirrhosis and controls (P < 0.01). Serum iron and ferritin levels were markedly elevated (P < 0.001; P < 0.05) and hepcidin levels were lower (P < 0.001) in ACLF patients with MOF than those without and other groups (P < 0.001). Percentage Tf saturation (%SAT) was higher in ACLF-MOF (39.2%; P < 0.001) and correlated with poor outcome (hazard ratio: 6.970; P < 0.01). Intracellular LIP indices were significantly elevated in the subsets of circulating macrophages in ACLF-MOF, compared to other groups (P < 0.01). Whereas expression of iron-regulatory genes was markedly down-regulated, genes related to endoplasmic reticulum stress, apoptosis, and inflammation were up-regulated in ACLF patients, compared to patients with cirrhosis. Severe dysregulation of autophagy mechanisms was also observed in the former. Conclusions: Iron metabolism and transport are severely deranged in ACLF patients and more so in those with MOF. %SAT, circulating hepcidin, and LIP in macrophages correlate with disease severity and %SAT could be used for early prognostication in ACLF patients. (HEPATOLOGY 2015;61:1306-1320

show abstract

The serum hepcidin:ferritin ratio is a potential biomarker for cirrhosis

Abstract: The hepcidin:ferritin ratio is reduced in relation to increasing fibrosis in CLD and the use of this ratio may have potential future diagnostic implications as a marker of cirrhosis.

Cited by 61 publications

References 35 publications

Circulating Iron Levels Interaction with Central Obesity on the Risk of Nonalcoholic Fatty Liver Disease: A Case–Control Study in Southeast China

Circulating Iron Levels Interaction with Central Obesity on the Risk of Nonalcoholic Fatty Liver Disease: A Case–Control Study in Southeast China

Iron-deficiency Anemia Caused by a Proton Pump Inhibitor

Dysregulated iron homeostasis is strongly associated with multiorgan failure and early mortality in acute‐on‐chronic liver failure

Contact Info

Product

Resources

About