Liver Iron Level Is a Possible Marker for Severe Fibrosis

Patients with chronic hepatitis C frequently have mild-to-moderate elevations of iron in their livers, which increases as fibrosis progresses. Some researchers have therefore hypothesized that iron might enhance liver fibrosis progression, but the actual impact of iron on liver disease is not well understood.

As reported in the April 2007 Journal of Hepatology, researchers conducted a study of 586 hepatitis C patients who received liver biopsies prior to starting antiviral therapy. The investigators assessed the effects of confounding variables, taking into account all factors known to influence both iron overload and fibrosis. Serum ferritin and liver iron were correlated with clinical, biological, and histological variables in univariate and multivariate analyses.

Results

• Hyperferritinemia (elevated serum ferritin) was observed in 27% of subjects.

• Elevated ferritin was associated with liver iron deposits in only 46% of cases.

• Levels of iron in the liver were elevated in 17% of subjects.

• Elevated liver iron was associated with older age, male sex, and increased alcohol intake.

• The univariate analysis showed a strong link between liver iron and fibrosis, but this disappeared after adjusting for confounding variables.

Conclusion

"According to the results of this study, liver iron should be considered more as a surrogate marker for disease severity than as a fibrogenic factor per se," the authors concluded.

04/03/07

Reference
D Guyader, A-S Thirouard, L Erdtmann, and others. Liver iron is a surrogate marker of severe fibrosis in chronic hepatitis C. Journal of Hepatology 46(4): 587-595. April 2007.