Non-HFE iron overload as a surrogate marker of disease severity in patients of liver cirrhosis

Indian J Gastroenterol. 2016 Jan;35(1):33-9. doi: 10.1007/s12664-016-0623-6. Epub 2016 Feb 13.

Abstract

Background: Decompensated liver cirrhosis is an important cause of mortality worldwide. Various modifiable and non-modifiable factors are involved in the pathogenesis of cirrhosis and its complications. This study was aimed to evaluate the association of iron overload and disease severity in patients of liver cirrhosis and its association with HFE gene mutation.

Methods: Forty-nine patients with decompensated liver cirrhosis were recruited. Clinical and laboratory parameters were compared in patients with and without iron overload. C282Y and H63D gene mutation analysis was performed in all patients with iron overload.

Results: Iron overload was found in 20 (40.82%) patients. A significant positive correlation of transferrin saturation with Child-Turcotte-Pugh (CTP) score (r = 0.705, p < 0.001) and model for end-stage liver disease (MELD) score (r = 0.668, p < 0.001) was found. Transferrin saturation was also independently associated with high CTP and MELD score on multivariate analysis. Mortality over 3 months was significantly more common in iron-overloaded patients (p = 0.028). C282Y homozygosity or C282Y/H63D compound heterozygosity was not found in any of the patients with iron overload.

Conclusion: Iron overload was significantly associated with disease severity and reduced survival in patients of decompensated liver cirrhosis.

Keywords: CTP score; HFE gene mutation; Iron overload; Liver cirrhosis; MELD score.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Female
  • Genetic Association Studies*
  • Hemochromatosis Protein / genetics*
  • Humans
  • Iron Overload / blood
  • Iron Overload / complications*
  • Iron Overload / genetics*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / etiology*
  • Liver Cirrhosis / genetics*
  • Liver Cirrhosis / mortality
  • Male
  • Middle Aged
  • Mutation
  • Severity of Illness Index
  • Survival Rate
  • Transferrin / metabolism

Substances

  • Biomarkers
  • HFE protein, human
  • Hemochromatosis Protein
  • Transferrin