Liver iron is a surrogate marker of severe fibrosis in chronic hepatitis C
Liver iron is a surrogate marker of severe fibrosis in chronic hepatitis C
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DOI：
10.1016/j.jhep.2006.09.021
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发表时间：
2007-04-01
影响因子：
25.7
通讯作者：
Deugnier, Yves
中科院分区：
文献类型：
--
作者：
Guyader, Dominique;Thirouard, Anne-Sophie;Deugnier, Yves
背景/目的：慢性丙型肝炎患者经常有轻度至中度的肝脏铁超载，并随着纤维化阶段的增加而增加。因此，有人推测铁可以促进纤维化的进展。然而，铁的真实的影响仍然存在争议。本研究旨在确定混杂变量的影响。所有已知的影响铁超载和纤维化的因素被考虑到。方法：五百八十六例患者，谁进行了肝活检前的抗病毒治疗，包括在内。单因素和多因素分析显示血清铁蛋白和肝脏铁与临床、生物学和组织学变量相关。铁对纤维化的影响进行了评估，在整个组和380例患者的亚组中的多变量分析提供datesinfection.Results：高铁蛋白血症，遇到27%，与肝脏铁沉积在只有46%的情况下。17%的患者肝脏铁含量升高，与年龄、男性性别和酒精摄入量相关。调整混杂变量后，肝铁和纤维化之间存在的单变量强联系消失：结论：根据这项研究的结果，肝铁应被认为是一个替代指标的疾病严重程度比作为一个纤维化因素本身。(c)2006年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims: Patients with chronic hepatitis C have frequently mild to moderate liver iron overload which increases with fibrosis stage. Thus, it has been postulated that iron could enhance the progression of fibrosis. However, the real impact of iron is still controversial. The study was undertaken to determine the effect of confounding variables. All factors known to influence both iron overload and fibrosis were taken into account.Methods: Five hundred and eighty-six patients, who had liver biopsy performed prior to antiviral treatment, were included. Serum ferritin and liver iron were correlated with clinical, biological and histological variables in univariate and multivariate analysis. The impact of iron on fibrosis was evaluated in multivariate analysis in the whole group and in the subgroup of 380 patients with available date of infection.Results: Hyperferritinemia, encountered in 27%, was associated with liver iron deposits in only 46% of cases. Liver iron was elevated in 17%, and correlated with age, male sex, and alcohol intake. The univariate strong link which existed between liver iron and fibrosis disappeared after adjustment for confounding variables.Conclusions: 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. (c) 2006 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.