Dual-energy X-ray absorptiometry with serum ferritin predicts liver iron concentration and changes in concentration better than ferritin alone.
Dual-energy X-ray absorptiometry with serum ferritin predicts liver iron concentration and changes in concentration better than ferritin alone.
复制标题
血清铁蛋白的双能量X射线吸收法可以预测肝铁浓度和浓度的变化比单独的铁蛋白更好。
DOI：
10.1016/j.jocd.2010.05.003
复制
发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Fung EB
中科院分区：
文献类型：
--
作者：
Shepherd JA;Fan B;Lu Y;Marquez L;Salama K;Hwang J;Fung EB
准确评估肝脏铁浓度（LIC）是最佳监测多次输血患者铁毒性的关键。血清铁蛋白是最广泛使用的，尽管其与LIC的关联仅是适度的。我们研究了在地中海贫血（塔尔）患者中，使用双能X线吸收测定（DXA）系统的肝脏特异性测量是否可以改善LIC估计值。研究了37例塔尔患者（19.2 ± 9.0岁，20例男性），其中10例多次就诊。在5周内测量身高、体重、铁蛋白、全身DXA和肝脏超导量子干涉仪（SQUID）。DXA肝密度测量使用右肋骨，整个肝脏，和多个亚肝区域。使用铁蛋白、体重、DXA肝下区3骨矿物质含量（BMC）和右肋骨BMC的组合发现与SQUID LIC的最佳一致性。DXA与铁蛋白的单独相关性从R2=0.35改善至R2=0.62。使用DXA的连续LIC变化与连续SQUID变化相关（r=0.73，p=0.02）。单独铁蛋白的变化不显著（p=0.06）。我们的结论是，除了全身DXA措施和体重大大增加了LIC的准确性和LIC的变化估计单独使用铁蛋白，可能是有用的，当磁共振成像或SQUID不可用。
Accurate assessment of liver iron concentration (LIC) is critical for optimal monitoring of iron toxicity in multi-transfused patients. Serum ferritin is the most widely used although its association to LIC is only modest. We studied if a liver-specific measure using dual-energy X-ray absorptiometry (DXA) systems could improve LIC estimates over ferritin alone in Thalassemia (Thal) patients. Thirty-seven patients with Thal (19.2 ± 9.0 yr, 20 male) were studied and 10 had multiple visits. Height, weight, ferritin, whole-body DXA, and hepatic superconducting quantum interference device (SQUID) were measured within 5 wk. DXA hepatic density was measured using right rib, whole liver, and multiple subliver regions. The best agreement to SQUID LIC was found using a combination of ferritin, weight, DXA subliver region 3 bone mineral content (BMC), and right rib BMC. DXA with ferritin improved the ferritin alone correlation from R2=0.35 to R2=0.62. Serial LIC changes using DXA were associated with serial SQUID changes (r=0.73, p=0.02). Changes in ferritin alone were not significant (p=0.06). We conclude that the addition of whole-body DXA measures and body weight substantially increased the accuracy of LIC and change in LIC estimates over the use of ferritin alone and could be useful when magnetic resonance imaging or SQUID is not available.