Iron overload correlates with serum liver fibrotic markers and liver dysfunction: Potential new methods to predict iron overload-related liver fibrosis in thalassemia patients
Iron overload correlates with serum liver fibrotic markers and liver dysfunction: Potential new methods to predict iron overload-related liver fibrosis in thalassemia patients
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铁过载与血清肝纤维化标志物和肝功能障碍相关：预测地中海贫血患者铁过载相关肝纤维化的潜在新方法
DOI：
10.1177/2050640616646525
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发表时间：
2017-02-01
影响因子：
6
通讯作者：
Xia, Yang
中科院分区：
文献类型：
--
作者：
Wang, Man;Liu, Rongrong;Xia, Yang
背景：早期发现地中海贫血患者肝纤维化并迅速开始治疗以干预其进展是极其重要的。目的寻找一种除肝活检外，灵敏、易检测、无创的方法早期检测地中海贫血患者肝纤维化。方法选择244例中国非输血依赖型地中海贫血（NTDT, n = 105）或重度地中海贫血（TM, n = 139）患者和120名健康人群，测定其血液IV型胶原（C IV）、III型前胶原（PIIINPC）及透明质酸（HA）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和铁蛋白水平。MRI检测肝铁浓度。评价血清指标与肝铁负荷及肝功能的相关性。结果中国NTDT患者血清C IV、PIIINPC和HA显著升高，TM患者血清C IV、PIIINPC和HA进一步升高。此外，C IV、PIIINPC和HA也与血清铁蛋白和肝铁浓度呈正相关，并在NTDT患者多器官损害的过程中进一步升高。最后，血清铁蛋白和肝铁浓度与AST和ALT测定的肝功能障碍有显著相关性。结论综上所述，我们的研究结果表明，监测血清C IV、PIIINPC和HA是预测中国地中海贫血患者铁负荷相关性肝纤维化风险的潜在敏感方法。
Background Early detection of liver fibrosis in thalassemia patients and rapid initiation of treatment to interfere with its progression are extremely important. Objective This study aimed to find a sensitive, easy-to-detect and noninvasive method other than liver biopsy for early detection of liver fibrosis in thalassemia patients. Methods A total of 244 Chinese Thalassemia patients with non-transfusion-dependent thalassemia (NTDT, n = 105) or thalassemia major (TM, n = 139) and 120 healthy individuals were recruited into the present study, and blood collagen type IV (C IV), precollagen type III (PIIINPC) and hyaluronic acid (HA), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ferritin were measured. Liver iron concentration was determined by MRI. The correlation of serum markers with liver iron load and liver function was evaluated. Results Serum C IV, PIIINPC and HA were significantly elevated in Chinese patients with NTDT and further elevated in TM patients. Moreover, C IV, PIIINPC and HA were also positively correlated to serum ferritin and liver iron concentration and further elevated during the progression to multi-organ damage in NTDT patients. Finally, serum ferritin and liver iron concentration were significantly correlated with liver dysfunction determined by AST and ALT. Conclusion Taken together, our results indicate that monitoring serum C IV, PIIINPC and HA is a potentially sensitive method to predict the risks for iron overload-related liver fibrosis in Chinese thalassemia patients.