Serum ferritin and transferrin saturation in patients with chronic alcoholic and non‐alcoholic liver diseases

Bell, H.; Skinningsrud, Anders; Raknerud, N; Try, K.

doi:10.1111/j.1365-2796.1994.tb00802.x

Cited by 115 publications

(86 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Serum ferritin is an extremely sensitive indicator of iron storage status, with hyperferritinemia occurring in the setting of numerous disorders associated with iron overload (hemochromatosis, 60 sickle cell disease, 61 and thalassemia 62 ). Additionally, hyperferritinemia serves as a nonspecific marker for a variety of neoplasms, [63][64][65] infectious diseases, 66-68 alcohol ingestion, 69 and a sedentary lifestyle. 70 While we examined self-reported data regarding a number of chronic diseases as well as recent alcohol ingestion experience, we were unable to explain dif- * Post-traumatic stress disorder was screened for by questionnaire using criteria reported in the Diagnostic and Statistical Manual of Mental Disorder, fourth edition.…”

Section: Resultsmentioning

confidence: 99%

Increased postwar symptoms and psychological morbidity among U.S. Navy Gulf War veterans.

Gray¹,

Kaiser²,

Hawksworth³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. To investigate reports on war-related morbidity, 527 active-duty Gulf War veterans and 970 nondeployed veterans from 14 Seabee commands were studied in 1994 with a questionnaire, sera collection, handgrip strength, and pulmonary function testing. The questionnaire assessed postwar symptoms, war exposures, and screened for chronic fatigue syndrome, post-traumatic stress disorder, and psychological symptoms suggesting neurosis (Hopkins Symptom Checklist). Sera were tested with four nonspecific reactant assays: C-reactive protein, transferrin, ferritin, and haptoglobin. Gulf War veterans reported a higher prevalence for 35 of 41 symptoms, scored higher on psychological symptom scales, were more likely to screen for post-traumatic stress disorder, had lower handgrip strength, and had higher serum ferritin assay results. Numerous comparisons of these morbidity outcomes with 30 self-reported exposures demonstrated many associations, but no unique exposure or group of exposures were implicated. Morbidity data are consistent with other postwar observations, but the etiology for morbidity findings remains uncertain.

show abstract

Section: Resultsmentioning

confidence: 99%

Increased postwar symptoms and psychological morbidity among U.S. Navy Gulf War veterans.

Gray¹,

Kaiser²,

Hawksworth³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…Moreover, iron overload was more intense in the presence of liver disease, as shown by higher serum concentrations of ferritin and transferrin saturation. Although ferritin and transferrin saturation may be questioned as markers of iron overload in the presence of liver disease, since ferritin elevation may result from necroinflammatory activity, and decreased hepatic protein production may occur secondary to liver disease [36] , resulting in lower TIBC and higher transferrin saturation, previous studies in patients with liver disease have shown significantly higher ferritin levels in patients with alcohol-related liver disease [12] . Furthermore, in the present study, we observed a positive correlation between serum ferritin and the degree of hepatic iron deposition in patients who had a liver biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Alcoholic liver disease (ALD) is often associated with elevated serum iron indices and hepatic iron overload [11][12][13][14] . Iron is also believed to be central in the pathogenesis of ALD, and some reports show iron overload as a predictive indicator of higher mortality [15] , and development of hepatocellular carcinoma [16] .…”

Section: Introductionmentioning

confidence: 99%

Iron homeostasis and H63D mutations in alcoholics with and without liver disease

Machado¹,

Ravasco²,

Martins³

et al. 2009

WJG

View full text Add to dashboard Cite

AIM:To evaluate the prevalence of HFE gene mutation and indices of disturbed iron homeostasis in alcoholics with and without liver disease. METHODS:One hundred and fifty-three heavy drinkers (defined as alcohol consumption > 80 g/d for at least 5 years) were included in the study. These comprised 78 patients with liver disease [liver disease alcoholics (LDA)] in whom the presence of liver disease was confirmed by liver biopsy or clinical evidence of hepatic decompensation, and 75 subjects with no evidence of liver disease, determined by normal liver tests on two occasions [non-liver disease alcoholics (NLDA)], were consecutively enrolled. Serum markers of iron status and HFE C282Y and H63D mutations were determined. HFE genotyping was compared with data obtained in healthy blood donors from the same geographical area. RESULTS:Gender ratio was similar in both study groups. LDA patients were older than NLDA patients (52 ± 10 years vs 48 ± 11 years, P = 0.03). One third and one fifth of the study population had serum transferrin saturation (TS) greater than 45% and 60% respectively. Serum iron levels were similar in both groups. However, LDA patients had higher TS (51 ± 27 vs 36 ± 13, P < 0.001) and ferritin levels (559 ± 607 ng/mL vs 159 ± 122 ng/mL, P < 0.001), and lower total iron binding capacity (TIBC) (241 ± 88 µg/dL vs 279 ± 40 µg/dL, P = 0.001). The odds ratio for having liver disease with TS greater than 45% was 2.20 (95% confidence interval (CI): 1.37-3.54). There was no difference in C282Y allelic frequency between the two groups. However, H63D was more frequent in LDA patients (0.25 vs 0.16, P = 0.03). LDA patients had a greater probability of carrying at least one HFE mutation than NLDA patients (49.5% vs 31.6%, P = 0.02). The odds ratio for LDA in patients with H63D mutation was 1.57 (95% CI: 1.02-2.40). CONCLUSION:The present study confirms the presence of iron overload in alcoholics, which was more severe in the subset of subjects with liver disease, in parallel with an increased frequency of H63D HFE mutation.

show abstract

“…Published series of gastrointestinal endoscopy in patients with iron deficiency anemia vary in the criteria they use to diagnose the iron deficiency, but most studies use ferritin below 20-50 ng/mL [1][2][3][4][5]. However, studies using bone marrow hemosiderin as the gold standard have shown that in older patients and/or in patients with comorbidites, iron deficiency anemia is often present despite normal levels of ferritin [6][7][8][9][10]. In a study of 101 anemic veterans who underwent bone marrow examination with hemosiderin stain, the mean ferritin in irondeficient patients was 53 ng/mL, with a range of 9-518 ng/mL [6].…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal endoscopic findings in men with unexplained anemia and low normal ferritin values

et al. 2006

View full text Add to dashboard Cite

Background: Most practice guidelines recommend endoscopic evaluation of the gastrointestinal (GI) tract in men and postmenopausal women with anemia and a serum ferritin less than 20-40 ng/ml. The diagnostic yield of endoscopy in patients with anemia, no GI symptoms or signs, and low normal ferritin is not known. Objective: The aim of this study was to investigate the yield of upper and lower GI endoscopic evaluations in anemic patients with ferritin levels between 40 and 100 ng/ml. Design: A retrospective review of patients' charts was conducted. Subjects and methods: Patients at the Veterans Affairs Connecticut Healthcare System who underwent GI endoscopic evaluation for the sole indication of anemia and ferritin in the low normal range (40-100 ng/ml) were included in this study. Measurements: Incidence of pathology of the upper and lower GI tract was determined. Results: We identified 54 male patients who had a ferritin level of 40-100 ng/ml and no GI symptoms or known GI bleeding. Upper GI findings (malignancy, peptic ulcers, Helicobacter pylori gastritis, arteriovenous malformations) were found in 14/47 cases (30%). Lower gastrointestinal findings, including large tubular adenomas and arteriovenous malformation, were identified in 3/53 cases (6.7%). Conclusion: Our study supports GI endoscopy in anemic patients with ferritin between 40 and 100 ng/ml, even in the absence of GI symptoms or documented bleeding. Am. J. Hematol. 81:324-327, 2006. V V C 2006 Wiley-Liss, Inc.

show abstract

Serum ferritin and transferrin saturation in patients with chronic alcoholic and non‐alcoholic liver diseases

Cited by 115 publications

References 20 publications

Increased postwar symptoms and psychological morbidity among U.S. Navy Gulf War veterans.

Increased postwar symptoms and psychological morbidity among U.S. Navy Gulf War veterans.

Iron homeostasis and H63D mutations in alcoholics with and without liver disease

Gastrointestinal endoscopic findings in men with unexplained anemia and low normal ferritin values

Contact Info

Product

Resources

About