Serum iron parameters in patients with alcoholic and chronic cirrhosis and hepatitis

The aim of our study was to asses the serum iron status of patients with various forms of hepatitis and cirrhosis of the liver and to determine the correlation between the degree of hepatocyte damage and the status of serum iron parameters.

The study involved 136 subjects with chronic viral hepatitis type C (group I, n=71) and type B (group II, n=29), alcoholic cirrhosis of the liver (group III, n=15), postinflammatory cirrhosis of the liver (group IV, n=13), and alcoholic hepatitis (group V, n=8). In all these patients, serum alanine (ALT) and aspartate (AST) aminotransferase activity were used as a secondary measure of necroinflammatory activity. The serum iron status measurements included iron concentration (Fe), total iron-binding capacity (TIBC), transferrin saturation, and ferritin concentration.

Our study results led us to conclude that the mean value of serum iron concentration did not differ significantly among the analysed groups (p>0.05). The transferrin value - estimated as the total iron-binding capacity (TIBC) - was significantly lower in alcoholic cirrhosis of the liver in comparison to both chronic hepatitis C (p<0.004) and chronic hepatitis B (p<0.04). The transferrin saturation was statistically the higher in group III in comparison with both group I (p<0.0031) and group II (p<0.024). Serum ferritin was significantly higher in cirrhotic patients regardless of etiology, in comparison with patients with chronic viral hepatitis (p<0.045). We found correlation between an increase of both AST and ALT and a higher level of ferritin in patients with chronic hepatitis type C (p<0.005, p<0.02) and type B (p<0.05, p<0.03) and alcoholic hepatitis (p<0.05).

In the course of chronic liver diseases we may observe slight irregularities in iron status relating to both the serum and store pool of this element. The most significant disturbances are seen in patients with alcoholic cirrhosis of the liver.