Influence of iron on the severity of hepatic fibrosis in patients with chronic hepatitis C

Table 1 Demographic and laboratory data of 32 patients with CHC

Variable	Total population(n = 32)	Severe fibrosis(n = 16)	Mild fibrosis(n = 16)	P
Age (yr)	56.47 ± 10.92	60.75 ± 6.50	52.19 ± 12.85	0.024
Sex (male:female)	15 : 17	8 : 8	7 : 9	0.723
AST (IU/L)	105.47 ± 56.18	119.31 ± 55.75	91.63 ± 54.82	0.167
ALT (IU/L)	163.03 ± 102.99	167.81 ± 102.15	158.25 ± 106.95	0.798
Iron (μg/dL)	155.07 ± 43.27	149.50 ± 33.00	160.27 ± 51.71	0.513
TIBC (μg/dL)	356.97 ± 48.38	351.50 ± 41.23	362.07 ± 55.18	0.566
Transferrin saturation (%)	43.63 ± 11.69	42.51 ± 7.85	44.68 ± 14.62	0.621
Ferritin (ng/mL)	291.19 ± 213.72	329.41 ± 222.08	255.53 ± 206.72	0.362
Increased serum Iron store	14 (43.75%)	8 (50.00%)	6 (37.50%)	0.476
Positive hepatic Iron stain	4 (12.50%)	1 (6.25%)	3 (18.75%)	0.600
Viral genotype (1:2)	22 : 6	12 : 2	10 : 4	0.648
Viral load
(× 106 copies/mL)	4.94 ± 6.26	6.39 ± 8.16	3.48 ± 3.22	0.231

CHC: Chronic hepatitis C; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; TIBC: Total iron binding capacity. Data are expressed as mean ± SD or patients number (percentage). Transferrin saturation was calculated as serum iron divided by TIBC × 100%. The increased serum iron store was defined by transferrin saturation > 50% and/or ferritin > upper normal limit.

Table 2 Multivariate logistic regression analysis of independent predictors of severe hepatic fibrosis

Variable	Odds ratio	95% CI	P
Age	1.312	1.020-1.688	0.035
Male gender	14.138	0.835-239.266	0.066
Increased serum iron store	0.834	0.081-8.595	0.879
Positive hepatic iron stain	1.584	0.067-37.349	0.775
Viral load	1.412	0.923-2.161	0.112

CI: Confidence interval; ALT: Alanine aminotransferase. The increased serum iron store was defined by transferrin saturation > 50% and/or ferritin > upper normal limit. The ALT and viral genotype were eliminated in multivariate backward logistic regression analysis. We forcibly add the two factors increased serum iron store and positive hepatic iron stain into the analysis.

Table 3 Univariate analysis of demographic and laboratory data in relation to hepatic iron stain

Variable	Positive hepaticiron stain (n = 4)	Negative hepaticiron stain (n = 28)	P
Age (yr)	52.50 ± 9.04	57.04 ± 11.19	0.446
Sex (male:female)	3 : 1	12 : 16	0.319
AST (IU/L)	141.50 ± 99.94	100.32 ± 47.89	0.473
ALT (IU/L)	275.00 ± 172.18	147.04 ± 82.23	0.017
Iron (μg/dL)	210.50 ± 45.11	146.20 ± 36.55	0.019
Transferrin saturation (%)	62.34 ± 10.71	40.64 ± 8.80	0.003
Ferritin (ng/mL)	591.23 ± 119.70	243.19 ± 184.65	0.008

Data are expressed as mean ± SD. AST: Aspartate aminotransferase; ALT: Alanine aminotransferase. Transferrin saturation was calculated as (the serum iron divided by the TIBC) × 100%.

Table 4 Correlations with ferritin levels among laboratory data, hepatic inflammation and fibrosis scores

Variable	ALT	Iron	Transferrinsaturation	Inflammationscore	Fibrosisscore
Spearman coeff	0.531	0.467	0.556	-0.085	0.317
P	0.003	0.011	0.002	0.659	0.094

ALT: Alanine aminotransferase. Transferrin saturation was calculated as (the serum iron divided by the TIBC) × 100%.