Keywords :
Alcohol liver disease, C-reactive protein, Ferritin, Iron
Citation Information :
Jangam M, Nandeesha H, Kadhiravan T, Murugaiyan S. Association of Severity Serum Iron Indices and High-sensitivity C-reactive Protein with Disease Severity in Men with Alcoholic Liver Disease. Indian J Med Biochem 2021; 25 (3):96-99.
Aim and objective: Earlier studies have reported an association between chronic alcohol consumption, iron overload and liver disease. However, there are only limited data from India on serum iron indices and inflammatory markers in alcoholic liver disease. The objective of the study is to estimate serum iron indices and C-reactive protein levels in alcoholic liver disease and their association with disease severity.
Materials and methods: We enrolled 46 alcoholic liver disease cases and 40 controls. Serum iron, ferritin and high-sensitivity C-reactive protein levels were estimated in both groups.
Results: Serum iron, ferritin, transferrin saturation and C-reactive protein were significantly increased in alcoholic liver disease patients compared to controls. Both iron (r = 0.372, p = 0.011) and ferritin (r = 0.352, p = 0.016) were positively correlated with model for end stage liver disease score an indicator of severity in alcoholic liver disease. C-reactive protein had a significant correlation with iron (r = 0.294, p = 0.048), ferritin (r = 0.483, p = 0.001) and model for end stage liver disease score (r = 0.344, p = 0.019) in alcoholic liver disease cases.
Conclusion: We conclude that serum iron indices and C-reactive protein are elevated in alcohol liver disease and associated with severity of liver disease.
Clinical significance: Serum iron indices and C-reactive protein can be used as biomarkers for predicting disease severity in alcoholic liver disease.
Acharya P, Chouhan K, Weiskirchen S, et al. Cellular mechanisms of liver fibrosis. Front Pharmacol 2021;12:671640. DOI: 10.3389/fphar.2021.671640.
Sakaguchi S, Takahashi S, Sasaki T, et al. Progression of alcoholic and non-alcoholic steatohepatitis: common metabolic aspects of innate immune system and oxidative stress. Drug Metab Pharmacokinet 2011;26(1):30–46. DOI: 10.2133/dmpk.dmpk-10-rv-087.
Pohl K, Moodley P, Dhanda AD. Alcohol's impact on the gut and liver. Nutrients 2021;13(9):3170. DOI: 10.3390/nu13093170.
Thursz M. Iron, haemochromatosis and thalassaemia as risk factors for fibrosis in hepatitis C virus infection. Gut 2007;56(5):613–614. DOI: 10.1136/gut.2006.113076.
Husić-Selimović A, Huskić J, Vukobrat-Bijedić Z, et al. The role of nitric oxide and ferritin in the pathogenesis of alcoholic liver disease: a controlled clinical study. Bosn J Basic Med Sci 2009;9(3):204–209. DOI: 10.17305/bjbms.2009.2807.
Kohgo Y, Ohtake T, Ikuta K, et al. Dysregulation of systemic iron metabolism in alcoholic liver diseases. J Gastroenterol Hepatol 2008;23(1):S78–S81. DOI: 10.1111/j.1440-1746.2007.05290.x.
Nahon P, Ganne-Carrié N, Trinchet JC, et al. Hepatic iron overload and risk of hepatocellular carcinoma in cirrhosis. Gastroenterol Clin Biol 2010;34(1):1–7. DOI: 10.1016/j.gcb.2009.07.032.
Pan X, Wen SW, Kaminga AC, et al. Gut metabolites and inflammation factors in non-alcoholic fatty liver disease: a systematic review and meta-analysis. Sci Rep 2020;10(1):8848. DOI: 10.1038/s41598-020-65051-8.
Pieri G, Agarwal B, Burroughs AK. C-reactive protein and bacterial infection in cirrhosis. Ann Gastroenterol 2014;27(2):113–120.
Machado MV, Ravasco P, Martins A, et al. Iron Homeostasis and H63D mutations in alcoholics with and without liver disease. World J Gastroenterol 2009;15(1):106–111. DOI: 10.3748/wjg.15.106.
Kamath PS, Kim WR. The model for end-stage liver disease (MELD). Hepatology 2007;45(3):797–805. DOI: 10.1002/hep. 21563.
Wójtowicz-Chomicz K, Cichoz-Lach H, Lis E, et al. Parametry gospodarki zelazem w przewlekłych chorobach watroby [serum iron parameters in chronic liver diseses]. Pol Merkur Lekarski 2013;35(206):77–81.
Mathurin P, Hadengue A, Bataller R, et al. EASL clinical practical guidelines: management of alcoholic liver disease. J Hepatol 2012;57(2):399–420. DOI: 10.1016/j.jhep.2012.04.004.
Vermeulen E, Vermeersch P. Hepcidin as a biomarker for the diagnosis of iron metabolism disorders: a review. Acta Clin Belg 2012;67(3):190–197. DOI: 10.2143/ACB.67.3.2062654.
Harrison-Findik DD, Schafer D, Klein E, et al. Alcohol metabolism-mediated oxidative stress down-regulates hepcidin transcription and leads to increased duodenal iron transporter expression. J Biol Chem 2006;281(32):22974–22982. DOI: 10.1074/jbc.M602098200.
Harrison-Findik D, Klein E, Crist C, et al. Iron-mediated regulation of liver hepcidin expression rats and mice is abolished by alcohol. Hepatology 2007;46(6):1979–1985. DOI: 10.1002/hep.21895.
Kaptoge S, Di Angelantonio E, Pennells L, et al. C-reactive protein, fibrinogen, and cardiovascular disease prediction. N Engl J Med 2012;367(14):1310–1320. DOI: 10.1056/NEJMoa1107477.
Ciećko-Michalska I, Szczepanek M, Cibor D, et al. Serum cytokine concentration as prognostic factor in patients with alcoholic liver disease. Przegl Lek 2006;63(5):249–252.
Soultati AS, Dourakis SP, Alexopoulou A, et al. Predicting utility of a model for end stage liver disease in alcoholic liver disease. World J Gastroenterol 2006;12(25):4020–4025. DOI: 10.3748/wjg.v12. i25.4020.
Walter PB, Fung EB, Killilea DW, et al. Oxidative stress and inflammation in iron-overloaded patients with beta-thalassaemia or sickle cell disease. Br J Haematol 2006;135(2):254–263. DOI: 10.1111/j.1365-2141.2006.06277.x.
Li S, Hong M, Tan H-Y, et al. Insights into the role and interdependence of oxidative stress and inflammation in liver disease. Oxid Med Cell Longev 2016. 4234061–4234068. DOI: 10.1155/2016/4234061.
