Excess alcohol greatly increases the prevalence of cirrhosis in hereditary hemochromatosis.
OBJECTIVE
The progression of fibrosis to cirrhosis is the most significant prognostic factor in hereditary hemochromatosis. We aimed to determine the range of hepatic iron concentration associated with cirrhosis in the absence of alcohol and other pro-fibrogenic cofactors and to quantify the contribution of excess alcohol consumption to the development of cirrhosis.


METHODS
Liver biopsy data were evaluated on 224 C282Y homozygous hemochromatosis subjects. To determine the effect of alcohol alone on the development of fibrosis, subjects with viral hepatitis or nonalcoholic steatohepatitis were excluded. Subjects were divided into those who consumed less than 60 g alcohol per day and those who consumed 60 g per day or more.


RESULTS
Seven percent of subjects who consumed less than 60 g per day had severe fibrosis/cirrhosis compared with 61% of excess alcohol consumers.


CONCLUSIONS
Hemochromatosis subjects who drink more than 60 g alcohol per day are approximately 9 times more likely to develop cirrhosis than those who drink less than this amount, and the range of hepatic iron concentration associated with cirrhosis in the absence of cofactors was 233-675 micromol/g dry weight.
Fletcher
Linda M
LM
Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Lin_Fletcher@health.qld.gov.au
Dixon
Jeannette L
JL
Purdie
David M
DM
Powell
Lawrie W
LW
Crawford
Darrell H G
DH
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D005723:gamma-Glutamyltransferase / Q000097:blood
D005293:Ferritins; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase