title: Excess alcohol greatly increases the prevalence of cirrhosis in hereditary hemochromatosis.
abstract: 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.
authors.affiliation: Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Lin_Fletcher@health.qld.gov.au
authors.forename: Linda M
authors.initials: LM
authors.lastname: Fletcher
authors.forename: Jeannette L
authors.initials: JL
authors.lastname: Dixon
authors.forename: David M
authors.initials: DM
authors.lastname: Purdie
authors.forename: Lawrie W
authors.initials: LW
authors.lastname: Powell
authors.forename: Darrell H G
authors.initials: DH
authors.lastname: Crawford
mesh_terms: 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
chemical_list: D005293:Ferritins; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase