Effects of venesections and restricted diet in patients with the insulin-resistance hepatic iron overload syndrome.
OBJECTIVE
We evaluated the effect of venesections and restricted diet on iron and metabolic indices and liver function tests in patients with insulin-resistance hepatic iron overload (IR-HIO).


METHODS
Patients were divided in three groups: (a) patients without any therapy who were followed-up for 36+28 months; (b) patients venesected; and (c) patients on dietary treatment. In each group baseline and end-point levels of serum iron and metabolic indices, and liver function tests were compared by Student's paired t-test and the relationship between serum ferritin and the other variables during treatment was evaluated by linear regression analysis.


CONCLUSIONS
In the follow-up group, iron and metabolic indices did not change over time. Serum alanine aminotransferase, gamma-glutamyl transferase, cholesterol and triglycerides significantly decreased after iron depletion. Serum glucose, cholesterol, triglyceride, ferritin and liver function tests significantly decreased after dietary treatment. Transferrin saturation decreased below 20% during phlebotomy treatment in 52% of the patients. In conclusion, our results show that IR-HIO patients had relatively low amount of iron overload that seems not to increase even after a long follow-up period. Both venesections and diet improved iron, metabolic and hepatic indices. Data suggest a relationship between hepatic iron overload and insulin resistance, and a role for both iron overload and insulin resistance in hepatocellular damage. The behaviour of iron indices during venesections suggests an impaired iron release from hepatic cells.
Clinica Medica, Università degli Studi di Milano-Bicocca, Azienda Ospedaliera San Gerardo Monza, 20052 Monza, Italy. apiperno@tiscali.it
Alberto
A
Piperno
Anna
A
Vergani
Alessandra
A
Salvioni
Paola
P
Trombini
Mauro
M
Viganò
Alessia
A
Riva
Adele
A
Zoppo
Giuseppe
G
Boari
Giuseppe
G
Mancia
D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007501:Iron / Q000097:blood; D019190:Iron Overload / Q000097:blood / Q000473:pathology / Q000628:therapy*; D019266:Iron, Dietary / Q000008:administration & dosage*; D008107:Liver Diseases / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy; D016896:Treatment Outcome
D019266:Iron, Dietary; D007501:Iron