title: Iron overload and glucose abnormalities in chronic hepatitis C virus infection: phlebotomy lowers risk of new-onset diabetes.
abstract: OBJECTIVE
  Iron overload and hyperglycemia are common findings in patients with chronic hepatitis C (CHC). The aim of this study was to determine the relation of serum ferritin and hepatic hepcidin expression with glucose metabolic parameters and to evaluate whether long term phlebotomy lowers the risk of new-onset diabetes in CHC patients.
  
  
  METHODS
  Hepatic hepcidin mRNA expression was measured in 28 CHC patients and their relation with clinical parameters and histological findings was evaluated. Ninety-two patients without type 2 diabetes were divided into two groups: a phlebotomy group underwent an initial period of phlebotomy and maintenance phlebotomy was performed; data obtained in CHC patients that declined to receive phlebotomy were used as control.
  
  
  RESULTS
  Hepatic hepcidin expression was positively correlated with body mass index and glucose metabolic parameters. A total number of five patients had onset of type 2 diabetes over 38.9 months of follow-up. Long-term phlebotomy tended to lower the risk of new-onset diabetes compared with control CHC patients. In addition, high ferritin levels predicted further episodes of diabetes in control patients.
  
  
  CONCLUSIONS
  Iron overload is a risk for the development of diabetes in patients with CHC and that reduction of body iron stores lowers this risk.
authors.forename: Rumi
authors.initials: R
authors.lastname: Mifuji-Moroka
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Hirohide
authors.initials: H
authors.lastname: Miyachi
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sugimoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ishihara
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaito
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Takei
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005293:Ferritins / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D064451:Hepcidins / Q000235:genetics / Q000378:metabolism; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy; D012333:RNA, Messenger / Q000378:metabolism; D012372:ROC Curve; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D064451:Hepcidins; D012333:RNA, Messenger; D005293:Ferritins