title: Serum Ferritin in Patients With Cirrhosis is Associated With Markers of Liver Insufficiency and Circulatory Dysfunction, but Not of Portal Hypertension.
abstract: OBJECTIVE
  Iron overload is an increasingly recognized phenomenon in nonhemochromatosis cirrhosis. To evaluate the relationship between iron overload and liver insufficiency and portal hypertension.
  
  
  METHODS
  Cirrhotics with hepatic hemodynamic and ferritin measurement (within 30 d) were included. Exclusion criteria were malignancy (except hepatocellular carcinoma Milan-in), severe chronic obstructive pulmonary disease, acute events in the previous 2 weeks, immunosuppression, transjugular intrahepatic portosystemic shunt or portal vein thrombosis, and end-stage renal disease. Patients were followed-up until death or liver transplant. Univariate and multivariate analysis were used.
  
  
  RESULTS
  Fifty-one patients were included (male 61%; median age 57 y; interquartile range, 47 to 66 y); Child-Pugh A 11/B 25/C 15). A positive correlation was observed between ferritin and markers of inflammation (C-reactive protein: r=0.273, P=0.06 and aspartate aminotransferase: r=0.302, P=0.035). No correlation between ferritin and hepatic venous pressure gradient was seen. Negative correlations were observed between ferritin and circulatory dysfunction (mean arterial pressure: r=-0.360, P=0.014 and serum sodium: r=-0.419, P=0.002). In contrast, associations to markers of liver failure such as international normalized ratio (r=0.333, P=0.005), bilirubin (r=0.378, P=0.007), albumin (r=-0.265, P=0.082), model for end-stage liver disease (r=0.293, P=0.041), and Child-Pugh score (r=0.392, P=0.009) were observed. No differences in survival according to ferritin was detected.
  
  
  CONCLUSIONS
  In patients with cirrhosis, serum ferritin levels are associated with markers of liver insufficiency, inflammation, and circulatory dysfunction but not portal hypertension.
authors.affiliation: First Department of Internal Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ripoll
authors.forename: Felix
authors.initials: F
authors.lastname: Keitel
authors.forename: Marcus
authors.initials: M
authors.lastname: Hollenbach
authors.forename: Robin
authors.initials: R
authors.lastname: Greinert
authors.forename: Alexander
authors.initials: A
authors.lastname: Zipprich
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D048550:Hepatic Insufficiency / Q000097:blood / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood* / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D019190:Iron Overload / Q000453:epidemiology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D005293:Ferritins