title: In alcoholic cirrhosis, low-serum hepcidin levels associate with poor long-term survival.
abstract: OBJECTIVE
  Iron constitutes a potentially toxic element and consequently, hepatic iron overload may accelerate liver disease progression and development of hepatocellular carcinoma (HCC). Hepcidin is the central negative regulator of iron metabolism that is produced primarily by the liver.
  
  
  METHODS
  To study the prognostic significance of serum hepcidin, we assessed the influence of baseline serum hepcidin levels on the outcome of a French cohort encompassing 237 patients with alcoholic cirrhosis prospectively followed up in the setting of HCC screening.
  
  
  RESULTS
  Hepcidin values correlated weakly with serum ferritin levels (r = 0.33) and hepatic iron scores (r = 0.3). After a median follow-up of 68 months, patients with baseline lower hepcidin level had a higher risk of HCC occurrence [hazard ratio, HR = 1.76 (1.01-3.06), P = 0.031] and overall death [HR = 1.63 (1.07-2.44), P = 0.019]. According to Cox multivariate analyses, lower hepcidin levels were independently associated with death [HR = 2.84 (1.29-6.25), P = 0.009] along with higher Child-Pugh score while HCC occurrence was mainly associated with clinical confounders interfering with iron metabolism (older age and higher BMI, adjusted P-value for hepcidin = 0.119).
  
  
  CONCLUSIONS
  In conclusion, low-serum hepcidin levels in patients with alcoholic cirrhosis bear a long-term prognostic significance warranting further explorations.
authors.affiliation: AP-HP, Service d'Hépatologie, Hôpital Jean Verdier, Bondy, France.|Université Paris 13, Sorbonne Paris Cité, "Equipe labellisée Ligue Contre le Cancer", F-93206, Saint-Denis, France.|Inserm, UMR-1162, "Génomique fonctionnelle des tumeur solides", F-75000, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Nahon
authors.affiliation: Department of Internal Medicine III, RWTH University Hospital Aachen, Aachen, Germany.
authors.forename: Renwar
authors.initials: R
authors.lastname: Nuraldeen
authors.affiliation: APHP, Biostatistics Unit, GH Pitié-Salpêtrière, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Rufat
authors.affiliation: APHP, Biochemistry Unit, Jean Verdier Hospital, Bondy, France.|University Paris 13-UFR SMBH/INSERM U1148, Bobigny, France.
authors.forename: Angela
authors.initials: A
authors.lastname: Sutton
authors.affiliation: Department of Internal Medicine III, RWTH University Hospital Aachen, Aachen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Trautwein
authors.affiliation: Department of Internal Medicine III, RWTH University Hospital Aachen, Aachen, Germany.|Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Aachen, Germany.
authors.forename: Pavel
authors.initials: P
authors.lastname: Strnad
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D064451:Hepcidins / Q000097:blood*; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000209:etiology / Q000378:metabolism; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013223:Statistics as Topic
chemical_list: D064451:Hepcidins; D007501:Iron
keywords: alcoholic cirrhosis; hepatocellular carcinoma; hepcidin; iron metabolism; prognosis