title: Non-HFE iron overload as a surrogate marker of disease severity in patients of liver cirrhosis.
abstract: BACKGROUND
  Decompensated liver cirrhosis is an important cause of mortality worldwide. Various modifiable and non-modifiable factors are involved in the pathogenesis of cirrhosis and its complications. This study was aimed to evaluate the association of iron overload and disease severity in patients of liver cirrhosis and its association with HFE gene mutation.
  
  
  METHODS
  Forty-nine patients with decompensated liver cirrhosis were recruited. Clinical and laboratory parameters were compared in patients with and without iron overload. C282Y and H63D gene mutation analysis was performed in all patients with iron overload.
  
  
  RESULTS
  Iron overload was found in 20 (40.82%) patients. A significant positive correlation of transferrin saturation with Child-Turcotte-Pugh (CTP) score (r = 0.705, p < 0.001) and model for end-stage liver disease (MELD) score (r = 0.668, p < 0.001) was found. Transferrin saturation was also independently associated with high CTP and MELD score on multivariate analysis. Mortality over 3 months was significantly more common in iron-overloaded patients (p = 0.028). C282Y homozygosity or C282Y/H63D compound heterozygosity was not found in any of the patients with iron overload.
  
  
  CONCLUSIONS
  Iron overload was significantly associated with disease severity and reduced survival in patients of decompensated liver cirrhosis.
authors.affiliation: Department of Gastroenterology, Sri Aurobindo Medical College and Post Graduate Institute, Saims Campus, Indore-Ujjain State Highway, Near MR-10 Crossing, Indore, 453 111, India. noorpgi@gmail.com.
authors.forename: Mohd Talha
authors.initials: MT
authors.lastname: Noor
authors.affiliation: Department of Gastroenterology, Sri Aurobindo Medical College and Post Graduate Institute, Saims Campus, Indore-Ujjain State Highway, Near MR-10 Crossing, Indore, 453 111, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Tiwari
authors.affiliation: Central Research Laboratory, Sri Aurobindo Medical College and Post Graduate Institute, Saims Campus, Indore-Ujjain State Highway, Near MR-10 Crossing, Indore, 453 111, India.
authors.forename: Ravindra
authors.initials: R
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D056726:Genetic Association Studies; D000071020:Hemochromatosis Protein / Q000235:genetics*; D006801:Humans; D019190:Iron Overload / Q000097:blood / Q000150:complications* / Q000235:genetics*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000209:etiology* / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012720:Severity of Illness Index; D015996:Survival Rate; D014168:Transferrin / Q000378:metabolism
chemical_list: D015415:Biomarkers; C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D014168:Transferrin
keywords: CTP score; HFE gene mutation; Iron overload; Liver cirrhosis; MELD score