Clinical Significance of Serum Ferritin Level in the Determination of Liver Damage in Patients with Chronic Hepatitis B_West China Medical Journal

Authors：

 DengCechuan , LiLixin , TangJiangtao , TaoChuanmin , LuoLimei , YanKening ,  WangLanlan

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

WangLanlan, Email: wanglanlan999@163.com

Keywords：

Chronic hepatitis B; Serum ferritin; Liver damage

DOI：

10.7507/1002-0179.201600189

Video：

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Objective To explore the relationship between the level of serum ferritin (SF) and liver damage in patients with chronic hepatitis B (CHB). Methods The concentration of serum ferritin of 98 patients with CHB from July to October 2014 was measured, and then correlation analysis was performed to analyze the correlation between SF and such indexes as serum tumor marker α-fetoprotein, biochemical markers [alanine amino transferase (ALT), aspartate amino transferase (AST), total protein (TP), albumin and total bilirubin (TBIL)], and hepatitis B serum markers (hepatitis B surface antigen, hepatitis B surface antibody, hepatitis B e antigen, hepatitis B e antibody, and hepatitis B core antigen). Serum hepatitis B virus DNA (HBV-DNA) viral load was also tested, and then the discrepancy of SF levels in the high and low viral load groups was analyzed. Results The average concentration of the abnormally elevated SF was (878.69±837.98) ng/mL. The SF mean difference between low-load HBV-DNA and high-load HBV-DNA was statistically significant (P < 0.05). Serum ferritin levels were independently and positively correlated with ALT, AST, and TBIL (P < 0.01) and inversely correlated with TP and albumin (P < 0.01). Conclusion The rise of SF is associated with liver damage, which can reflect the state of inflammation of patients with CHB.

Citation： DengCechuan, LiLixin, TangJiangtao, TaoChuanmin, LuoLimei, YanKening, WangLanlan. Clinical Significance of Serum Ferritin Level in the Determination of Liver Damage in Patients with Chronic Hepatitis B. West China Medical Journal, 2016, 31(4): 692-696. doi: 10.7507/1002-0179.201600189 Copy

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12.	Tunçcan OG, Yegin ZA, Ozkurt ZN, et al. High ferritin levels are associated with hepatosplenic candidiasis in hematopoietic stem cell transplant candidates[J]. Int J Infect Dis, 2010, 14 (Suppl 3): e104-e107.
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14.	Walker NM, Stuart KA, Ryan RJ, et al. Serum ferritin concentration predicts mortality in patients awaiting liver transplantation[J]. Hepatology, 2010, 51(5): 1683-1691.
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16.	Mao W, Hu Y, Lou Y, et al. Abnormal serum iron markers in chronic hepatitis B virus infection may be because of liver injury[J]. Eur J Gastroenterol Hepatol, 2015, 27(2): 130-136.
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1. Anderson GJ. Things that go BMP in the liver: bone morphogenetic protein 6 and the control of body iron homeostasis[J]. Hepatology, 2009, 50(1): 316-319.
2. 王继贵. 铁代谢疾病检测的进展[J]. 实验与检验医学, 2013, 31(1): 46-48.
3. 仇慧珠, 潘湘涛, 陆晔, 等. 消化道肿瘤贫血患者血清铁调素及炎症介质因子的表达[J]. 实验与检验医学, 2013, 31(1): 13-14.
4. Yonal O, Akyuz F, Demir K, et al. Decreased prohepcidin levels in patients with HBV-related liver disease: relation with ferritin levels[J]. Dig Dis Sci, 2010, 55(12): 3548-3551.
5. 中华医学会肝病学分会, 中华医学会感染病学分会, Association CM. 慢性乙型肝炎防治指南(2010年版)[J]. 中华肝脏病杂志, 2011, 19(1): 13-24.
6. 刘冰, 赵慧. 慢性乙肝血清HBV-DNA载量在其抗病毒治疗中的意义[J]. 中原医刊, 2008, 35(2): 63-64.
7. Hasuike Y, Nonoguchi H, Tokuyama M, et al. Serum ferritin predicts prognosis in hemodialysis patients: the Nishinomiya study[J]. Clin Exp Nephrol, 2010, 14(4): 349-355.
8. Jenq CC, Hsu CW, Huang WH, et al. Serum ferritin levels predict all-cause and infection-cause 1-year mortality in diabetic patients on maintenance hemodialysis[J]. Am J Med Sci, 2009, 337(3): 188-194.
9. O’glasser AY, Scott DL, Corless CL, et al. Hepatic and cardiac iron overload among patients with end-stage liver disease referred for liver transplantation[J]. Clin Transplant, 2010, 24(5): 643-651.
10. Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults[J]. Diabetes Care, 2004, 27(10): 2422-2428.
11. ten Kate J, Drenth JP, Kahn MF, et al. Iron saturation of serum ferritin in patients with adult onset Still’s disease[J]. J Rheumatol, 2001, 28(10): 2213-2215.
12. Tunçcan OG, Yegin ZA, Ozkurt ZN, et al. High ferritin levels are associated with hepatosplenic candidiasis in hematopoietic stem cell transplant candidates[J]. Int J Infect Dis, 2010, 14 (Suppl 3): e104-e107.
13. Cunha BA, Chak A, Strollo S. Fever of unknown origin(FUO):de Quervain’s subacute thyroiditis with highly elevated ferritin levels mimicking temporal arteritis(TA)[J]. Heart Lung, 2010, 39(1): 73-77.
14. Walker NM, Stuart KA, Ryan RJ, et al. Serum ferritin concentration predicts mortality in patients awaiting liver transplantation[J]. Hepatology, 2010, 51(5): 1683-1691.
15. Wu J, Chen L, Chen Y, et al. Serum ferritin concentration predicts mortality in patients with hepatitis B virus-related acute on chronic liver failure[J]. Arch Med Res, 2014, 45(3): 251-256.
16. Mao W, Hu Y, Lou Y, et al. Abnormal serum iron markers in chronic hepatitis B virus infection may be because of liver injury[J]. Eur J Gastroenterol Hepatol, 2015, 27(2): 130-136.
17. 邵飞, 朱凤群, 李春姬. 慢性乙型病毒性肝炎血清铁及铁蛋白检测[J]. 西安交通大学学报:医学版, 2006, 27(3): 292-294.
18. Blumberg BS, Lustbader ED, Whit-ford PL. Changes in serum iron levels due to infection with hepatitis B virus[J]. Proc Natl Acad Sci USA, 1981, 78(5): 3222-3224.

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Clinical Significance of Serum Ferritin Level in the Determination of Liver Damage in Patients with Chronic Hepatitis B

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