Aim: To re-evaluate the diagnostic criteria of insulin resistance hepatic iron overload based on clinical, biochemical and histopathological findings. Methods: We studied 81 patients with hepatic iron overload not explained by known genetic and acquired causes. The metabolic syndrome (MS) was defined according to ATP. criteria. Iron overload was assessed by liver biopsy. Liver histology was evaluated by Ishak's score and iron accumulation by Deugnier's score; steatosis was diagnosed when present in ≥ 5% of hepatocytes. Results: According to transferrin saturation levels, we observed significant differences in the amount of hepatic iron overload and iron distribution, as well as the number of metabolic abnormalities. Using Receiving Operating Curve analysis, we found that the presence of two components of the MS differentiated two groups with a statistically significant different hepatic iron overload (P < 0.0001). Patients with ≥ 2 metabolic alterations and steatosis had lower amount of hepatic iron, lower transferrin saturation and higher sinusoidal iron than patients with < 2 MS components and absence of steatosis. Conclusion: In our patients, the presence of ≥ 2 alterations of the MS and hepatic steatosis was associated with a moderate form of iron overload with a prevalent sinusoidal distribution and a normal transferrin saturation, suggesting the existence of a peculiar pathogenetic mechanism of iron accumulation. These patients may have the typical dysmetabolic iron overload syndrome. By contrast, patients with transferrin saturation ≥ 60% had more severe iron overload, few or no metabolic abnormalities and a hemochromatosis-like pattern of iron overload.

Riva, A., Trombini, P., Mariani, R., Salvioni, A., Coletti, S., Bonfadini, S., et al. (2008). Re-evaluation of clinical and histological criteria for diagnosis of dysmetabolic iron overload syndrome. WORLD JOURNAL OF GASTROENTEROLOGY, 14(30), 4745-4752 [10.3748/wjg.14.4745].

Re-evaluation of clinical and histological criteria for diagnosis of dysmetabolic iron overload syndrome

MARIANI, RAFFAELLA;SALVIONI, ALESSANDRA;COLETTI, SABINA;BONFADINI, SILVIA;PAOLINI, VALENTINA;POZZI, MATTEO;FACCHETTI, RITA LUCIA;PIPERNO, ALBERTO
2008

Abstract

Aim: To re-evaluate the diagnostic criteria of insulin resistance hepatic iron overload based on clinical, biochemical and histopathological findings. Methods: We studied 81 patients with hepatic iron overload not explained by known genetic and acquired causes. The metabolic syndrome (MS) was defined according to ATP. criteria. Iron overload was assessed by liver biopsy. Liver histology was evaluated by Ishak's score and iron accumulation by Deugnier's score; steatosis was diagnosed when present in ≥ 5% of hepatocytes. Results: According to transferrin saturation levels, we observed significant differences in the amount of hepatic iron overload and iron distribution, as well as the number of metabolic abnormalities. Using Receiving Operating Curve analysis, we found that the presence of two components of the MS differentiated two groups with a statistically significant different hepatic iron overload (P < 0.0001). Patients with ≥ 2 metabolic alterations and steatosis had lower amount of hepatic iron, lower transferrin saturation and higher sinusoidal iron than patients with < 2 MS components and absence of steatosis. Conclusion: In our patients, the presence of ≥ 2 alterations of the MS and hepatic steatosis was associated with a moderate form of iron overload with a prevalent sinusoidal distribution and a normal transferrin saturation, suggesting the existence of a peculiar pathogenetic mechanism of iron accumulation. These patients may have the typical dysmetabolic iron overload syndrome. By contrast, patients with transferrin saturation ≥ 60% had more severe iron overload, few or no metabolic abnormalities and a hemochromatosis-like pattern of iron overload.
No
Articolo in rivista - Articolo scientifico
Scientifica
Hepatic iron distribution; Hepatic steatosis; Iron overload; Metabolic syndrome; Transferrin saturation;
English
4745
4752
8
Riva, A., Trombini, P., Mariani, R., Salvioni, A., Coletti, S., Bonfadini, S., et al. (2008). Re-evaluation of clinical and histological criteria for diagnosis of dysmetabolic iron overload syndrome. WORLD JOURNAL OF GASTROENTEROLOGY, 14(30), 4745-4752 [10.3748/wjg.14.4745].
Riva, A; Trombini, P; Mariani, R; Salvioni, A; Coletti, S; Bonfadini, S; Paolini, V; Pozzi, M; Facchetti, R; Bovo, G; Piperno, A
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/4080
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