Iwasa Motoh, Kaito Masahiko, Ikoma Jiro, Kobayashi Yoshinao, Tanaka Yuji, Higuchi Kunihiro, Takeuchi Keisuke, Iwata Kazuko, Watanabe Shozo, Adachi Yukihiko
Third Department of Internal Medicine, Mie University School of Medicine, Edobashi 2-174, Tsu City, Mie 514-8507, Japan.
Hepatogastroenterology. 2002 Mar-Apr;49(44):529-31.
BACKGROUND/AIMS: It is generally accepted that iron overload plays an important role in the pathogenesis of liver cell injury in chronic hepatitis C. The present study was undertaken to evaluate whether low-iron diet improves liver function tests in patients with chronic hepatitis C.
Seventeen patients with chronic hepatitis C (13 men and 4 women, 54 +/- 14 years old) that did not respond to, or were unsuitable for interferon therapy, were enrolled in this study. All patients had been pretreated with ursodeoxycholic acid for more than 12 months before the beginning of the study. Dietary iron intake was restricted to less than 7 mg/day, and the patients were followed up for 18 months.
Mean daily iron intakes, calculated from food records, were 5.9 and 6.4 mg after 6 and 12 months, respectively. The mean serum ferritin decreased significantly from 362 ng/mL at entry to 179 ng/mL after 18 months. The serum unsaturated iron binding capacity level increased significantly from 163 micrograms/dL at entry to 203 micrograms/dL after 18 months. The serum aspartate aminotransferase decreased significantly from 62 IU/L at entry to 47 IU/L after 18 months, and serum alanine aminotransferase from 68 IU/L at entry to 53 IU/L after 18 months. Serum iron, hepatitis C virus-RNA titer and platelet count remained unchanged throughout the study.
These results suggest that iron-restricted diet may be an important therapeutic modality for improving liver injury in patients with chronic hepatitis C.
背景/目的：人们普遍认为铁过载在慢性丙型肝炎肝细胞损伤的发病机制中起重要作用。本研究旨在评估低铁饮食是否能改善慢性丙型肝炎患者的肝功能检查。
17例对干扰素治疗无反应或不适合干扰素治疗的慢性丙型肝炎患者（13例男性，4例女性，年龄54±14岁）纳入本研究。所有患者在研究开始前均已接受熊去氧胆酸预处理超过12个月。饮食中铁摄入量限制在每日7毫克以下，对患者进行18个月的随访。
根据饮食记录计算，6个月和12个月后的平均每日铁摄入量分别为5.9毫克和6.4毫克。平均血清铁蛋白从入组时的362纳克/毫升显著降至18个月后的179纳克/毫升。血清不饱和铁结合能力水平从入组时的163微克/分升显著升至18个月后的203微克/分升。血清天冬氨酸转氨酶从入组时的62国际单位/升显著降至18个月后的47国际单位/升，血清丙氨酸转氨酶从入组时的68国际单位/升降至18个月后的53国际单位/升。在整个研究过程中，血清铁、丙型肝炎病毒RNA滴度和血小板计数保持不变。
这些结果表明，限制铁饮食可能是改善慢性丙型肝炎患者肝损伤的一种重要治疗方式。
