Shan Ying, Lambrecht Richard W, Bonkovsky Herbert L
Department of Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA.
Clin Infect Dis. 2005 Mar 15;40(6):834-41. doi: 10.1086/428062. Epub 2005 Feb 21.
There is growing evidence that mildly increased amounts of iron in the liver can increase hepatic injury, particularly if combined with other hepatotoxic factors, such as alcohol use, use of porphyrogenic drugs, or chronic viral hepatitis. In the present study, the association of hepatitis C virus (HCV) infection with serum measurements of iron status was assessed in the US population.
We analyzed data from a total of 14,462 participants in the Third National Health and Nutrition Examination Survey. We excluded subjects who were aged <12 years, subjects for whom measurements of serum levels of iron or ferritin or the results of liver function tests were missing, and subjects who had a serum transferrin saturation of > or =50% (to help exclude subjects with hemochromatosis).
Mean serum levels of ferritin and iron (+/- standard error) were significantly higher among subjects with HCV infection (100+/-3 ng/mL and 229+/-17 microg/dL, respectively) than among subjects without liver disease (83+/-0.3 ng/mL and 101+/-2.1 microg/dL, respectively) (P<.0001). Serum levels of ferritin were directly and significantly correlated with serum levels of alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transpeptidase (r=0.25, r=0.24, and r=0.28, respectively; P<.0001), whereas platelet counts were inversely correlated with serum levels of ferritin (r=-0.12; P<.0001).
HCV infection is significantly associated with higher serum levels of ferritin and iron in the US population.
越来越多的证据表明，肝脏中铁含量轻度增加会加重肝损伤，尤其是在与其他肝毒性因素（如饮酒、使用致卟啉药物或慢性病毒性肝炎）并存时。在本研究中，我们评估了美国人群中丙型肝炎病毒（HCV）感染与铁状态血清检测指标之间的关联。
我们分析了第三次全国健康与营养检查调查中总共14462名参与者的数据。我们排除了年龄小于12岁的受试者、血清铁或铁蛋白水平测量值或肝功能测试结果缺失的受试者，以及血清转铁蛋白饱和度≥50%的受试者（以帮助排除血色素沉着症患者）。
HCV感染受试者的血清铁蛋白和铁平均水平（±标准误）（分别为100±3 ng/mL和229±17 μg/dL）显著高于无肝病受试者（分别为83±0.3 ng/mL和101±2.1 μg/dL）（P<0.0001）。血清铁蛋白水平与丙氨酸转氨酶、天冬氨酸转氨酶和γ-谷氨酰转肽酶的血清水平直接且显著相关（r分别为0.25、0.24和0.28；P<0.0001），而血小板计数与血清铁蛋白水平呈负相关（r=-0.12；P<0.0001）。
在美国人群中，HCV感染与较高的血清铁蛋白和铁水平显著相关。
