Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.
Liver Int. 2012 Oct;32(9):1391-9. doi: 10.1111/j.1478-3231.2012.02828.x. Epub 2012 Jun 7.
Serum hepcidin concentration is potentially affected by inflammation and iron stores in chronic liver disease (CLD), but little is known about the relationship between hepcidin and the degree of hepatic fibrosis. We investigated the potential role of serum hepcidin as a biomarker of advanced liver disease.
Serum hepcidin was measured in 332 adults with CLD of varying aetiologies, 45 healthy and 50 non-liver disease patient controls. Liver biopsy data were available for 228 CLD subjects.
Hepcidin was decreased in CLD patients compared with non-liver disease patient controls (P < 0.0001) but not healthy controls, and was lowest in those with cirrhosis (P < 0.0001). Serum hepcidin correlated with hepatic hepcidin mRNA expression in 91 biopsy samples available for genetic analysis (r = 0.68, P < 0.0001). Hepcidin also correlated positively with serum ferritin concentration, transferrin saturation, ALT, serum albumin and haemoglobin, but negatively with serum bilirubin. The hepcidin:ferritin ratio was significantly lower in CLD subjects compared with healthy and disease controls, and decreased with each increase in the stage of fibrosis and siderosis. The hepcidin:ferritin ratio was associated with progressive fibrosis on linear regression, and a value of less than 0.1 was independently associated with cirrhosis on logistic regression analyses (OR 5.54, P < 0.001). Receiver operating characteristic analysis showed the hepcidin:ferritin ratio was able to distinguish between F0 and F4 stages of fibrosis (area under receiver operating characteristic curve = 0.86).
The hepcidin:ferritin ratio is reduced in relation to increasing fibrosis in CLD and the use of this ratio may have potential future diagnostic implications as a marker of cirrhosis.
血清铁调素浓度可能受慢性肝病（CLD）炎症和铁储存的影响，但关于铁调素与肝纤维化程度的关系知之甚少。我们研究了血清铁调素作为晚期肝病生物标志物的潜在作用。
检测了 332 名不同病因的 CLD 成人、45 名健康对照者和 50 名非肝脏疾病患者的血清铁调素。228 名 CLD 患者的肝活检数据可用。
CLD 患者的铁调素水平低于非肝脏疾病患者对照组（P<0.0001），但与健康对照组无差异，且肝硬化患者最低（P<0.0001）。在 91 份可供基因分析的肝活检样本中，血清铁调素与肝铁调素 mRNA 表达相关（r=0.68，P<0.0001）。铁调素与血清铁蛋白浓度、转铁蛋白饱和度、ALT、血清白蛋白和血红蛋白呈正相关，与血清胆红素呈负相关。CLD 患者的铁调素：铁蛋白比值明显低于健康对照组和非肝脏疾病患者对照组，且随纤维化和铁沉积程度的增加而降低。铁调素：铁蛋白比值与线性回归的纤维化进展相关，在逻辑回归分析中，比值小于 0.1 与肝硬化独立相关（OR 5.54，P<0.001）。受试者工作特征分析显示，铁调素：铁蛋白比值能够区分 F0 和 F4 期纤维化（曲线下面积 0.86）。
CLD 患者的铁调素：铁蛋白比值随纤维化程度的增加而降低，该比值的使用可能具有未来作为肝硬化标志物的潜在诊断意义。
