Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Department of Gastroenterology, Children's Hospital 2, Ho Chi Minh City, Vietnam.
Med Arch. 2022 Apr;76(2):122-126. doi: 10.5455/medarh.2022.76.122-126.
High serum ferritin levels are associated with liver cirrhosis severity and worse outcomes for hepatopathies. This study determined the serum ferritin cutoff values for predicting cirrhosis severity in children with cholestatic jaundice.
A retrospective study was performed, including all cases diagnosed with cirrhosis in children aged 1 month to 16 years at Children's Hospital 2-Vietnam between 2016 and 2021. Receiver operating characteristic (ROC) curve analysis was used to estimate ferritin cutoff values for predicting disease severity.
The study included 95 patients with cirrhosis due to cholestatic jaundice. Decompensated cirrhosis accounted for the majority (74.7%) of cases. Increased serum ferritin concentrations predicted cirrhosis severity in children, and the optimal ferritin cutoff value for predicting decompensated cirrhosis was determined to be 195 μg/l, resulting in a sensitivity of 65.22%, a specificity of 95.83%, and an area under the ROC curve (AUC) or 0.82. The Child-Pugh C group had higher ferritin levels than the Child-Pugh A and B group (p < 0.001), and the ferritin cutoff value for distinguishing between Child-Pugh classifications was 195 μg/l, resulting in a sensitivity of 71.2%, a specificity of 87.9%, and an AUC of 0.80.
Serum ferritin levels are significantly associated with decompensated cirrhosis and disease severity (as assessed by Child-Pugh score). Routine serum ferritin testing may contribute to predicting cirrhosis severity in children.
血清铁蛋白水平升高与肝硬化严重程度以及肝疾病不良预后相关。本研究旨在确定血清铁蛋白临界值，以预测胆汁淤积性黄疸患儿的肝硬化严重程度。
本回顾性研究纳入了 2016 年至 2021 年期间在越南儿童医院 2-Vietnam 诊断为肝硬化的所有 1 个月至 16 岁儿童的病例。采用受试者工作特征（ROC）曲线分析来评估铁蛋白临界值预测疾病严重程度的能力。
本研究共纳入了 95 例由胆汁淤积性黄疸导致的肝硬化患儿。失代偿性肝硬化占大多数（74.7%）。血清铁蛋白浓度升高可预测儿童肝硬化的严重程度，预测失代偿性肝硬化的最佳铁蛋白临界值为 195μg/l，其灵敏度为 65.22%，特异性为 95.83%，ROC 曲线下面积（AUC）为 0.82。Child-Pugh C 级患儿的铁蛋白水平高于 Child-Pugh A 级和 B 级患儿（p<0.001），区分 Child-Pugh 分级的铁蛋白临界值为 195μg/l，其灵敏度为 71.2%，特异性为 87.9%，AUC 为 0.80。
血清铁蛋白水平与失代偿性肝硬化和疾病严重程度（根据 Child-Pugh 评分评估）显著相关。常规检测血清铁蛋白可能有助于预测儿童肝硬化的严重程度。
