Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Department of Gastroenterology-Hepatology, SUNY Downstate, Brooklyn, NY, USA.
Clin Chem Lab Med. 2023 Aug 7;62(3):373-384. doi: 10.1515/cclm-2023-0540. Print 2024 Feb 26.
Dysregulation of hepcidin-iron axis is presumed to account for abnormal iron status in patients with chronic liver disease (CLD). Our aim is to determine the effect of specific etiologies of CLD and of cirrhosis on serum hepcidin levels.
PubMed, Embase, Web of Science were searched for studies comparing serum hepcidin levels in patients with CLD to that in controls using enzyme-linked immunosorbent assay. The study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Guidelines. Statistical analysis was carried out with STATA using random effects model to calculate the mean difference (MD) between two groups.
Hepcidin levels were significantly lower in subjects with hepatitis C virus (16 studies) [MD -1.6 (95 % CI: -2.66 to -0.54), p<0.01] and alcoholic liver disease (3 studies) [MD -0.84 (95 % CI: -1.6 to -0.07), p=0.03] than controls. Serum hepcidin was significantly higher in subjects with non-alcoholic fatty liver disease (12 studies) [MD 0.62 (95 % CI: 0.21 to 1.03), p<0.01], but did not differ in subjects with hepatitis B and controls (eight studies) [MD -0.65 (95 % CI: -1.47 to 0.16), p=0.12]. Hepcidin levels were significantly lower in patients with cirrhosis of any etiology (four studies) [MD -1.02 (CI: -1.59 to -0.45), p<0.01] vs. controls (CI: confidence interval).
Serum hepcidin levels are altered in common forms of CLD albeit not in a consistent direction. Additional study is needed to determine how changes in hepcidin levels are related to dysregulation of iron metabolism in CLD.
铁调素-铁轴的失调被认为是导致慢性肝病（CLD）患者铁状态异常的原因。本研究旨在确定 CLD 的特定病因和肝硬化对血清铁调素水平的影响。
检索 PubMed、Embase、Web of Science 数据库，使用酶联免疫吸附试验比较 CLD 患者与对照组的血清铁调素水平。本研究遵循系统评价和荟萃分析的首选报告项目指南进行。使用 STATA 进行统计分析，采用随机效应模型计算两组间的平均差异（MD）。
与对照组相比，丙型肝炎病毒（16 项研究）[MD-1.6（95%可信区间：-2.66 至-0.54），p<0.01]和酒精性肝病（3 项研究）[MD-0.84（95%可信区间：-1.6 至-0.07），p=0.03]患者的血清铁调素水平显著降低。非酒精性脂肪性肝病（12 项研究）[MD 0.62（95%可信区间：0.21 至 1.03），p<0.01]患者的血清铁调素水平显著升高，但乙型肝炎患者与对照组之间无差异（8 项研究）[MD-0.65（95%可信区间：-1.47 至 0.16），p=0.12]。任何病因肝硬化患者（4 项研究）[MD-1.02（CI：-1.59 至-0.45），p<0.01]的血清铁调素水平明显低于对照组（CI：置信区间）。
尽管方向不一致，但常见形式的 CLD 患者的血清铁调素水平发生了改变。需要进一步研究以确定铁调素水平的变化与 CLD 中铁代谢失调的关系。
