Effects of venesections and restricted diet in patients with the insulin-resistance hepatic iron overload syndrome.

Abstract

GOAL:

We evaluated the effect of venesections and restricted diet on iron and metabolic indices and liver function tests in patients with insulin-resistance hepatic iron overload (IR-HIO).

MATERIALS AND METHODS:

Patients were divided in three groups: (a) patients without any therapy who were followed-up for 36+28 months; (b) patients venesected; and (c) patients on dietary treatment. In each group baseline and end-point levels of serum iron and metabolic indices, and liver function tests were compared by Student's paired t-test and the relationship between serum ferritin and the other variables during treatment was evaluated by linear regression analysis.

FINDINGS AND CONCLUSIONS:

In the follow-up group, iron and metabolic indices did not change over time. Serum alanine aminotransferase, gamma-glutamyl transferase, cholesterol and triglycerides significantly decreased after iron depletion. Serum glucose, cholesterol, triglyceride, ferritin and liver function tests significantly decreased after dietary treatment. Transferrin saturation decreased below 20% during phlebotomy treatment in 52% of the patients. In conclusion, our results show that IR-HIO patients had relatively low amount of iron overload that seems not to increase even after a long follow-up period. Both venesections and diet improved iron, metabolic and hepatic indices. Data suggest a relationship between hepatic iron overload and insulin resistance, and a role for both iron overload and insulin resistance in hepatocellular damage. The behaviour of iron indices during venesections suggests an impaired iron release from hepatic cells.

• Authors: Alberto Piperno, Anna Vergani, Alessandra Salvioni, Paola Trombini, Mauro Viganò, Alessia Riva, Adele Zoppo, Giuseppe Boari, Giuseppe Mancia
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 24 Issue 5 Pg. 471-6 (Oct 2004) ISSN: 1478-3223 [Print] United States
• PMID: 15482345 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Iron, Dietary
• Iron

Topics

• Female
• Humans
• Insulin Resistance
• Iron (blood)
• Iron Overload (blood, pathology, therapy)
• Iron, Dietary (administration & dosage)
• Liver Diseases (blood, pathology, therapy)
• Liver Function Tests
• Male
• Middle Aged
• Phlebotomy
• Treatment Outcome