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Liver Int. 2004 Oct;24(5):471-6.

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

Author information

1
Clinica Medica, Università degli Studi di Milano-Bicocca, Azienda Ospedaliera San Gerardo Monza, 20052 Monza, Italy. apiperno@tiscali.it

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.

PMID:
15482345
DOI:
10.1111/j.1478-3231.2004.0988.x
[Indexed for MEDLINE]

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