Clinical and Laboratory Associations with Persistent Hyperferritinemia in 373 Black Hemochromatosis and Iron Overload Screening Study Participants

Ann Hepatol. 2017 Sep-Oct;16(5):802-811. doi: 10.5604/01.3001.0010.2815.

Abstract

Background: 373 black participants had elevated screening and post-screening serum ferritin (SF) (> 300 μg/L men; > 200 μg/L women).

Material and methods: We retrospectively studied SF and post-screening age; sex; body mass index; transferrin saturation (TS); ALT; AST; GGT; elevated C-reactive protein; ß-thalassemia; neutrophils; lymphocytes; monocytes; platelets; metacarpophalangeal joint hypertrophy; hepatomegaly; splenomegaly; diabetes; HFE H63D positivity; iron/alcohol intakes; and blood/erythrocyte transfusion units. Liver disease was defined as elevated ALT or AST. We computed correlations of SF and TS with: age; body mass index; ALT; AST; GGT; C-reactive protein; blood cell counts; and iron/alcohol. We compared participants with SF > 1,000 and ≤ 1,000 μg/L and performed regressions on SF.

Results: There were 237 men (63.5%). Mean age was 55 ± 13 (SD) y. 143 participants had liver disease (62 hepatitis B or C). There were significant correlations of SF: TS, ALT, AST, GGT, and monocytes (positive); and SF and TS with platelets (negative). 22 participants with SF > 1,000 μg/L had significantly higher median TS, ALT, and AST, and prevalences of anemia and transfusion > 10 units; and lower median platelets. Regression on SF revealed significant associations: TS; male sex; age; GGT; transfusion units (positive); and splenomegaly (negative) (p < 0.0001, 0.0016, 0.0281, 0.0025, 0.0001, and 0.0096, respectively). Five men with SF > 1,000 μg/L and elevated TS had presumed primary iron overload (hemochromatosis). Four participants had transfusion iron overload.

Conclusion: Persistent hyperferritinemia in 373 black adults was associated with male sex, age, TS, GGT, and transfusion. 2.4% had primary iron overload (hemochromatosis) or transfusion iron overload.

Keywords: Alanine aminotransferase; Aspartate aminotransferase; Metabolic syndrome; Transferrin saturation; γ-glutamyl transpeptidase.

MeSH terms

  • Adult
  • Aged
  • Alabama / epidemiology
  • Biomarkers / blood
  • Black or African American / genetics
  • Blood Transfusion
  • Comorbidity
  • Female
  • Ferritins / blood*
  • Hemochromatosis / blood*
  • Hemochromatosis / ethnology
  • Hemochromatosis / genetics
  • Hemochromatosis / therapy
  • Humans
  • Iron Overload / blood*
  • Iron Overload / ethnology
  • Iron Overload / genetics
  • Iron Overload / therapy
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Transferrin / metabolism
  • Treatment Outcome
  • Up-Regulation
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • Transferrin
  • Ferritins
  • gamma-Glutamyltransferase
  • gamma-glutamyltransferase, human