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

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.

• Authors: James C Barton, J Clayborn Barton, Paul C Adams
• Journal: Annals of hepatology (Ann Hepatol) 2017 Sep-Oct Vol. 16 Issue 5 Pg. 802-811 ISSN: 1665-2681 [Print] Mexico
• PMID: 28809726 (Publication Type: Journal Article)

Chemical References

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

Topics

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