Abstract
Background and aimThe association between iron-metabolism-related variables and liver fibrosis in chronic hepatitis C and nonalcoholic fatty liver disease is now well known. However, the relationship has not been extensively studied in autoimmune hepatitis (AIH). We aimed to investigate the association between variables associated with iron metabolism and advanced liver fibrosis among untreated patients with AIH.MethodsNinety-seven untreated AIH patients were enrolled in this cross-sectional study. All participants underwent iron metabolism index detection and liver biopsy. Multiple logistic regression analysis was used to explore the association of iron-metabolism-related variables with advanced liver fibrosis.ResultsAmong the 97 AIH patients, 38 (39.2%) had advanced liver fibrosis, and 59 (60.8%) did not. In multivariate logistic regression analysis, immunoglobulin G (odds ratio [OR], 1.123; 95% confidence interval [CI] 1.023–1.232, P = 0.014), platelet count (OR 0.988; 95% CI 0.979–0.997, P = 0.013), prothrombin time (OR 1.758; 95% CI 1.143–2.704, P = 0.010) and ferritin (OR 1.002; 95% CI 1.001–1.004, P = 0.012) were independent risk factors for predicting advanced liver fibrosis in AIH patients.ConclusionHigher serum ferritin was independently associated with advanced liver fibrosis among patients with treatment-naive AIH.
Highlights
Autoimmune hepatitis (AIH) is a chronic and progressive inflammatory liver disease characterized by elevated levels of serum aminotransferases and immunoglobulin G (IgG), the presence of autoantibodies, and interface hepatitis with lymphoplasmacytic infiltration in liver histology [1]
Several noninvasive markers for assessing liver fibrosis and cirrhosis have been applied in clinical practice, including the fibrosis index based on 4 factors (FIB-4), the aspartate transaminase-to-platelet ratio index (APRI), the aspartate aminotransferase/alanine aminotransferase ratio (AAR), and the AAR/platelet ratio index (AARPRI) [10, 11]
General characteristics of patients by liver fibrosis stage The included patients were divided into an advanced fibrosis group and a nonadvanced fibrosis group according to the results of liver biopsy analysis
Summary
Autoimmune hepatitis (AIH) is a chronic and progressive inflammatory liver disease characterized by elevated levels of serum aminotransferases and immunoglobulin G (IgG), the presence of autoantibodies, and interface hepatitis with lymphoplasmacytic infiltration in liver histology [1]. Several noninvasive markers for assessing liver fibrosis and cirrhosis have been applied in clinical practice, including the fibrosis index based on 4 factors (FIB-4), the aspartate transaminase-to-platelet ratio index (APRI), the aspartate aminotransferase/alanine aminotransferase ratio (AAR), and the AAR/platelet ratio index (AARPRI) [10, 11]. These noninvasive markers can be used to detect cirrhosis in patients with chronic viral hepatitis and nonalcoholic fatty liver disease.
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