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Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), defined as excessive liver fat deposition and one of end-stage liver disease causes. Increased ferritin levels are associated with insulin resistance and a higher hepatic iron and fat content. Hyperferritinemia has been associated with severity o...

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Autores principales: Khodadoostan, Mahsa, Zamanidoost, Maryam, Shavakhi, Ahmad, Sanei, Hosein, Shahbazi, Masood, Ahmadian, Mehdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343605/
https://www.ncbi.nlm.nih.gov/pubmed/28299304
http://dx.doi.org/10.4103/2277-9175.200787
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author Khodadoostan, Mahsa
Zamanidoost, Maryam
Shavakhi, Ahmad
Sanei, Hosein
Shahbazi, Masood
Ahmadian, Mehdi
author_facet Khodadoostan, Mahsa
Zamanidoost, Maryam
Shavakhi, Ahmad
Sanei, Hosein
Shahbazi, Masood
Ahmadian, Mehdi
author_sort Khodadoostan, Mahsa
collection PubMed
description BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), defined as excessive liver fat deposition and one of end-stage liver disease causes. Increased ferritin levels are associated with insulin resistance and a higher hepatic iron and fat content. Hyperferritinemia has been associated with severity of liver damage in NAFLD. The study aimed to evaluate the effects of phlebotomy on liver enzymes and histology in such patients. MATERIALS AND METHODS: Thirty-two eligible patients who had NAFLD and after 6 months of lifestyle modification still had NAFLD, and whose ferritin serum was above 250 mg/dl, were enrolled in this clinical trial study. After written informed consent was obtained, each patient's blood serum was taken for aspartate transaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK-P), complete blood count (CBC), total iron-binding capacity (TIBC), iron, and ferritin. Then the patients underwent liver biopsy. After that patients underwent phlebotomy, giving 350 cc blood monthly. Before every phlebotomy, hemoglobin and ferritin were checked. If they were in the goal range, phlebotomy was discontinued and the patient underwent liver biopsy. A serum sample was taken for testing at the beginning of the study. The results before and after phlebotomy were compared. The maximum duration of the study was 6 months. RESULTS: Thirty-two patients (26 males and 6 females) were enrolled, and the mean average age was 33.7 ± 6.74 years. Phlebotomy improved liver enzymes and histology of liver significantly (P < 0.001) and induced reduction of ferritin. CONCLUSION: Phlebotomy is effective for the improvement of liver enzymes and histology in patients with NAFLD and hyperferritinemia.
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spelling pubmed-53436052017-03-15 Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease Khodadoostan, Mahsa Zamanidoost, Maryam Shavakhi, Ahmad Sanei, Hosein Shahbazi, Masood Ahmadian, Mehdi Adv Biomed Res Original Article BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), defined as excessive liver fat deposition and one of end-stage liver disease causes. Increased ferritin levels are associated with insulin resistance and a higher hepatic iron and fat content. Hyperferritinemia has been associated with severity of liver damage in NAFLD. The study aimed to evaluate the effects of phlebotomy on liver enzymes and histology in such patients. MATERIALS AND METHODS: Thirty-two eligible patients who had NAFLD and after 6 months of lifestyle modification still had NAFLD, and whose ferritin serum was above 250 mg/dl, were enrolled in this clinical trial study. After written informed consent was obtained, each patient's blood serum was taken for aspartate transaminase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK-P), complete blood count (CBC), total iron-binding capacity (TIBC), iron, and ferritin. Then the patients underwent liver biopsy. After that patients underwent phlebotomy, giving 350 cc blood monthly. Before every phlebotomy, hemoglobin and ferritin were checked. If they were in the goal range, phlebotomy was discontinued and the patient underwent liver biopsy. A serum sample was taken for testing at the beginning of the study. The results before and after phlebotomy were compared. The maximum duration of the study was 6 months. RESULTS: Thirty-two patients (26 males and 6 females) were enrolled, and the mean average age was 33.7 ± 6.74 years. Phlebotomy improved liver enzymes and histology of liver significantly (P < 0.001) and induced reduction of ferritin. CONCLUSION: Phlebotomy is effective for the improvement of liver enzymes and histology in patients with NAFLD and hyperferritinemia. Medknow Publications & Media Pvt Ltd 2017-02-22 /pmc/articles/PMC5343605/ /pubmed/28299304 http://dx.doi.org/10.4103/2277-9175.200787 Text en Copyright: © 2017 Advanced Biomedical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Khodadoostan, Mahsa
Zamanidoost, Maryam
Shavakhi, Ahmad
Sanei, Hosein
Shahbazi, Masood
Ahmadian, Mehdi
Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease
title Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease
title_full Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease
title_fullStr Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease
title_full_unstemmed Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease
title_short Effects of Phlebotomy on Liver Enzymes and Histology of Patients with Nonalcoholic Fatty Liver Disease
title_sort effects of phlebotomy on liver enzymes and histology of patients with nonalcoholic fatty liver disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343605/
https://www.ncbi.nlm.nih.gov/pubmed/28299304
http://dx.doi.org/10.4103/2277-9175.200787
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