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World J Gastroenterol. Mar 21, 2014; 20(11): 3002-3010
Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.3002
Published online Mar 21, 2014. doi: 10.3748/wjg.v20.i11.3002
A randomized trial of iron depletion in patients with nonalcoholic fatty liver disease and hyperferritinemia
Luca Valenti, Anna Ludovica Fracanzani, Paola Dongiovanni, Serena Rovida, Raffaela Rametta, Erika Fatta, Edoardo Alessandro Pulixi, Silvia Fargion, Department of Pathophysiology and Transplantation, Metabolic Liver Diseases Research Center, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Policlinico, via F Sforza 35, 20122, Milano, Italy
Marco Maggioni, Pathology, Fondazione IRCCS Ca’ Granda Ospedale Policlinico, 20122 Milano, Italy
Author contributions: All Authors contributed to literature review and writing of this paper.
Supported by Associazione Malattie Metaboliche del Fegato ONLUS (Non-profit organization for the Study and Care of Metabolic Liver Diseases), Centro Studi Malattie Metaboliche del Fegato, Università degli Studi di Milano
Correspondence to: Luca Valenti, MD, Department of Pathophysiology and Transplantation, Metabolic Liver Diseases Research Center, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Policlinico, via F Sforza 35, 20122, Milano, Italy. luca.valenti@unimi.it
Telephone: +39-25-320278 Fax: +39-25-320296
Received: September 16, 2013
Revised: November 6, 2013
Accepted: December 3, 2013
Published online: March 21, 2014
Revised: November 6, 2013
Accepted: December 3, 2013
Published online: March 21, 2014
Core Tip
Core tip: We compared in a randomized controlled trial iron depletion by phlebotomy (n = 21) to standard therapy (n = 17) in patients with severe nonalcoholic fatty liver disease and hyperferritinemia despite at least 6 mo of lifestyle changes. Phlebotomy was associated with normalization of iron parameters without adverse events. In the 21 patients compliant to the study protocol, the rate of histological improvement was higher in iron depleted vs control subjects (P = 0.039). In patients followed-up at two years (n = 35), by the end of the study alanine aminotransferases, aspartate aminotransferase, and gamma-glutamyl-transferases levels were lower in iron-depleted than in control patients (P < 0.05).