RELATIONSHIPS AMONG SERUM IRON STATUS MARKERS, CHEMICAL AND HISTOCHEMICAL LIVER IRON CONTENT IN 117 PATIENTS WITH ALCOHOLIC AND NONALCOHOLIC HEPATIC-DISEASE

Histochemical and chemical liver iron and iron status markers (serum ( S-) ferritin, transferrin saturation) were determined in 109 patients with various types of liver disease (71 alcoholic, 38 non-alcoholic di sease) and 8 normal subjects. In the series as a whole there was a sig nificant correlation between histochemical hepatocyte iron and chemica l iron (rho = 0.48, p = 0.0001). Of the iron status markers, only S-fe rritin showed clinically significant correlations with histochemical l iver iron (rho = 0.54, p = 0.0001) and chemical liver iron (r = 0.45, p = 0.0001) (log vs. log values. The highest correlation was found bet ween S-ferritin and the product of chemical iron x ASAT (r = 0.61, p = 0.0001) (log vs. log values). None of the normal livers had stainable hepatocyte iron; median chemical iron content was 15 mu mol/g dry wei ght (range 8-25). The entire group of alcoholics had a median liver ir on content of 21 mu mol/g; all patients had a hepatic iron index (hepa tic iron/age) of under 1.4. In alcoholic liver disease, median chemica l liver iron content was 15 mu mol/g (range 3-36) in 35 subjects with grade 0 hepatocyte iron; 24 mu mol/g (range 6-90) in 25 subjects with grade 1 + 2 hepatocyte iron; 30 mu mol/g (range 14-74) in 11 subjects with grade 3 + 4 hepatocyte iron. Among subjects with alcoholic liver disease and normal liver iron (< 26 mu mol/g), 39 % had stainable hepa tocyte iron vs. 70 % in subjects with increased liver iron (greater th an or equal to 26 mu mol/g). The corresponding figures in subjects wit h non-alcoholic liver disease were 13 % and 20 %. This difference was statistically significant (chi square = 20.9, p = 0.0001) and suggests a redistribution of hepatocyte iron from ferritin to hemosiderin in a lcoholic liver disease. Although chemical liver iron measurement remai ns the method of reference, histochemical liver iron assessment appear s to be of great value in the routine examination.