Additional effect of low iron diet on iron reduction therapy by phlebotomy for chronic hepatitis C

Fumiaki Kimura, Hisao Hayashi, Motoyoshi Yano, Kentaro Yoshioka, Tadashi Matsumura, Tomoko Fukuda, Nobuyuki Shigeto, Shigehiro Yamahara, Fukada Koushi, Yasuo Mishima, Tadashi Yoshino, Mitsune Tanimoto, Ikuro Kimura

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Abstract

Background/Aims: Iron-induced oxidative stress plays an important role in the pathogenesis of chronic hepatitis C. Both phlebotomy for removing body iron stores and low iron diet for minimizing portal iron supply to the liver have been shown to improve serum transaminase levels in patients with the disease. However, the cooperative effects of phlebotomy and low iron diet have not yet been elucidated in detail. Methodology: A pilot study was undertaken to investigate whether a low iron diet could improve the efficacy of phlebotomy in iron reduction therapy. Of 21 patients diagnosed with chronic hepatitis C, 10 patients were treated with phlebotomy alone (group A), while 11 patients were treated with a low iron diet plus phlebotomy (group B). Phlebotomy was repeated biweekly until serum ferritin levels reached 10ng/mL in both A and B groups. In addition, a low iron diet (iron intake of 8mg/day or less) was recommended for group B, followed by estimation of iron intake from daily diet records. Results: Serum alanine aminotransferase levels were significantly improved from 106±30 to 68±22 IU/L (p<0.005, paired t-test) in group A and from 100±33 to 46±10 IU/L (p<0.002, paired t-test) in group B. The enzyme levels after treatment were significantly higher in group A (p<0.02, non-paired t-test), which showed a higher upward distribution of the enzyme activity. The estimated dietary iron intake in group B was reduced from 17.6±6.1 to 8.2±3.7mg/day. Conclusions: These findings suggest that phlebotomy alone does not completely remove iron-induced oxidative stress and a low iron diet induces an additional effect in iron reduction therapy for chronic hepatitis C.

Original languageEnglish
Pages (from-to)563-566
Number of pages4
JournalHepato-gastroenterology
Volume52
Issue number62
Publication statusPublished - Mar 1 2005

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Keywords

  • Ferritin
  • Oxidative stress
  • Transaminase

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Kimura, F., Hayashi, H., Yano, M., Yoshioka, K., Matsumura, T., Fukuda, T., Shigeto, N., Yamahara, S., Koushi, F., Mishima, Y., Yoshino, T., Tanimoto, M., & Kimura, I. (2005). Additional effect of low iron diet on iron reduction therapy by phlebotomy for chronic hepatitis C. Hepato-gastroenterology, 52(62), 563-566.