Assessment of Serum Iron Indices and Levels of C-Reactive Protein in Patients of Alcoholic Liver Disease and Their Relationship with Severity of Disease

Abstract

Background: Diagnosing ALD presents a number of difficulties including early-stage ALD is often symptom-free, and there is currently no confirmed etiological laboratory biomarker or diagnostic test. There have been a few studies on the effects of iron excess on alcohol-related liver disease, but none have examined the correlation between blood iron indices and C-reactive protein or disease severity in the Pakistani population. Objective: Therefore, the objective of the study is to assess the serum iron indices and levels of c-reactive protein in patients of alcoholic liver disease and their relationship with severity of disease. Study Design: Case control study. Settings: This study was conducted in Biochemistry Department of Central Park Medical College, Lahore Pakistan. Duration: Six months from January 2022 to June 2022. Methods: In this study the demographic details were recorded on a questionnaire. This questionnaire was made to describe the demographic variables age, weight and height for BMI. After taking consents from ALD and healthy individuals the blood was drawn for biochemical analysis. All parameters underwent low and high-level internal quality check before analysis. After ensuring that the standard deviation of the internal quality control was less than one standard deviation. A total of 55 patients of ALD and 55 as healthy control enrolled in this study. The statistical analysis was done by using SPSS version 20. Results: The mean age of control group is 42.3 ± 5.0 years and 39.2 ± 4.2 years of ALD patients in case group.  The albumin levels were significantly lower in patients with ALD compared to controls (p<0.001), while serum iron, ferritin, high-sensitivity C-reactive protein, bilirubin, aspartate transaminase, alanine transaminase, alkaline phosphatase, and prothrombin time were all significantly elevated. The transferrin saturation is increased in ALD group but not significant. The model for end stage liver disease score is a measure of the severity of alcoholic liver disease, and it was shown to be positively connected with iron (r = 0.345, p = 0.014) and ferritin (r = 0.456, p = 0.012). Iron (r = 0.931, p <0.001), ferritin (r = 0.964, p <0.001) were all significantly correlated with high-sensitivity C-reactive protein in alcoholic liver disease patients. Conclusion: Alcohol's effects on iron and proteins in iron metabolism. The effects of alcohol on ferritin and serum iron levels are uncertain and may be either beneficial or detrimental. In this research, patients with alcoholic liver disease had higher levels of serum iron, ferritin, and C-reactive protein, all of which are indicative of iron overload and inflammation. Iron, ferritin, and C-reactive protein levels correlated significantly with the MELD score, indicating that iron excess and inflammation may contribute to the severity of ALD in these patients.