The prevalence of primary hereditary hemochromatosis in central Anatolia

BACKGROUND/AIMS

Hereditary hemochromatosis is an autosomal recessive disorder associated with the HFE genes. Early identification and diagnosis is important as end stage organ damage may occur if treatment is delayed.. This study aimed to identify the prevalence of hereditary hemochromatosis in Kayseri and surroundings known as Central Anatolia.

MATERIALS AND METHODS

2304 participants (1220 males, 1084 females) who were older then the age of 17 were included in the study conducted between December 2005 and December 2006 in Kayseri, Turkey. Transferin saturation was measured from overnight fasting blood samples. Serum iron, total iron binding capacity, and transferin saturation were measured. Serum ferritin levels and hereditary hemochromatosis genetic analysis were also performed after an overnight fasting blood samples from participants whose transferin saturation results were more than 50% in man and more than 45% in women.

RESULTS

The homozygote C282Y mutation and heterozygote C282Y mutation prevalences were found as 0.08% (1/1220) and 0.08% (1/1220) in male participants, respectively. The heterozygote H63D mutation prevalence was found in 0.09% (1/1084) of female participants. Calculated prevalences in general population are as follows; The homozygote C282Y mutation prevalence is 0.043% (1/2304), the heterozygote C282Y mutation prevalence is 0.043% (1/2304) and the heterozygote H63D mutation prevalence is 0.043% (1/2304).

CONCLUSIONS

The prevalence of hereditary hemochromatosis in Central Anatolia is 0.043% (1/2304). Because of the relatively low frequency, population screening studies are not cost-effective.

A new marker for lipid peroxidation: serum paraoxonase activity in non-alcoholic steatohepatitis

BACKGROUND/AIMS

Relationship between hepatic antioxidant paraoxonase 1 (PON1) activity, lipid peroxidation and liver injury was investigated in patients with non-alcoholic steatohepatitis.

METHODS

A total of 23 patients with non-alcoholic steatohepatitis (15 males, 8 females; mean age: 40.30+/-7.67 yrs) and 23 healthy controls (14 males, 9 females; mean age: 39.70+/- 8.78 yrs) were enrolled in the study. Serum paraoxonase 1 activity and levels of a well-known lipid peroxidation marker, serum malondialdehyde, were determined.

RESULTS

Serum paraoxonase 1 activity decreased significantly in non-alcoholic steatohepatitis compared to the control group (p<0.01). Serum malondialdehyde levels were significantly higher in patients with non-alcoholic steatohepatitis as compared with the control group (p<0.05). No statistically significant correlations were found between serum paraoxonase 1 activities and the grade-stage of non-alcoholic steatohepatitis, serum lipid levels or serum malondialdehyde levels (p>0.05).

CONCLUSIONS

Increased lipid peroxidation may be either a cause or a result of liver injury in patients with non-alcoholic steatohepatitis. Although serum paraoxonase 1 activity does not reflect the degree of liver damage in non-alcoholic steatohepatitis, reduced paraoxonase 1 activity, especially in the presence of mild disease, could be interpreted as a biochemical marker of the lipid peroxidation.

Importance of anticoagulant proteins in chronic liver diseases

BACKGROUND/AIMS

This study was conducted to elucidate the importance of anticoagulant proteins in chronic liver disease and their possible role as markers in determining the severity of the liver disease.

METHODS

This study was conducted on 35 patients with cirrhosis, 15 patients with chronic active hepatitis and 10 healthy controls. Coagulation inhibitor proteins such as protein C, protein S and antithrombin, as well as D-dimer level and thrombin time, which reflect fibrin degradation products, were measured. Cirrhotic patients were categorized as Child A, B and C and chronic active hepatitis patients as mild or moderate activity according to the modified Knodell histopathologic classification. The parameters were compared between patient groups and healthy controls.

RESULTS

In comparison with controls, the cirrhotics had significantly decreased protein C, protein S, antithrombin levels and increased D-dimer levels. The Child B and Child C patients differed significantly with respect to protein C and antithrombin levels only. In the chronic active hepatitis patients, protein S, protein C and fibrinogen were within normal limits, whereas antithrombin was low.

CONCLUSIONS

In chronic active hepatitis, the antithrombin level may be used as an early marker of hepatocellular damage. In cirrhotics, protein C and antithrombin may be useful for assessment of hepatocellular damage, whereas D-dimer may be important for the transition to decompensation.

Efficacy of five days of subcutaneous octreotide treatment after sclerotherapy in preventing rebleeding from esophageal varices

BACKGROUND/AIMS

Acute variceal bleeding is the most severe consequence of portal hypertension. Mortality due to bleeding among cirrhotic patients is high; between 30 and 50% die within six weeks of the first bleeding episode. This dismal outcome has led to attempts both to stop acute bleeding and to prevent rebleeding. The aim of this study was to investigate the efficacy of subcutaneous octreotide treatment, administered after emergency sclerotherapy, in preventing rebleeding of esophageal varices

METHODS

After a bolus injection of 50 microgram octreotide, 34 patients, forming the standard therapy (ST) group, received octreotide infusion at a rate of 50 microgram/h until endoscopic sclerotherapy performed within 36 hours. The same procedure was applied to another 27 patients in the maintenance therapy (MT) group in which octreotide was given at 100 microgram/8h via subcutaneous (sc) route after sclerotherapy for five days. In both groups, sclerotherapy was repeated on the 5th-7th day. Patients were followed for three weeks for rebleeding.

RESULTS

Nine patients rebled in the ST group but only one patient bled in the MT group (3.7% vs. 26.5% vs. 3.7%; p<0.05). Transfusion requirement and duration of hospitalization period were similar in both groups.

CONCLUSIONS

This study suggests that maintenance subcutaneous octreotide therapy is effective in controlling rebleeding episodes.