Iron-related indexes in chronic alcoholics. Effect of alcohol withdrawal

Background. Increased serum transferrin saturation and ferritin levels have been reported in chronic alcoholics. Aim, To evaluate modifications in serum iron-related indexes in chronic alcohol abusers with and without cirrhosis, at enrolment and after complete alcohol withdrawal. Patients. Fifty-one consecutive chronic alcohol abusers, 33 without and 18 with cirrhosis. Methods, Liver function tests were performed and transferrin saturation percent and serum ferritin levels measured at time 0 and after 7 and 14 days of complete alcohol withdrawal. Results. Duration of alcohol abuse was significantly longer in patients with cirrhosis than in those without (24 +/- 13 SD vs 18 +/- 13 SD years, p<0.01). A concomitant increase in transferrin saturation percent and serum ferritin was found in 60% of the cirrhotics and 45% of the non cirrhotic group. During the observation period, transferrin saturation percent and serum ferritin fell significantly in both groups (from 59 +/- 33 SD to 36 +/- 22% SD, p<0.05, and from 900 +/- 933 SD to 469 +/- 457 SD ng/ml, p<0.01, in cirrhotics, and from 46 +/- 30 SD to 27 +/- 12% SD, p<0.01, and from 702 +/- 602 SD to 340 +/- 290 SD ng/ml, p<0.01, in non cirrhotics). Conclusions, Iron-related indexes increase with chronic alcohol abuse and return to normal rapidly after complete alcohol withdrawal. In chronic alcoholics the timing of determinations of iron-related indexes is crucial, and screening for possible concomitant genetic haemochromatosis must be postponed.