Role of Serum ferritin as a marker of decompensated cirrhosis and its correlation with CTP, MELD and MELD-Na scores
1 Department of Gastrointestinal, Hepatobiliary and Pancreatic Disorders, BIRDEM General Hospital, Dhaka, Bangladesh.
2 250 Bed General Hospital, Tangail, Dhaka, Bangladesh.
3 Department of Gastroenterology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
4 Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
5 Department of Opthalmology, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 20(01), 165–175.
Article DOI: 10.30574/wjbphs.2024.20.1.0696
Publication history:
Received on 17 August 2024; revised on 02 October 2024; accepted on 05 October 2024
Abstract:
Objectives: Liver cirrhosis, when decompensated; is associated with considerable morbidity and mortality. Scoring systems used to define the severity of cirrhosis and predict mortality include several clinical and biochemical parameters. Serum ferritin is a universally available biomarker, elevated in inflammatory conditions including hepatic necroinflammation. The study aimed to analyze whether serum ferritin has a role as a biomarker of decompensation and correlation with severity in cirrhotic patients.
Methods: 131 patients with cirrhosis; both compensated and decompensated admitted at Gastroenterology, BIRDEM General Hospital, Dhaka, Bangladesh from November 2019 to March 2022 were included in this cross-sectional study. To determine severity, Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD) and MELD-sodium (MELD-Na) were estimated. Comparison of ferritin between and among different groups was done and the relationship with severity was assessed.
Results: Serum ferritin was significantly higher in decompensated (mean 474.20±769.53 ng/mL) than in compensated (80.85±35.31) cirrhosis patients (P<0.001). Ferritin levels among different CTP grading differed significantly (P<0.001). It was higher in grade C (694.14±975.57) than in grade B (213.02±219.17) and A (80.85±35.31) as per pairwise comparison. Moderate positive correlations were observed between ferritin and MELD along with MELD-Na scores. Receiver operating characteristic (ROC) analysis of serum ferritin for predicting hepatic decompensation gave a significant area under the curve (AUC) value (0.821) and the best cut-off value was 105.5 ng/mL (sensitivity 76.2%, specificity 84.6%).
Conclusion: The study suggests serum ferritin can be used as an alternate biomarker for screening hepatic decompensation and stratifying severity.
Keywords:
Cross-sectional study; Cirrhosis; Decompensated cirrhosis; Child-Turcotte-Pugh score; Model for End-Stage Liver Disease score; MELD-sodium score; Serum ferritin
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