Dataset Information

Portal hypertensive gastropathy is associated with iron deficiency anemia.

ABSTRACT:

Background and aims

Portal hypertensive gastropathy (PHG) is common in patients with cirrhosis and may cause bleeding. This study systematically explored the independent impact of patient characteristics, portal hypertension and hepatic dysfunction on PHG severity and associated anemia.

Methods

Patients with cirrhosis undergoing endoscopy were included in this retrospective analysis and PHG was endoscopically graded as absent, mild or severe. Clinical and laboratory parameters and hepatic venous pressure gradient (HVPG) were assessed with respect to an association with severity of PHG.

Results

A total of 110 patients (mean age: 57 years, 69% male) with mostly alcoholic liver disease (49%) or viral hepatitis (30%) were included: 15 (13.6%) patients had no PHG, 59 (53.6%) had mild PHG, and 36 (32.7%) had severe PHG. Severe PHG was significantly associated with male sex (83.3% vs. 62.2% in no or mild PHG; p?=?0.024) and higher Child-Turcotte-Pugh (CTP) stage (CTP-C: 38.9% vs. 27.0% in no or mild PHG; p?=?0.030), while MELD was similar (p?=?0.253). Patients with severe PHG had significantly lower hemoglobin values (11.2?±?0.4?g/dL vs. 12.4?±?0.2?g/dL; p?=?0.008) and a higher prevalence of iron-deficiency anemia (IDA: 48.5% vs. 26.9%; p?=?0.032). Interestingly, HVPG was not significantly higher in severe PHG (median 20?mm?Hg) vs. mild PHG (19?mm?Hg) and no PHG (18?mm?Hg; p?=?0.252). On multivariate analysis, CTP score (odds ratio, OR: 1.25, 95% confidence interval, CI 1.02-1.53; p?=?0.033) was independently associated with severe PHG, while only a trend towards an independent association with IDA was observed (OR: 2.28, 95% CI 0.91-5.72; p?=?0.078).

Conclusion

The CTP score but not HVPG or MELD were risk factors for severe PHG. Importantly, anemia and especially IDA are significantly more common in patients with severe PHG.

SUBMITTER: Simbrunner B

PROVIDER: S-EPMC6978296 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Portal hypertensive gastropathy is associated with iron deficiency anemia.

Simbrunner Benedikt B Beer Andrea A Wöran Katharina K Schmitz Fabian F Primas Christian C Wewalka Marlene M Pinter Matthias M Dolak Werner W Scheiner Bernhard B Puespoek Andreas A Trauner Michael M Oberhuber Georg G Mandorfer Mattias M Reiberger Thomas T

Wiener klinische Wochenschrift 20200107 1-2

<h4>Background and aims</h4>Portal hypertensive gastropathy (PHG) is common in patients with cirrhosis and may cause bleeding. This study systematically explored the independent impact of patient characteristics, portal hypertension and hepatic dysfunction on PHG severity and associated anemia.<h4>Methods</h4>Patients with cirrhosis undergoing endoscopy were included in this retrospective analysis and PHG was endoscopically graded as absent, mild or severe. Clinical and laboratory parameters and ...[more]

PMID: 31912289

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Project description:Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status.The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status.Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at ?20 wk gestation, aged ?18 y, and with hemoglobin ?100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) <15 ?g/L and body iron (BI) <0 mg/kg; 2) maternal ID anemia [ID + anemia (IDA); hemoglobin <110 g/L]; and 3) neonatal ID (cord blood ferritin <75 ?g/L or zinc protoporphyrin/heme >118 ?mol/mol).A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates (809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% CI: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% CI: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% CI: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BI). Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (? per 10 capsules = 2.60, P < 0.05).Prenatal iron supplementation reduced anemia, ID, and IDA in pregnant women in rural China, but most women and >45% of neonates had ID, regardless of supplementation. This trial was registered at clinicaltrials.gov as NCT02221752.

Dataset Information

Portal hypertensive gastropathy is associated with iron deficiency anemia.

Background and aims

Methods

Results

Conclusion

Publications

Portal hypertensive gastropathy is associated with iron deficiency anemia.

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