Expression levels of duodenal proteins involved in iron absorption in patients with alcoholic liver disease.

OBJECTIVES OF THE STUDY: This study tested the hypothesis that alcohol ingestion causes up-regulation of proteins involved in duodenal iron absorption, leading to iron overload. METHODS: Patients with alcoholic cirrhosis (AC) (n = 24) were the subjects of the study. Such patients who were required to undergo a medically-indicated upper gastrointestinal endoscopy were recruited into the study after informed consent. Patients who underwent an endoscopy for investigation of dyspepsia and who were found to have no endoscopic abnormalities served as control subjects (n = 30). Duodenal mucosal and blood samples were obtained from the subjects. Duodenal tissue was used to determine mRNA levels of divalent metal transporter 1 (DMT1) and ferroportin, both of which are involved in non-heme iron absorption in the duodenum. Blood was used for estimation of serum C-reactive protein (CRP), ferritin, iron, haematological parameters and tests of liver function. Data were analyzed by student’s t-test and analysis of variance or Kruskall-Willis and Mann-Whitneys test, as appropriate. A p value of less than 0.05 was taken to indicate statistical significance. RESULTS: Patients with AC had significantly lower levels of haemoglobin and serum iron and higher levels of serum CRP. Other haematological and iron indices were not significantly altered. Parameters of liver function were deranged in these patients. Levels of mRNA for DMT1 and ferroportin in the duodenal mucosa of these patients tended to be higher, when compared with control subjects; however, these increases were not statistically significant. Gene expression of DMT1 and ferroportin tended to be higher in those with AC. However, these results need confirmation to ascertain whether this up-regulation may contribute to the iron overload associated with alcoholic liver disease