Serum Ferritin Level Predicts Advanced Hepatic Fibrosis among U.S. Patients with Phenotypic Hemochromatosis

Background: DNA-based HFE gene testing can confirm heredi-tary hemochromatosis in most people of Northern European de-scent. However, liver biopsy is important to detect cirrhosis. Objective: To develop noninvasive criteria to predict the pres-ence or absence of advanced hepatic fibrosis or cirrhosis in Amer-icans with hemochromatosis. Design: Cross-sectional study. Setting: Six tertiary care referral clinics. Patients: 182 patients with phenotypically defined hemochroma-tosis. Measurements: Liver histopathology and serum ferritin, aspar-tate aminotransferase, and alanine aminotransferase levels. Mul-tivariate logistic regression analysis was used to examine factors associated with cirrhosis (defined as bridging fibrosis or unequiv-ocal cirrhosis on biopsy)