Serum Iron indices and C-Reactive protein in Alcoholic Liver Disease

Abstract

Introduction: Alcoholic liver disease (ALD) is a leading cause of chronic liver morbidity in India, driven by metabolic dysfunction and systemic inflammation. Chronic alcohol intake suppresses hepatic hepcidin, causing unregulated iron absorption and oxidative stress while C-reactive protein (CRP) serves as a critical marker of systemic inflammation. Objectives: To estimate and compare iron indices and C-reactive protein levels in individuals with and without ALD and to determine their relationship with disease severity. Materials and Methods: An analytical cross-sectional study was conducted in the Department of Biochemistry in collaboration with Department of Medicine and Multi-Disciplinary Research Unit (MRU), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur from February 2024 to February 2026. It included 60 diagnosed cases of ALD and 60 individuals without ALD. Serum iron indices (iron, ferritin, total iron binding capacity, transferrin saturation), CRP, LFT, KFT, PT-INR were assessed. Data were analysed using Student’s t test and Spearman’s correlation. Results: The mean age of the study participants was 51.3 years with 96.7% males. Serum iron, ferritin, transferrin saturation and CRP were significantly higher among the ALD patients, while TIBC was significantly lower in the cases compared to controls. Serum iron, transferrin saturation and ferritin demonstrated a very strong positive correlation with ALD severity (Child-Pugh score), whereas TIBC showed a negative correlation among the cases. CRP also exhibited a significant positive correlation with Child-Pugh scores. Conclusion: Coexisting iron overload and systemic inflammation, evidenced by elevated ferritin and CRP, synergistically accelerate hepatic fibrosis and cirrhosis. Combined assessment of iron indices and CRP provides a robust framework for improving diagnostic accuracy and risk stratification in ALD.

Keywords: Alcoholic liver disease, Iron indices, CRP, Child-Pugh score, Biomarkers