P104 Predictive factors for hepatic fibrosis in genetic haemochromatosis: a retrospective analysis

<h3>Introduction</h3> Genetic haemochromatosis is an important cause of hepatic fibrosis. Identifying early markers and risk factors associated with hepatic fibrosis in haemochromatosis cohort is crucial for preventing the progression to severe liver outcomes. Our study aims to determine the predictive correlation of the ferritin and transferrin saturation values at diagnosis with the degree of hepatic fibrosis. <h3>Methods</h3> We conducted retrospective analysis of HFE-related haemochromatosis patients, who underwent assessment for liver fibrosis with elastography. We compared the demographics, genotypes, initial ferritin, transferrin saturation, elastography, body mass index (BMI), alcohol intake and the incidence of type 2 diabetes mellitus in fibrosis and non-fibrosis group. <h3>Results</h3> A total 95 patients with haemochromatosis were studied. Median age was 55(95% CI: 52.8, 58.6), 70.5% were men. Of these, 27 had fibrosis with the median stiffness of 17 kPa (95% CI: 17, 31), while 68 did not (median stiffness 5.2 kPa, 95% CI: 4.9, 5.9). For genotypes, 55.8% and 8.4% were p.Cys282Tyr homozygotes and heterozygotes respectively, whereas 22.1% and 13.7% were compound p.Cys282Tyr/p.His63Asp and heterozygotes p.His63Asp respectively. There was no statistically significant difference between genotypes in fibrosis and non-fibrosis groups. We noted statistically significant association between higher initial ferritin level and hepatic fibrosis group compared to those without fibrosis (p=0.0034, 95% CI -0.4357, -0.08903, median ferritin level 948 (95% CI 646, 2550) in fibrosis group, 783 (95% CI 593, 948) in non-fibrosis group). The difference in transferrin saturation was not statistically significant (p=0.7178, 95% CI -0.09937, 0.06873). Comparison of the BMI between fibrosis and non-fibrosis groups revealed a significant difference (p=0.0003, 95% CI -6.633 to -2.063) with median BMI of 31 (95% CI: 30, 34) among fibrosis patients, and 27 (95% CI: 26, 29) for non-fibrosis patients. The proportion of patients consuming alcohol above the safe limit was 10.52% in the fibrosis group and 20% in the non-fibrosis group, with no statistical significance (p=0.3852). The prevalence of T2DM was 8.60% in both groups. <h3>Conclusion</h3> We conclude that higher initial ferritin levels have potential predictive value for advanced hepatic fibrosis in patients with HFE-related haemochromatosis. Higher BMI has significantly correlated with fibrosis, underscoring the importance of weight management in patients with haemochromatosis. Considering the proportions of high BMI (88.9%) and significant alcohol consumption (10.52%) in fibrosis group of haemochromatosis patients, we conclude that the progression of liver disease is influenced by multiple risk factors and necessitates a multidisciplinary management.