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Histologic Features of the Liver in Insulin Resistance–Associated Iron Overload
A Study of 139 Patients

Bruno Turlin MD, Michel H. Mendler MD, Romain Moirand MD, PhD, Dominique Guyader MD, PhD, Anne Guillygomarc’h MD, Yves Deugnier MD
DOI: http://dx.doi.org/10.1309/WWNE-KW2C-4KTW-PTJ5 263-270 First published online: 1 August 2001


The aim of the present study was to describe histologic features of the liver in insulin resistance–associated hepatic iron overload (IR-HIO), defined as the association of metabolic disorders and hepatic iron overload. We included 139 patients in the study on the basis of one or more metabolic disorders and liver iron overload unrelated to usual causes. Liver biopsy specimens were reviewed, and histologic data were compared with those of a previously published, well-defined population with genetic hemochromatosis.

Iron overload was characterized by a mixed pattern with iron deposits in hepatocytes and sinusoidal cells. Steatosis was present in 59.7% of patients with inflammation in 32.4% of cases. Periportal fibrosis was found in 67.4% of patients. These patients were older, had higher sinusoidal iron scores, and had a higher prevalence of steatosis and inflammation than patients without fibrosis. Iron overload in IR-HIO was histologically different from that in genetic hemochromatosis.

Key Words:
  • Iron overload
  • Liver
  • Steatosis
  • Fibrosis
  • Genetic hemochromatosis