Abstract: Objective To analyze the incidence of iron deficiency anemia and its influence on clinical outcomes in patients with compensatory and decompensated liver cirrhosis. Methods We conducted a retrospective analysis of cirrhosis patients with hepatitis B who were admitted to our hospital from February 2010 to May 2022. The patients were divided into compensatory stage and decompensated stage according to Child-Pugh classification of liver function. Serum transferrin and hemoglobin levels of all patients were collected, and the incidence of iron deficiency anemia was analyzed in both groups. The Chi-square test was used to compare the incidence of iron deficiency anemia between patients in the compensatory stage and those in the decompensated stage. The adverse outcomes of both groups were followed up to analyze the influence of iron deficiency anemia on the clinical outcomes of the two groups. Results A total of 189 cirrhosis patients with hepatitis B were included, comprising of 109 males and 80 females, with an age range of 32-68 years. Among them, 86 cases in the compensatory period, while 103 cases in the decompensated period. There were 14 cases (16.3%) and 88 cases (85.4%) of ascites in compensatory and decompensated patients, respectively, and the difference was statistically significant (P<0.05). In the compensatory period, there were 62 cases (72.1%) with no anemia, 16 cases (18.6%) with iron deficiency anemia, and 8 cases (9.3%) with anemia resulting from other causes. In the decompensated period, there were 37 cases (35.9%) with no anemia, 42 cases (40.8%) with iron deficiency anemia, and 24 cases (23.3%) with anemia resulting from other causes. The difference was statistically significant (P<0.05). The hemoglobin concentration, ferritin concentration, transferrin concentration and transferrin saturation in compensatory patients were (14.±2.4) g/dL, (161.1±23.1) mcg/L, (248.3±69.1) mg/dL and (34.6 3.1) mg/dL, respectively, which were significantly higher than those in decompensated patients [(11.3±2.8) g/dL, (138.4±27.2) mcg/L, (213.2±53.4) mg/dL and (29.7±3.7) mg/dL, P<0.05]. The difference in the incidence of anemia between decompensated and compensated patients with hepatitis B cirrhosis was statistically significant (P<0.05). Furthermore, the incidence of iron deficiency anemia in the decompensated period was significantly higher than that in compensated patients with hepatitis B cirrhosis (P<0.05). The hemoglobin concentration, ferritin concentration, transferrin concentration and transferrin saturation in patients without anemia were (13.7±2.8) g/dL, (165.1±27.1) mcg/L, (251.1±71.2) mg/dL and (36.8±4.2) mg/dL, respectively, which were significantly higher than those in patients with decompensation[(10.4±2.3) g/dL, (135.2±26.5) mcg/L, (221.2±57.8) mg/dL and (29.7±3.1) mg/dL, P<0.05]. During the follow-up, 44 patients in the compensatory period progressed to decompensated period, among which 16 patients developed iron deficiency anemia. There were 56 cases with adverse outcomes in the decompensation period, including 21 cases with massive ascites, 10 cases with hepatorenal syndrome, 5 cases with severe hepatic encephalopathy, 13 cases with varicose veins bleeding and 7 cases with liver failure. Among the patients with adverse outcome in the decompensation period, 45 cases had iron deficiency anemia. In the compensatory and decompensated patients, patients with iron deficiency anemia were more likely to have adverse clinical outcomes (P<0.05). Conclusion The incidence of iron deficiency anemia is higher in patients with hepatitis B decompensated cirrhosis. When iron deficiency anemia is present, patients with compensatory and decompensated hepatitis B cirrhosis are prone to adverse clinical outcomes.

Key words: Hepatitis B, Cirrhosis of the liver, Iron deficiency anemia, Prognosis