ArticleFrontiers in medicine2026
Serum biomarker analysis may guide management of anemia in patients with chronic liver disease.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chronic liver disease (CLD) is a significant global health threat and has emerged as one of the leading causes of mortality worldwide. Anemia is a prevalent complication observed in patients with CLD, with 75% of these patients being susceptible to the condition. The utility of anemia-associated biomarkers for the diagnosis and management of this condition remains inadequately defined. In this study, we collected hematological data from patients with CLD and analyzed a panel of anemia-related biomarkers, aiming to investigate the correlations between these markers in patients with anemia secondary to chronic liver disease. Methods: The first cohort of 119 patients from the Department of Hepatology at Qilu Hospital of Shandong University was recruited for the study. Demographic data of the patients were included and ANOVA analysis based on anemia types was conducted. A subset of 64 patients with available serum samples for hepcidin measurement was included as a second cohort for downstream analysis. The model for end-stage liver disease (MELD), aspartate aminotransferase to platelet ratio index (APRI), and fibrosis-4 (FIB-4) scores were used to evaluate liver functions. The correlation of these markers was also calculated. SPSS software and R program were utilized to perform statistical analysis and plot graphs. Results: This study indicates that anemia in CLD is closely associated with disease severity and related complications. We found that in patients with macrocytic and normocytic anemia, the level of erythropoietin (EPO) was positively correlated with soluble transferrin receptor (STFR). While mean corpuscular volume (MCV) was positively correlated with MELD and APRI scores, total bilirubin (TBIL) was positively correlated with FIB-4 scores. WBC and ferritin were positively correlated. Additionally, various biomarkers were statistically significant across macrocytic, normocytic, and microcytic anemia groups, as well as different groups by the bilirubin level. Conclusion: Anemia in chronic liver disease should not be overlooked. This exploratory study suggests that anemia-related biomarkers may hold promise for evaluating liver function and could inform the management of anemia in these patients, though future validation in larger cohorts is necessary to confirm these preliminary findings and establish their clinical utility.
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