Study of serum ferritin levels in patients of non-alcoholic fatty liver disease with and without metabolic syndrome
DOI:
https://doi.org/10.18203/2320-6012.ijrms20261673Keywords:
NAFLD, Serum ferritin, Metabolic syndromeAbstract
Background: Non-alcoholic fatty liver disease (NAFLD), defined as excessive deposition of fat >5% of liver weight is considered as liver manifestation of systemic metabolic dysregulation. Abdominal imaging is not able to determine which individuals with NAFLD have associated liver-cell death and inflammation (i.e., NASH), and specific blood tests to diagnose NASH are not yet available. Serum ferritin is a protein, expressed in an acute phase, elevated in the case of liver necrosis, inflammation. Therefore, this study aims to analyze the correlations between serum ferritin levels and NAFLD in patients with and without metabolic syndrome to explore a new biological marker for diagnosis and treatment.
Methods: A prospective study was performed among 100 cases of metabolic syndrome and 100 controls without metabolic syndrome, from November 2022-August 2024. Patients fulfilling inclusion criteria underwent ultrasonography for diagnosis and grading of NAFLD and their serum ferritin, clinical and lipid profiles were assessed in both the groups with and without metabolic syndrome.
Results: Serum ferritin levels were higher in cases across NAFLD grades compared to controls, and a strong positive correlation was observed between serum ferritin levels and NAFLD severity.
Conclusions: Patients with NAFLD exhibited a strong positive relationship between serum ferritin levels and NAFLD severity, suggesting that elevated ferritin levels may be an important marker for NAFLD progression. The findings underscore the importance of monitoring metabolic parameters and serum ferritin in assessing severity of NAFLD and adds value to the available armamentarium to tackle the syndrome.
References
Mörwald K, Aigner E, Bergsten P, Brunner SM, Forslund A, Kullberg J, et al. Serum ferritin correlates with liver fat in male adolescents with obesity. Front Endocrinol. 2020;11:340.
Yan JX, Pan BJ, Zhao PP, Wang LT, Liu JF, Fu SB. Serum ferritin is correlated with non-alcoholic fatty liver disease in middle-aged and older patients with type 2 diabetes. Endocr Connect. 2021;10(12):1560-9.
Angulo P. Nonalcoholic fatty liver disease: N Engl J Med. 2002;346:1221-31.
Duseja A, Chawla Y. Nonalcoholic fatty liver disease in India: how much? How soon? Trop Gastroenterol. 2005;26:1-3.
Ratziu V, Charlotte F, Heurtier A, Gombert S, Giral P, Bruckert E, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology. 2005;128(7):1898-906.
Pavlides M, Birks J, Fryer E, Delaney D, Sarania N, Banerjee R, et al. Interobserver variability in histologic evaluation of liver fibrosis using categorical and quantitative scores. Am J Clin Pathol. 2017;147(4):364-9.
Bell H, Skinningsrud A, Raknerud N, Try K. Serum ferritin and transferrin saturation in patients with chronic alcoholic and non‐alcoholic liver diseases. J Intern Med. 1994;236(3):315-22.
Fassio E, Alvarez E, Dominguez N, Landeira G, Longo C. Natural history of nonalcoholic steatohepatitis: a longitudinal study of repeat liver biopsies. Hepatology. 2004;40:820-6.
Duseja A. Nonalcoholic fatty liver disease in India- a lot done, yet more required! Indian J Gastroenterol. 2010;29(6):217-25.
Manousou P, Kalambokis G, Grillo F, Watkins J, Xirouchakis E, Pleguezuelo M, et al. Serum ferritin is a discriminant marker for both fibrosis and inflammation in histologically proven non‐alcoholic fatty liver disease patients. Liver Int. 2011;31(5):730-9.
Yoneda M, Nozaki Y, Endo H, Mawatari H, Iida H, Fujita K, et al. Serum ferritin is a clinical biomarker in Japanese patients with nonalcoholic steatohepatitis (NASH) independent of HFE gene mutation. Digest Dis Sci. 2010;55(3):808-14.
Rosselli M, Lotersztajn S, Vizzutti F, Arena U, Pinzani M, Marra F. The metabolic syndrome and chronic liver disease. Curr Pharm Design. 2014;20:5010-24.
Valenti L, Dongiovanni P, Fargion S. Diagnostic and therapeutic implications of the association between ferritin level and severity of nonalcoholic fatty liver disease. World J Gastroenterol. 2012;18(29):3782-6.
Bellentani, S. The epidemiology of non-alcoholic fatty liver disease. Liver Int. 2017;37:81-4.
Wong VW, Chu WC, Wong GL, Chan RS, Chim AM, Ong A, et al. Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: a population study using proton-magnetic resonance spectroscopy and transient elastography. Gut. 2012;61(3):409-15.
Cho H, Lee YB, Ha Y, Chon YE, Kim MN, Lee JH, et al. Changes in liver stiffness values assessed using transient elastography in chronic hepatitis B patients treated with tenofovir disoproxil fumarate: a prospective observational study. BMC Gastroenterol. 2023;23(1):210.
Marchesini G, Brizi M, Morselli Labate AM, Bianchi G, Bugianesi G, McCullough AJ, et al. Association of non-alcoholic fatty liver disease to insulin resistance. Am J Med. 1999;107:450-5.
Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-57.
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of non-alcoholic fatty liver disease- meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84.
Grander C, Grabherr F, Moschen AR, Tilg H. Non-Alcoholic Fatty Liver Disease: Cause or Effect of Metabolic Syndrome. Visc Med. 2016 Oct;32(5):329-334.
Younossi ZM, Loomba R, Anstee QM, Rinella ME, Bugianesi E, Marchesini G, et al. Diagnostic modalities for nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and associated fibrosis. Hepatology. 2018;68(1):349-360.
Downloads
Published
How to Cite
Issue
Section
