Document Detail


Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease.
MedLine Citation:
PMID:  21953442     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Serum ferritin (SF) levels are commonly elevated in patients with nonalcoholic fatty liver disease (NAFLD) because of systemic inflammation, increased iron stores, or both. The aim of this study was to examine the relationship between elevated SF and NAFLD severity. Demographic, clinical, histologic, laboratory, and anthropometric data were analyzed in 628 adult patients with NAFLD (age, ≥ 18 years) with biopsy-proven NAFLD and an SF measurement within 6 months of their liver biopsy. A threshold SF >1.5 × upper limit of normal (ULN) (i.e., >300 ng/mL in women and >450 ng/mL in men) was significantly associated with male sex, elevated serum alanine aminotransferase, aspartate aminotransferase, iron, transferrin-iron saturation, iron stain grade, and decreased platelets (P < 0.01). Histologic features of NAFLD were more severe among patients with SF >1.5 × ULN, including steatosis, fibrosis, hepatocellular ballooning, and diagnosis of NASH (P < 0.026). On multiple regression analysis, SF >1.5 × ULN was independently associated with advanced hepatic fibrosis (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05-2.62; P = 0.028) and increased NAFLD Activity Score (NAS) (OR, 1.99; 95% CI, 1.06-3.75; P = 0.033). CONCLUSIONS: A SF >1.5 × ULN is associated with hepatic iron deposition, a diagnosis of NASH, and worsened histologic activity and is an independent predictor of advanced hepatic fibrosis among patients with NAFLD. Furthermore, elevated SF is independently associated with higher NAS, even among patients without hepatic iron deposition. We conclude that SF is useful to identify NAFLD patients at risk for NASH and advanced fibrosis.
Authors:
Kris V Kowdley; Patricia Belt; Laura A Wilson; Matthew M Yeh; Brent A Neuschwander-Tetri; Naga Chalasani; Arun J Sanyal; James E Nelson;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't     Date:  2011-12-06
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  55     ISSN:  1527-3350     ISO Abbreviation:  Hepatology     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-22     Completed Date:  2012-02-17     Revised Date:  2012-05-24    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  77-85     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Association for the Study of Liver Diseases.
Affiliation:
Center for Liver Disease, Digestive Disease Institute, Virginia Mason Medical Center, Seattle, WA 98101, USA. kkowdley@benaroyaresearch.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
Biopsy
Fatty Liver / blood*,  epidemiology,  pathology*
Female
Ferritins / blood*
Humans
Iron / metabolism
Liver / metabolism,  pathology
Liver Cirrhosis / blood*,  epidemiology,  pathology*
Logistic Models
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Risk Factors
Severity of Illness Index*
Grant Support
ID/Acronym/Agency:
K24 DK002957-09/DK/NIDDK NIH HHS; K24 DK002957-10/DK/NIDDK NIH HHS; K24DK002957/DK/NIDDK NIH HHS; M01RR000065/RR/NCRR NIH HHS; M01RR000750/RR/NCRR NIH HHS; M01RR000827/RR/NCRR NIH HHS; M01RR00188/RR/NCRR NIH HHS; M01RR020359/RR/NCRR NIH HHS; R01 DK087696-01A1/DK/NIDDK NIH HHS; R56 DK087696-01/DK/NIDDK NIH HHS; R56DK087696/DK/NIDDK NIH HHS; U01 DK061728-10/DK/NIDDK NIH HHS; U01DK061713/DK/NIDDK NIH HHS; U01DK061718/DK/NIDDK NIH HHS; U01DK061728/DK/NIDDK NIH HHS; U01DK061730/DK/NIDDK NIH HHS; U01DK061731/DK/NIDDK NIH HHS; U01DK061732/DK/NIDDK NIH HHS; U01DK061734/DK/NIDDK NIH HHS; U01DK061737/DK/NIDDK NIH HHS; U01DK061738/DK/NIDDK NIH HHS; UL1RR02413101/RR/NCRR NIH HHS; UL1RR024989/RR/NCRR NIH HHS; UL1RR02501401/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 7439-89-6/Iron; 9007-73-2/Ferritins
Comments/Corrections
Comment In:
Korean J Hepatol. 2012 Mar;18(1):105-7   [PMID:  22511912 ]

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