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Serum ferritin is a discriminant marker for both fibrosis and inflammation in histologically proven non-alcoholic fatty liver disease patients.
MedLine Citation:
PMID:  21457446     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Introduction: Differentiation between steatosis and non-alcoholic steatohepatitis (NASH) in non-alcoholic fatty liver disease (NAFLD) is important as NASH progress to cirrhosis. No specific laboratory/imaging technique exists either to diagnose NASH or to select patients for liver biopsy. Patients and methods: We evaluated serum ferritin and the features of metabolic syndrome with respect to histological inflammation and/or fibrosis in NAFLD patients. The Kleiner scoring system was used to classify NAFLD in consecutive liver biopsies. One hundred and eleven patients: median age 52.6, 64 males, obesity 62, diabetes mellitus (DM) 58, arterial hypertension 26 and hyperlipidaemia 40%. Results: Histologically, 40.7 had fatty liver, 30.6% had borderline NASH, 28.7% had NASH and 11% had cirrhosis. Multivariate regression showed that diabetes, serum ferritin concentrations, body mass index (BMI) and AST were independently associated with NASH: together, the areas under the receiver operating characteristic (AUROC) was 0.91 (95% confidence interval 0.86-0.96); fibrosis was associated with ferritin concentrations and BMI: AUROC 0.87, portal inflammation with ferritin and DM: AUROC 0.82, while lobular inflammation was associated with BMI, DM and ferritin: AUROC 0.85. Conclusion: Serum ferritin concentrations and BMI are strongly associated with fibrosis, portal and lobular inflammation in NAFLD patients. Both ferritin and BMI are potential discriminant markers to select patients for liver biopsy and are associated with inflammation and fibrosis.
Authors:
Pinelopi Manousou; George Kalambokis; Federica Grillo; Jennifer Watkins; Elias Xirouchakis; Maria Pleguezuelo; Gioacchino Leandro; Vasiliki Arvaniti; Giacomo Germani; David Patch; Vincenza Calvaruso; Dimitri P Mikhailidis; Amar P Dhillon; Andrew K Burroughs
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Publication Detail:
Type:  Journal Article     Date:  2011-03-06
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  31     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  730-9     Citation Subset:  IM    
Copyright Information:
© 2011 John Wiley & Sons A/S.
Affiliation:
The Royal Free Sheila Sherlock Liver Centre, Division of Surgery and Interventional Sciences, University College London, London, UK Department of Histopathology, Royal Free Hospital, London, UK Department of Clinical Biochemistry, Royal Free Hospital, London, UK.
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