Evaluating the association of serum ferritin and hepatic iron with disease severity in non‐alcoholic fatty liver disease

Liver International - Tập 39 Số 7 - Trang 1325-1334 - 2019
Elena Buzzetti1,2, Salvatore Petta3, Roberta Manuguerra4, Tu Vinh Luong4, Daniela Cabibi5, Elena Corradini1, Antonio Craxı̀3, Massimo Pinzani2, Emmanuel Tsochatzis2, Antonello Pietrangelo1
1Division of Internal Medicine 2 and Center for Hemochromatosis University of Modena and Reggio Emilia Modena Italy
2UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK
3Section of Gastroenterology and Hepatology, Di.Bi.M.I.S., University of Palermo, Palermo, Italy
4Department of Cellular Pathology, Royal Free Hospital, London, UK
5Department of Sciences for the Promotion of Health and Mother and Child Care, Anatomic Pathology, University of Palermo, Palermo, Italy

Tóm tắt

AbstractBackground & AimsHyperferritinemia, with or without increased hepatic iron, represents a common finding in non‐alcoholic fatty liver disease (NAFLD). However, it is unclear whether it reflects hepatic inflammation or true iron‐overload and, in case the latter is confirmed, whether this influences disease progression. We therefore explored the association between serum ferritin, degree and pattern of hepatic iron deposition and liver disease severity in patients with NAFLD.MethodsWe selected 468 patients with biopsy‐proven NAFLD from 2 European centres. Iron, hepatic and metabolic parameters were collected at the time of liver biopsy. Iron deposits in hepatocytes and reticuloendothelial cells were assessed and graded. Diagnosis of non‐alcoholic steatohepatitis (NASH) and fibrosis staging were performed.ResultsA total of 122 (26%) patients had hyperferritinemia, whereas stainable hepatic iron was found in 116 (25%) patients (38% predominantly in hepatocytes, 20% in reticuloendothelial cells and 42% in both). Subjects with stainable hepatic iron, particularly those with a mixed pattern, had higher serum ferritin and transaminases but only a mixed pattern of iron deposition was among the variables significantly associated with presence of NASH. Serum ferritin was not associated with presence of NASH, however it increased with worsening fibrosis stage (F3 compared to F0‐F1), and significantly decreased in stage F4.ConclusionsA mixed pattern of hepatic iron deposition is associated with the presence of steatohepatitis, while serum ferritin increases with worsening fibrosis up to pre‐cirrhotic stage. In individual NAFLD patients, serum ferritin could be evaluated as part of non‐invasive diagnostic panels but not on its own.

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Tài liệu tham khảo

10.1016/j.jhep.2010.04.008

10.1097/MD.0b013e3182779d49

10.1016/j.metabol.2015.12.012

10.1016/j.jhep.2007.01.004

10.1111/liv.13513

10.1111/j.1478-3231.2011.02488.x

10.1002/hep.24706

10.1016/j.cgh.2013.11.035

10.1155/2015/343828

10.1111/liv.13144

10.1111/liv.13020

10.3748/wjg.v18.i34.4651

10.1055/s-0031-1286057

10.1016/j.jhep.2015.11.004

10.1055/s-0032-1306423

10.1161/circ.106.25.3143

10.1016/j.cld.2009.07.008

10.1002/hep.24376

10.1002/hep.20701

10.1053/j.gastro.2015.04.043

10.1002/hep.27368

Turlin B, 1998, Evaluation and interpretation of iron in the liver, Semin Diagn Pathol, 15, 237

10.1053/j.gastro.2009.11.013

10.1002/hep.24038

10.1002/hep.26238

10.1002/hep.27662

10.1002/hep.28856

10.1111/j.1440-1746.2011.07014.x

CorradiniE BernardisI DongiovanniP et al.Rare ceruloplasmin variants are associated with hyperferritinemia and increased hepatic iron in NAFLD patients: results from a NGS study. The International Liver Congress ILC Paris 2018.

10.1371/journal.pone.0048804

10.1111/liv.13513

10.1111/hepr.12327

10.1053/j.gastro.2004.01.020

Avila F, 2015, Serum ferritin is associated with metabolic syndrome and red meat consumption, Oxid Med Cell Longev, 2015, 769739

10.1002/hep.25856

10.5604/16652681.1226818

10.1002/hep.22716

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Liver International

Tập 39 Số 7

1325-1334

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