Hyperferritinemia Correlates to Metabolic Dysregulation and Steatosis in Chinese Biopsy-Proven Nonalcoholic Fatty Liver Disease Patients

Abstract

Qingling Wang,1,2,* Mingyu Zhu,2,* Hu Li,3 Peizhan Chen,4 Mingjie Wang,2 Leilei Gu,2 Xinxin Zhang,5 Li Chen2 1The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People’s Republic of China; 2Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 3Department of Infectious Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China; 4Central Laboratory, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 5Department of Infectious Disease, Research Laboratory of Clinical Virology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Li Chen, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, People’s Republic of China, Email [email protected]: Elevated serum ferritin (SF), also defined as hyperferritinemia, is commonly seen in patients with nonalcoholic fatty liver disease (NAFLD). However, the clinical significance of SF in NAFLD remains controversial. The aim of this study was to characterize the NAFLD patients with elevated SF and to explore the association of hyperferritinemia with the severity of NAFLD proved by liver biopsy in the Chinese population.Patients and Methods: A total of 136 NAFLD patients proved by liver biopsy were enrolled. The demographic, anthropometric, clinical historic, laboratory, and histological characteristics were compared between elevated and normal SF groups. The independent factors for elevated SF were determined using multivariate logistic regression analysis.Results: The median age and body mass index were 41.00 (33.00– 57.75) years and 28.28 (26.28– 31.34) kg/m2, respectively. Hyperferritinemia was detected in 57 (41.9%) patients. Patients in the elevated SF group presented with more severe lipo- and glucometabolic disorder, and higher aminotransferases compared to those in the normal SF group (p < 0.05). In terms of histopathology, elevated SF was associated with worse steatosis and a higher proportion of positive iron staining (p < 0.05). Multivariate logistic regression analysis identified homeostasis model assessment of insulin resistance (OR: 1.170, 95% CI: 1.036– 1.322, p = 0.012), alanine aminotransferase (OR: 1.012, 95% CI: 1.005– 1.019, p < 0.001), and positive Perl’s staining (OR: 4.880, 95% CI: 2.072– 11.494, p < 0.001) as independent risk factors of hyperferritinemia.Conclusion: NAFLD patients with hyperferritinemia were characterized as more severe metabolic dysfunction and liver injury. More attention should be paid to the metabolism state of NAFLD patients with elevated SF. Hyperferritinemia was correlated to hepatic steatosis in Chinese NAFLD patients.Keywords: nonalcoholic fatty liver disease, hyperferritinemia, histopathology, metabolic dysregulation, steatosis

Keywords

• nonalcoholic fatty liver disease
• hyperferritinemia
• histopathology
• metabolic dysregulation
• steatosis;