Licata Anna, Nebbia Maria Elena, Cabibbo Giuseppe, Iacono Giovanna Lo, Barbaria Francesco, Brucato Virna, Alessi Nicola, Porrovecchio Salvatore, Di Marco Vito, Craxì Antonio, Cammà Calogero
Gastroenterology and Hepatology Unit, Department of Internal Medicine, University of Palermo, 90127 Palermo, Italy.
World J Gastroenterol. 2009 May 7;15(17):2132-8. doi: 10.3748/wjg.15.2132.
To investigate the relationship between ferritin and steatosis in patients with chronically abnormal liver function tests (LFTs) and high ferritin level.
One hundred and twenty-four consecutive patients with hyperferritinemia (male > 300 ng/mL, female > 200 ng/mL) were evaluated; clinical, biochemical and serological data, iron status parameters, HFE gene mutations and homeostasis model assessment score were obtained. Steatosis was graded by ultrasound as absent or present. Histology was available in 53 patients only.
Mean level of ferritin was 881 +/- 77 ng/mL in men and 549 +/- 82 ng/mL in women. The diagnosis was chronic hepatitis C in 53 (42.7%), non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in 57 (45.9%), and cryptogenic liver damage in 14 (11.3%). None was diagnosed as hereditary hemochromatosis (HH). Hepatic siderosis on liver biopsy was present in 17 of 54 (32%) patients; grade 1 in eight and grade 2 in nine. Overall, 92 patients (74.2%) had steatosis. By logistic regression, ferritin and gamma-glutamyltransferase were independent predictors of steatosis. Ferritin levels were significantly related to low platelet count, steatosis and hepatitis C virus infection.
In a non-obese cohort of non-alcoholic patients with chronically abnormal LFTs without HH, high serum ferritin level is a risk factor for steatosis.
研究肝功能长期异常且铁蛋白水平升高的患者中铁蛋白与脂肪变性之间的关系。
对124例连续的高铁蛋白血症患者（男性>300 ng/mL，女性>200 ng/mL）进行评估；获取临床、生化和血清学数据、铁状态参数、HFE基因突变及稳态模型评估得分。通过超声对脂肪变性进行分级，分为无或有。仅53例患者有组织学检查结果。
男性铁蛋白平均水平为881±77 ng/mL，女性为549±82 ng/mL。诊断为慢性丙型肝炎的有53例（42.7%），非酒精性脂肪性肝病/非酒精性脂肪性肝炎的有57例（45.9%），原因不明的肝损伤有14例（11.3%）。无患者被诊断为遗传性血色素沉着症（HH）。54例患者中有17例（32%）肝活检显示肝铁沉积；8例为1级，9例为2级。总体而言，92例患者（74.2%）有脂肪变性。通过逻辑回归分析，铁蛋白和γ-谷氨酰转移酶是脂肪变性的独立预测因素。铁蛋白水平与低血小板计数、脂肪变性及丙型肝炎病毒感染显著相关。
在一组无HH的非肥胖非酒精性慢性肝功能异常患者中，高血清铁蛋白水平是脂肪变性的一个危险因素。
