Department of Infectious Diseases, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China.
NAFLD Research Center, Department of Hepatology, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, China.
J Clin Lab Anal. 2022 Feb;36(2):e24225. doi: 10.1002/jcla.24225. Epub 2022 Jan 7.
Elevated serum ferritin levels (SFLs) was previously reported to be related with hepatic histologic severity and advanced liver fibrosis among non-alcoholic fatty liver disease (NAFLD) patients. However, whether NAFLD influences SFLs remains uncertain and needs more clinical evidences. This study explored the differences of SFLs in US adults with or without NAFLD.
We conducted a cross-sectional study of 3689 participants aged 18-80 years using the National Health and Nutrition Examination Survey (NHANES) 2017-2018 cycle. NAFLD status was confirmed based on controlled attenuation parameter (CAP) values ≥274 dB/m through vibration controlled and transient elastography (VCTE). We performed weighted multivariable logistic regression models to evaluate the associations between NAFLD and SFLs in different age and gender.
There was a positive association between NAFLD and SFLs in all three models (model 1:β = 23.07, 95% CI: 10.32, 35.81; model 2:β = 23.68, 95% CI: 10.86, 36.50; model 3:β = 13.86, 95% CI: 0.29, 27.43). After adjusting for the covariates, this positive association persisted in females (β = 16.22, 95% CI: 2.81, 29.62). Further, relationships between NAFLD and SFLs were significantly different in various age groups. In the subgroup stratified by gender, their associations further differed. In males, the positive association was more prominent in 50-64 age group (β = 70.89, 95% CI: 25.14, 116.64). In females, this positive association was more prominent in 18-34 age group (β = 20.72, 95% CI: 7.45, 33.99). However, no correlations between severe steatosis, significant fibrosis, advanced fibrosis, cirrhosis, and SFLs in adults with NAFLD were found.
This study indicated that US adults suffered with NAFLD had significantly higher SFLs compared with their counterparts in non-NAFLD group. Moreover, the associations between NAFLD and SFLs further differed by age and gender.
先前有研究报道，血清铁蛋白水平（SFL）升高与非酒精性脂肪性肝病（NAFLD）患者的肝组织学严重程度和晚期纤维化有关。然而，NAFLD 是否影响 SFL 尚不确定，需要更多的临床证据。本研究旨在探讨美国成年人中是否存在 NAFLD 与 SFL 之间的差异。
我们使用 2017-2018 年全国健康与营养调查（NHANES）的数据进行了一项横断面研究，共纳入了 3689 名年龄在 18-80 岁的参与者。NAFLD 状态通过受控衰减参数（CAP）值≥274dB/m 确认，该值通过振动控制和瞬态弹性成像（VCTE）获得。我们使用加权多变量逻辑回归模型评估了不同年龄和性别组中 NAFLD 与 SFL 之间的关联。
在所有三个模型中，NAFLD 与 SFL 之间均呈正相关（模型 1：β=23.07，95%置信区间：10.32，35.81；模型 2：β=23.68，95%置信区间：10.86，36.50；模型 3：β=13.86，95%置信区间：0.29，27.43）。在校正了混杂因素后，这种正相关关系在女性中仍然存在（β=16.22，95%置信区间：2.81，29.62）。此外，NAFLD 与 SFL 之间的关系在不同年龄组中存在显著差异。在按性别分层的亚组中，其关联进一步不同。在男性中，50-64 岁年龄组的正相关更为显著（β=70.89，95%置信区间：25.14，116.64）。在女性中，18-34 岁年龄组的正相关更为显著（β=20.72，95%置信区间：7.45，33.99）。然而，在患有 NAFLD 的成年人中，并未发现严重脂肪变性、显著纤维化、晚期纤维化、肝硬化与 SFL 之间存在相关性。
本研究表明，与非 NAFLD 组相比，患有 NAFLD 的美国成年人的 SFL 明显更高。此外，NAFLD 与 SFL 之间的关联进一步因年龄和性别而异。
