Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, 430071, China.
Curr Med Sci. 2024 Jun;44(3):494-502. doi: 10.1007/s11596-024-2868-0. Epub 2024 May 15.
Ferritin, initially acting as an iron-storage protein, was found to be associated with metabolic diseases. Our study was designed to investigate the association between serum ferritin and metabolic-associated fatty liver disease (MAFLD) using data from the National Health and Nutrition Examination Survey (NHANES) of the United State of America.
A cross-sectional study was conducted, enrolling a total of 2145 participants from the NHANES in the 2017-2018 cycles. Hepatic steatosis and liver fibrosis were assessed by ultrasound images and several non-invasive indexes. Multiple regression analysis was conducted to determine the associations between serum ferritin concentration and MAFLD and liver fibrosis.
The analysis revealed that participants with higher serum ferritin levels (Q3 and Q4 groups) had a higher prevalence of MAFLD than those with the lowest serum ferritin levels [Q3 vs. Q1: OR=2.17 (1.33, 3.53), P<0.05 in fatty liver index (FLI); Q4 vs. Q1: OR=3.13 (1.91, 5.13), P<0.05 in FLI]. Additionally, participants with the highest serum ferritin levels (Q4 group) displayed a higher prevalence of liver fibrosis [Q4 vs. Q1: OR=2.59 (1.19, 5.62), P<0.05 in liver stiffness measurement; OR=5.06 (1.12, 22.94), P<0.05 in fibrosis-4 index], with significantly increased risk observed in participants with concomitant diabetes [OR=7.45 (1.55, 35.72), P=0.012].
Our study revealed that elevated serum ferritin levels are associated with a higher prevalence of MAFLD and advanced liver fibrosis in patients. Elevated serum ferritin levels combined with diabetes are important risk factors for liver fibrosis.
铁蛋白最初作为一种铁储存蛋白，现已被发现与代谢性疾病相关。本研究旨在通过美国国家健康和营养调查（NHANES）的数据，探讨血清铁蛋白与代谢相关脂肪性肝病（MAFLD）之间的关系。
本研究采用横断面研究，纳入了 2017-2018 年 NHANES 中总共 2145 名参与者。通过超声图像和几种非侵入性指标评估肝脂肪变性和肝纤维化。采用多元回归分析确定血清铁蛋白浓度与 MAFLD 和肝纤维化之间的关系。
分析结果显示，血清铁蛋白水平较高（Q3 和 Q4 组）的参与者 MAFLD 的患病率高于血清铁蛋白水平最低的参与者[Q3 与 Q1 相比：OR=2.17（1.33，3.53），在脂肪性肝病指数（FLI）中 P<0.05；Q4 与 Q1 相比：OR=3.13（1.91，5.13），在 FLI 中 P<0.05]。此外，血清铁蛋白水平最高的参与者（Q4 组）肝纤维化的患病率更高[Q4 与 Q1 相比：OR=2.59（1.19，5.62），在肝硬度测量中 P<0.05；OR=5.06（1.12，22.94），在纤维化-4 指数中 P<0.05]，且在同时患有糖尿病的参与者中观察到明显的风险增加[OR=7.45（1.55，35.72），P=0.012]。
本研究表明，血清铁蛋白水平升高与 MAFLD 患病率升高和患者肝纤维化进展相关。血清铁蛋白水平升高合并糖尿病是肝纤维化的重要危险因素。
