Albuminuria Is Associated with Hepatic Iron Load in Patients with Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome

Abstract

Background: Increased albuminuria is associated with increased serum ferritin, insulin resistance, and non-alcoholic fatty liver disease (NAFLD). Liver iron accumulation is also related to hyperferritinemia, insulin resistance, and NAFLD; however, there is no evidence on its relationship with albuminuria. Aims: To assess the relationship between hepatic iron load and urine albumin-to-creatinine ratio (UACR) in patients with metabolic syndrome (MetS) and NAFLD. Methods: In total, 75 MetS and NAFLD patients (aged 40–60 years, BMI 27–40 kg/m2) were selected from a cohort according to available data on hepatic iron load (HepFe) by magnetic resonance imaging (MRI). Subjects underwent anthropometric measurements, biochemistry testing, and liver MRI. Increased albuminuria was defined by UACR. Results: UACR correlated with NAFLD, HepFe, triglycerides, serum ferritin, fasting insulin, insulin resistance (calculated using the homeostatic model assessment for insulin resistance—HOMA-IR- formula), and platelets (p < 0.05). Multiple regression analysis adjusted for gender, age, eGFR, HbA1c, T2DM, and stages of NAFLD, found that HepFe (p = 0.02), serum ferritin (p = 0.04), fasting insulin (p = 0.049), and platelets (p = 0.009) were associated with UACR (R2 = 0.370; p = 0.007). UACR, liver fat accumulation, serum ferritin, and HOMA-IR increased across stages of HepFe (p < 0.05). Patients with severe NAFLD presented higher HepFe, fasting insulin, HOMA-IR, and systolic blood pressure as compared to patients in NAFLD stage 1 (p < 0.05). Conclusion: Hepatic iron load, serum ferritin, fasting insulin, and platelets were independently associated with albuminuria. In the context of MetS, increased stages of NAFLD presented higher levels of HepFe. Higher levels of HepFe were accompanied by increased serum ferritin, insulin resistance, and UACR. The association between iron accumulation, MetS, and NAFLD may represent a risk factor for the development of increased albuminuria.

Association between Physical Activity and Non-Alcoholic Fatty Liver Disease in Adults with Metabolic Syndrome: The FLIPAN Study

“…Anthropometric measurements were taken (weight, height, BMI, waist, hip, and neck circumferences) as described elsewhere [ 14 ]. Dietary intake was measured by means of a validated food frequency questionnaire (FFQ) [ 15 ].…”

“…Biochemical analysis included fasting plasma glucose, liver transferases (alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT)), triglycerides, and high-density lipoprotein (HDL) cholesterol. They were quantified by standard enzymatic methods, as previously described [ 14 ].…”

“…Alcohol consumption was classified as 0 alcoholic drinks, <7 drinks/week and ≥7 drinks/week without becoming alcoholic [ 20 ]. Blood pressure was measured in triplicate using a validated semi-automatic oscillometer (Omron HEM-705CP, Omron Healthcare Inc., Lake Forest, IL, USA) as previously described [ 14 ].…”

Impact of Physical Activity Differences Due to COVID-19 Pandemic Lockdown on Non-Alcoholic Fatty Liver Parameters in Adults with Metabolic Syndrome

“…Biochemical analysis was performed on participants' blood samples, which were collected from an antecubital vein after twelve hours overnight fast. All studied parameters were quantified by standard enzymatic methods [20]. These collections assessed aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), triglycerides, glucose and HDL-cholesterol.…”

“…Blood pressure was measured using a validated semi-automatic oscillometer (Omron HEM-705CP, Omron Healthcare Inc., Lake Forest, IL, USA) [20] and waist circumference was taken [20]. During lockdown, study personnel had telephonic contact with patients to help and motivate them to follow the diet and perform PA.…”