Serum ferritin as a biomarker for NAFLD: ready for prime time?

Shah, Raj; Kowdley, Kris V.

doi:10.1007/s12072-019-09934-7

Cited by 16 publications

(16 citation statements)

References 24 publications

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“…Our results corroborate that meat consumption, specifically red meat, was associated with ferritin concentration which could be influencing the development of NAFLD. Other research studies observed a relationship between ferritin and elevated ALT, a surrogate of liver damage [30,32,33]. In this context, we observed that participants above the median of red meat consumption presented higher ferritin and ALT concentrations than those with lower red meat consumption.…”

Section: Discussionsupporting

confidence: 66%

“…However, in inflammatory conditions ferritin concentrations are increased and it is synthesized as an acute phase protein, acting as a pro-inflammatory molecule capable of inducing liver damage. [33,35,36,37]. The potential anti-inflammatory effect and antioxidant capacity of omega-3 PUFAs [38], might ameliorate ferritin pro-oxidant and pro-inflammatory activity, although the exact molecular pathways are yet to be elucidated.…”

Section: Discussionmentioning

confidence: 99%

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Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study

Recaredo

Cantero

et al. 2019

Nutrients

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Non-alcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. Obesity and unhealthy dietary habits are described as risk factors for NAFLD. The aim of this study was to investigate the association between the consumption of different animal protein sources and hepatic status in NAFLD adults. A total of 112 overweight/obese participants with NAFLD from Fatty Liver in Obesity (FLiO) study were evaluated at baseline. Diet, body composition, and biochemical variables were evaluated. Hepatic status was also assessed by Magnetic Resonance Imaging, ultrasonography, and elastography. Red meat consumption showed a positive relationship with liver iron content (r = 0.224; p = 0.021) and ferritin concentration (r = 0.196; p = 0.037). Processed meat consumption exhibited a positive association with liver iron content (r = 0.308; p = 0.001), which was also found in the quantile regression (β = 0.079; p = 0.028). Fish consumption was related with lower concentration of ferritin (r = −0.200; p = 0.034). This association was further evidenced in the regression model (β = −0.720; p = 0.033). These findings suggest that the consumption of different animal protein sources differentially impact on liver status in obese subjects with NAFLD, showing fish consumption as a healthier alternative for towards NAFLD features.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study

Recaredo

Cantero

et al. 2019

Nutrients

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“…In this context, it remains unclear if serum ferritin reflects liver damage and accompanying inflammation features, increased body iron stores, or a combination of these factors [17]. Mild-to-moderate serum ferritin levels have been related to higher risk of NAFLD [18,19], and increased ferritin levels have been associated to more advanced NAFLD and higher mortality risk [20].…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study

et al. 2020

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The identification of affordable noninvasive biomarkers for the diagnosis and characterization of nonalcoholic fatty liver disease (NAFLD) is a major challenge for the research community. This study aimed to explore the usefulness of ferritin as a proxy biomarker of NAFLD condition, alone or in combination with other routine biochemical parameters. Subjects with overweight/obesity and ultrasound-confirmed liver steatosis (n = 112) from the Fatty Liver in Obesity (FLiO) study were assessed. The hepatic evaluation considered magnetic resonance imaging, ultrasonography, and credited routine blood liver biomarkers. Anthropometry and body composition, dietary intake (by means of a validated 137-item food frequency questionnaire), and specific biochemical markers were also determined. Serum ferritin levels were analyzed using a chemiluminescent microparticle immunoassay kit. Lower serum ferritin concentrations were associated with general better liver health and nutritional status. The evaluation of ferritin as a surrogate of liver damage by means of quantile regression analyses showed a positive association with alanine aminotransferase (ALT) (β = 19.21; p ≤ 0.001), liver fat content (β = 8.70; p = 0.008), and hepatic iron (β = 3.76; p ≤ 0.001), after adjusting for potential confounders. In receiver operating characteristic (ROC) analyses, the panel combination of blood ferritin, glucose, and ALT showed the best prediction for liver fat mass (area under the curve (AUC) 0.82). A combination of ferritin and ALT showed the higher predictive ability for estimating liver iron content (AUC 0.73). This investigation demonstrated the association of serum ferritin with liver health as well as with glucose and lipid metabolism markers in subjects with NAFLD. Current findings led to the identification of ferritin as a potential noninvasive predictive biomarker of NAFLD, whose surrogate value increased when combined with other routine biochemical measurements (glucose/ALT).

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“…For these reasons, SF is widely used as a surrogate marker of iron stores. In addition to this, SF has been found to be elevated in patient with inflammation, liver disease, and malignancy . Moreover, previous studies have suggested that high SF is associated with poor prognosis in pancreatic cancer, colorectal cancer, lung cancer, peripheral T‐cell lymphoma, and hepatocellular carcinoma .…”

Section: Introductionmentioning

confidence: 92%

“…In addition to this, SF has been found to be elevated in patient with inflammation, liver disease, and malignancy. [8][9][10][11] Moreover, previous studies have suggested that high SF is associated with poor prognosis in pancreatic cancer, colorectal cancer, lung cancer, peripheral T-cell lymphoma, and hepatocellular carcinoma. [12][13][14][15][16] Therefore, ferritin may not only function as a marker of iron stores, but may also aid in clinical decision-making, including diagnosis, prognosis, treatment, and/or patient management.…”

Section: Introductionmentioning

confidence: 99%

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000_SR analyzer in Chinese adults

Wang

Guo²,

et al. 2019

Clinical Laboratory Analysis

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Background Serum ferritin (SF) test has been widely used in clinical practice. However, its reference intervals (RIs) vary depending on the analytical method and ethnic origin. This study was to establish the RIs using indirect method for SF in Chinese adults. Methods SF was assayed on Abbott i2000SR analyzer. The SF test results of all health examinees (8913 males aged 18‐93 years and 5397 females aged 18‐90 years) between December 2010 and April 2019 were obtained from our laboratory information system. After Box‐Cox transformation of raw data and exclusion of outliers, parametric and non‐parametric approaches were used to calculate 95% RIs. The correlation between SF levels and ages, and the differences in SF levels between subgroups were also analyzed. Results SF levels in females were significantly different from those in males (Z = 88.96, Z* = 23.17; Z > Z*) and showed a weak positive correlation with age (r = .466, P < .0001). The RIs based on parametric approach in males were 66.12‐561.58 µg/L, whereas in all females were 3.59‐269.59 µg/L, females aged <50 years 3.26‐148.02 µg/L and those aged ≥50 years 17.28‐303.27 µg/L. The RIs based on non‐parametric approach in males were 65.00‐571.37 µg/L whereas in all females were 4.00‐254.00 µg/L, females aged <50 years 4.00‐152.00 µg/L and those aged ≥50 years 16.00‐304.05 µg/L. Conclusions Our indirect RIs for SF were markedly different from the manufacturer's recommended RIs and might be more suitable for Chinese adults, which would be helpful in interpreting laboratory data and clinical decision‐making.

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Serum ferritin as a biomarker for NAFLD: ready for prime time?

Cited by 16 publications

References 24 publications

Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study

Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study

Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000_SR analyzer in Chinese adults

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Serum ferritin as a biomarker for NAFLD: ready for prime time?

Cited by 16 publications

References 24 publications

Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study

Association between Different Animal Protein Sources and Liver Status in Obese Subjects with Non-Alcoholic Fatty Liver Disease: Fatty Liver in Obesity (FLiO) Study

Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study

Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000SR analyzer in Chinese adults

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Reference intervals established using indirect method for serum ferritin assayed on Abbott Architect i2000_SR analyzer in Chinese adults