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HomeMedicineInternal MedicineIs Serum Ferritin a Marker for Non-alcoholic Fatty Liver Disease?

Is Serum Ferritin a Marker for Non-alcoholic Fatty Liver Disease?

A new study investigates whether serum ferritin levels can act as a new, non-invasive diagnostic biomarker for non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD), w characterized by the buildup of excessive fat in liver cells, affects roughly 25% of the population. Its causes are not entirely clear, but it appears to be associated with insulin resistance, with those who are overweight and lead sedentary lifestyles being at high risk for developing insulin resistance. Diabetes, high cholesterol and triglyceride levels, and corticosteroid use constitute other risk factors for developing non-alcoholic fatty liver disease. A more serious form of the disease is non-alcoholic steatohepatitis, which is marked by liver inflammation that may progress to scarring (cirrhosis) and irreversible damage to the liver.

Current Standard for Diagnosis is Invasive

Liver biopsies are the standard method for the diagnosis of non-alcoholic fatty liver disease, but these are invasive. And while magnetic resonance imaging constitutes another option, it is expensive and its use is not widespread. The levels of serum ferritin, an iron storage protein, are elevated during injury and chronic inflammation, and some studies indicate that its levels can be used to assess the progress of non-alcoholic fatty liver disease to tissue scarring (fibrosis). However, the relationship between higher serum ferritin levels and non-alcoholic fatty liver disease is not entirely clear.

What is the Relationship between Serum Ferritin and NAFLD?

A recent study attempted to define this relationship by collectively analyzing previously published data. The results of this analysis were published recently in Lipids in Health and Disease.1 The study analyzed data from 14 previously published studies wherein serum ferritin levels were examined in patients with non-alcoholic fatty liver disease.  The researchers compared ferritin levels with biomarkers of non-alcoholic fatty liver disease such as non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH).

Data analysis revealed higher serum ferritin levels in the non-alcoholic fatty liver disease group compared to controls. Higher serum ferritin levels were also observed in patients with non-alcoholic fatty liver (NAFL) compared to controls and in the non-alcoholic steatohepatitis group (NASH) compared to the control group. Notably, higher serum ferritin levels were also observed in the non-alcoholic steatohepatitis group compared to the non-alcoholic fatty liver group.

Serum Ferritin: An Effective and Noninvasive Biomarker

These results indicate that serum ferritin levels can serve as an effective and noninvasive biomarker for the diagnosis of non-alcoholic fatty liver disease, and even discriminate between the benign and more serious forms of the disease. The authors conclude by underlining the need for further studies to understand the role of ferritin in the progression of non-alcoholic fatty liver disease.

Written by Usha B. Nair, Ph.D.

Reference: Du SX, Lu LL, Geng N, Victor DW, Chen LZ, Wang C, Yue HY, Xin YN, Xuan SY, Jin WW. Association of serum ferritin with non-alcoholic fatty liver disease: a meta-analysis. Lipids Health Dis. 2017 Dec 2;16(1):228. doi:10.1186/s12944-017-0613-4. PubMed PMID: 29197393; PubMed Central PMCID: PMC5712169.



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