Elevated Levels of Serum Ferritin May be Related to Non-Alcoholic Steatohepatitis

Abstract

Non-alcoholic steatohepatitis can progress to cirrhosis and hepatocellular carcinoma. Our aim is to evaluate serum ferritin and iron levels in patients with non-alcoholic steatohepatitis (NASH). 53 patients with NASH (36 males and 17 females) were selected from the Specialized Medical Hospital, Mansoura, Egypt. This is in addition to 50 apparently healthy subjects (30 males and 20 females) of age and sex matched as a control group. We detected serum ferritin, iron, immune-reactive insulin (IRI) and the calculated homeostasis model for assessment of insulin resistance (HOMA-IR), in addition to markers of oxidative stress (MDA and thiol) and tumor necrosis factor alpha (TNF-α).Patients with NASH have higher levels of ferritin, iron, IRI, HOMA-IR, MDA, TNF-α (p= 0.001) and thiol (p= 0.01) than control subjects. Serum ferritin has a significant positive correlation with body mass index, ALT, AST, fasting plasma glucose (FPG), total cholesterol, triglyceride, IRI, MDA, in NASH patients. However, after adjustment for age, sex, BMI and HOMA-IR in cases of NASH, ferritin still has a significant positive correlation with ALT, FPG, total cholesterol, MDA (p=0.001) and thiol (p=0.003). Serum iron has no significant correlation with grade of NASH or fibrosis. Serum ferritin level is higher in patients with NASH more than control subjects. Moreover it has a significant positive correlation with oxidative stress even after adjustment for age, sex, BMI and HOMA-IR.