Serum Ferritin Correlates With Liver Fat in Male Adolescents With Obesity

Abstract

Non-alcoholic fatty liver disease (NAFLD) contributes essentially to the burden of obesity and can start in childhood. NAFLD can progress to cirrhosis and hepatocellular carcinoma. The early phase of NAFLD is crucial because during this time the disease is fully reversible. Pediatric NAFLD shows unique features of histology and pathophysiology compared to adults. Changes in serum iron parameters are common in adult NAFLD and have been termed dysmetabolic iron overload syndrome characterized by increased serum ferritin levels and normal transferrin saturation; however, the associations of serum ferritin, inflammation, and liver fat content have been incompletely investigated in children. As magnetic resonance imaging (MRI) is an excellent measure for the degree of liver steatosis, we applied this method herein to clarify the interaction between ferritin and fatty liver in male adolescents. For this study, one hundred fifty male pediatric patients with obesity and who are overweight were included. We studied a subgroup of male patients with (n = 44) and without (n = 18) NAFLD in whom we determined liver fat content, visceral adipose tissue, and subcutaneous adipose tissue extent with a 1.5T MRI (Philips NL). All patients underwent a standardized oral glucose tolerance test. We measured uric acid, triglycerides, HDL-, LDL-, total cholesterol, liver transaminases, high sensitive CRP (hsCRP), interleukin-6, HbA1c, and insulin. In univariate analysis, ferritin was associated with MRI liver fat, visceral adipose tissue content, hsCRP, AST, ALT, and GGT, while transferrin and soluble transferrin receptor were not associated with ferritin. Multivariate analysis identified hsCRP and liver fat content as independent predictors of serum ferritin in the pediatric male patients. Our data indicate that serum ferritin in male adolescents with obesity is mainly determined by liver fat content and inflammation but not by body iron status.

Association between Metabolic Syndrome Diagnosis and the Physical Activity—Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study

“…The entire project and the primary publications’ references are available on the CORDIS website [ 27 ]. More recently, the Beta-JUDO study consortium also investigated the underlying mechanisms of disturbed glucose metabolism and non-alcoholic fatty liver disease [ 28 , 29 , 30 , 31 , 32 , 33 ]. The subjects were included in 2 centers (Pediatric Obesity Clinic at Uppsala University Children’s Hospital, Upsala, Sweden; and Paracelsus Medical University, Salzburg, Austria).…”

Serum iron and risk of nonalcoholic fatty liver disease and advanced hepatic fibrosis in US adults

“…Findings relating to the relationship between serum ferritin, TFR and the risk of liver injury have been reported [9][10][11][12] . We also found the positive association between serum ferritin, TFR and liver diseases risk.…”

“…Several epidemiological studies have confirmed this conclusion. Mörwald et.al reported that liver fat was positively correlated with serum ferritin, but not associated with serum transferrin or iron in male adolescents with obesity 12 ; Sabrina et.al revealed that the serum iron:ferritin ratio was associated with reduced risk of severe fatty liver progression in young adult women 35 . Thus, higher levels of serum iron may be related to lower storage of iron in a ferritin form to some extent.…”

“…There were also studies indicated that serum ferritin was positively associated with risk of NAFLD 9 – 11 and liver fat content 12 . However, a study of 30 patients with biopsy-proven NAFLD/non-alcoholic steatohepatitis (NASH) showed that there is no significant correlation between serum ferritin and the stage of fibrosis 13 .…”

Composition of Dietary Fatty Acids and Health Risks in Japanese Youths

“…In these subjects, liver enzyme levels mostly in the normal ranges could pose concerns to explain liver dysfunction. Recent studies indicate that serum iron status is associated with liver fat or inflammation in obese youths [ 38 , 39 ]. Similarly in the same population of this cohort, serum iron status was associated with elevated liver enzyme levels; the levels even within the normal ranges may suggest subclinical liver dysfunction [ 40 ].…”