A Population-Based and Clinical Cohort Validation of the Novel Consensus Definition of Metabolic Hyperferritinemia

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2023 Dec 21

PMID 38124275

Authors

Wen-Yue Liu

Li-You Lian

Huai Zhang

Sui-Dan Chen

Xin-Zhe Jin

Ni Zhang

Chen-Hui Ye

Wen-Ying Chen

George Goh Boon Bee

Fu-Di Wang

Luca Miele

Elena Corradini

Luca Valenti

Ming-Hua Zheng

Affiliations

Soon will be listed here.

Abstract

Context: There is limited data on the clinical significance of metabolic hyperferritinemia (MHF) based on the most recent consensus.

Objective: We aimed to validate the clinical outcomes of MHF in the general population and patients with biopsy-proven metabolic dysfunction-associated fatty liver disease (MAFLD).

Methods: The NHANES database and PERSONS cohort were included. MHF was defined as elevated serum ferritin with metabolic dysfunction (MD) and stratified into different grades according to ferritin (grade 1: 200 [females]/300 [males]-550 ng/mL; grade 2: 550-1000 ng/mL; grade 3: >1000 ng/mL). The clinical outcomes, including all-cause death, comorbidities, and liver histology, were compared between non-MHF and MHF in adjusted models.

Results: In NHANES, compared with non-MHF with MD, MHF was related to higher risks of advanced fibrosis (P = .036), elevated albumin-creatinine ratio (UACR, P = .001), and sarcopenia (P = .013). Although the association between all grades of MHF and mortality was insignificant (P = .122), grades 2/3 was associated with increased mortality (P = .029). When comparing with non-MHF without MD, the harmful effects of MHF were more significant in mortality (P < .001), elevated UACR (P < .001), cardiovascular disease (P = .028), and sarcopenia (P < .001). In the PERSONS cohort, MHF was associated with more advanced grades of steatosis (P < .001), lobular inflammation (P < .001), advanced fibrosis (P = .017), and more severe hepatocellular iron deposition (P < .001).

Conclusion: Both in the general population and in at-risk individuals with MAFLD, MHF was related with poorer clinical outcomes.

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Association of Serum Ferritin Levels With Obstructive Sleep Apnea in Overweight/Obese US Populations: A Population-Based Study From the NHANES.

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Association between serum iron levels and atherosclerotic cardiovascular diseases among American older adults: a cross-sectional study based on the National Health and Nutrition Examination Survey, 2009-2018.

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The validity of serum ferritin levels in predicting cardiovascular events of metabolic dysfunction-associated steatotic liver disease patients may need more consideration.

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