Serum ferritin level is associated with liver steatosis and fibrosis in Korean general population
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Elevation of serum ferritin levels is frequently observed in non-alcoholic fatty liver disease (NAFLD) patients. Our study aims to examine the association between serum ferritin levels and NAFLD in Korean population.
Methods and results
A total of 25,597 participants were selected from Korean National Health and Nutritional Examination Surveys 2007–2012. The NAFLD liver fat score (NLFS) was used to define NAFLD. Elevation of ALT levels was defined as ALT level > 40 IU/L for male and ALT level > 31 IU/L for female. Multiple logistic regression was used to examine the association of serum ferritin levels and NAFLD by sex. After adjusting for multiple covariates, the ORs (95% CI) of the elevated ALT levels were 1.56 (95% CI: 1.17–2.07), 1.84 (95% CI: 1.39–2.45), and 4.08 (95% CI: 3.08–5.40) for the second, third and fourth serum ferritin quartiles in male (p for trend < 0.01), 1.67 (95% CI: 1.24–2.23), 2.23 (95% CI: 1.68–2.96), and 5.72 (95% CI: 4.32–7.60) for the second, third and fourth serum ferritin quartiles in female (p for trend < 0.01). Serum ferritin levels were also significantly associated with NAFLD and liver fibrosis both in male and female.
Elevation of serum ferritin level is significantly associated with NAFLD and blood ALT elevation in Korean general population.
KeywordsIron Alanine aminotransferase Non-alcoholic fatty liver disease
Body mass index
Hepatic steatosis index
Korean National Health and Nutritional Examination Survey
Non-alcoholic fatty liver disease
Non-alcoholic fatty liver disease liver fat score
The data used in this study were obtained from the 4th and 5th Korean National Health and Nutrition Examination Survey database (Available from: https://knhanes.cdc.go.kr/knhanes/index.do).
This work was supported by the National Cancer Center Grant (Grant numbers NCC-1610170) and Kyung Hee University in 2017 (Grant: KHU-20170835). The funding organization had no role in the design or conduct of this research.
Compliance with ethical standards
Conflict of interest
Ju Young Jung, Jae Jun Shim, Sung Keun Park, Jae-Hong Ryoo, Joong-Myung Choi, In-Hwan Oh, Kyu-Won Jung, Hyunsoon Cho, Moran Ki, Young-Joo Won and Chang-Mo Oh have declared that no competing interests exist.
Ethics approval for the research protocol was obtained by the institutional review board (IRB) of the Kyung Hee University (IRB No: KHSIRB-17-073, Seoul, Korea).
Written informed consents were obtained from study participants before the KNHANES survey started.
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