Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new terminology characterized by liver steatosis. Iron status is related to many metabolic diseases. However, the researches on the associations of serum iron status with MAFLD are limited. The objective of this study was to investigate the associations of serum iron status biomarkers with MAFLD and liver fibrosis. A total of 5892 adults were enrolled in the current cross-sectional study using the 2017-March 2020 National Health and Nutrition Examination Survey. Liver steatosis and liver fibrosis were defined by the median values of controlled attenuation parameter ≥ 274 dB/m and liver stiffness measurement ≥ 8 kPa, respectively. The multivariable logistic/linear regression and restricted cubic spline analysis were conducted. After adjusting for potential confounders, higher ferritin levels were associated with higher odds of MAFLD (OR 4.655; 95% CI 2.301, 9.418) and liver fibrosis (OR 7.013; 95% CI 3.910, 12.577). Lower iron levels were associated with a higher prevalence of MAFLD (OR 0.622; 95% CI 0.458, 0.844) and liver fibrosis (OR 0.722; 95% CI 0.536, 0.974). Lower transferrin saturation (TSAT) was associated with a higher prevalence of MAFLD (OR 0.981; 95% CI 0.970, 0.991) and liver fibrosis (OR 0.988; 95% CI 0.979, 0.998). Higher ferritin levels, lower iron levels, and TSAT were associated with a higher prevalence of MAFLD and liver fibrosis. This study extended the knowledge of modifying iron status to prevent MAFLD and liver fibrosis. More prospective and mechanism studies were warranted to confirm the conclusions.
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Data Availability
The data that support the findings of this study are available from NHANES, which is available publicly at https://www.cdc.gov/nchs/nhanes/.
Abbreviations
- NHANES:
-
National Health and Nutrition Examination Surveys
- NCHS:
-
National Center for Health Statistics
- MEC:
-
Mobile examination center
- MAFLD:
-
Metabolic-associated fatty liver disease
- NAFLD:
-
Non-alcoholic fatty liver disease
- VCTE:
-
Vibration-controlled transient elastography
- CAP:
-
Controlled attenuation parameter
- LSM:
-
Liver stiffness measurement
- BMI:
-
Body mass index
- HOMA-IR:
-
Homeostasis model assessment-insulin resistance
- T2DM:
-
Type 2 diabetes mellitus
- OR:
-
Odds ratio
- FPG:
-
Fasting plasma glucose
- HBV:
-
Hepatitis B virus
- HCV:
-
Hepatitis C virus
- TSAT:
-
Transferrin saturation
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Acknowledgements
The authors thank all team members and participants in the NHANES study.
Funding
This research is supported by the National Natural Science Foundation of China (82170800), Guangdong Basic and Applied Basic Research Foundation (2021A1515110682), and Research Initiation Project of Shunde Hospital of Southern Medical University (SRSP2021001).
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Contributions
Study concept and design: GY, LL, YL, and CS.
Literature searches and data collection: XC, HD, HZ, and YJ.
Statistical analysis: GY, LL, and TQ.
Drafting of the manuscript: GY, LL, and TQ.
Critical revision: JS and HW.
Study supervision: JS and HW.
All authors contributed to the manuscript for important intellectual content and approved the submission.
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The original survey was approved by the NCHS Research Ethics Review Board, and informed consent for data collection and storage was obtained from all participants.
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Genfeng Yu, Lan Liu, and Tao Qin contributed equally to this manuscript and shared their first authorship.
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Yu, G., Liu, L., Qin, T. et al. Associations of Serum Iron Status with MAFLD and Liver Fibrosis in the USA: a Nationwide Cross-Section Study. Biol Trace Elem Res 202, 87–98 (2024). https://doi.org/10.1007/s12011-023-03666-4
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DOI: https://doi.org/10.1007/s12011-023-03666-4