The Clinical Significance of Serum Ferritin in Pediatric Non-Alcoholic Fatty Liver Disease
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Purpose: Non-alcoholic fatty liver disease (NAFLD) in children has become an important public health issue because of its high prevalence and severity. Several noninvasive methods for estimating NAFLD are under investigation. We aimed to evaluate the usefulness of serum ferritin as a biomarker of severity of pediatric NAFLD patients. Methods: A total of 64 NAFLD patient were enrolled from Severance Children’s Hospital from March 2010 to February 2013. Serum ferritin levels, liver related laboratory tests, liver magnetic resonance imaging (MRI) (2-dimensional [2D] proton density-fat fraction) and NAFLD severity markers were compared between obese group and overweight group. Correlation analyses were performed between serum ferritin and laboratory values including NAFLD severity markers. Results: In obese group, serum ferritin, alanine aminotransferase (ALT), total bilirubin, international normalized ratio (INR), MRI 2D proton density-fat fraction, aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis- 4 (FIB-4) (an index score calculated from platelet count, ALT, AST and age) were significantly higher than those of overweight group. NAFLD severity markers, APRI and FIB-4, and liver specific important laboratory values, AST, ALT, INR, cholesterol, triglyceride and low density lipoprotein show significant correlation with serum ferritin in NAFLD patients. Conclusion: Serum ferritin concentrations could be a candidate of useful severity marker in the pediatric NAFLD patients.
Abstract
Purpose: Non-alcoholic fatty liver disease (NAFLD) in children has become an important public health issue because of its high prevalence and severity. Several noninvasive methods for estimating NAFLD are under investigation. We aimed to evaluate the usefulness of serum ferritin as a biomarker of severity of pediatric NAFLD patients. Methods: A total of 64 NAFLD patient were enrolled from Severance Children’s Hospital from March 2010 to February 2013. Serum ferritin levels, liver related laboratory tests, liver magnetic resonance imaging (MRI) (2-dimensional [2D] proton density-fat fraction) and NAFLD severity markers were compared between obese group and overweight group. Correlation analyses were performed between serum ferritin and laboratory values including NAFLD severity markers. Results: In obese group, serum ferritin, alanine aminotransferase (ALT), total bilirubin, international normalized ratio (INR), MRI 2D proton density-fat fraction, aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis- 4 (FIB-4) (an index score calculated from platelet count, ALT, AST and age) were significantly higher than those of overweight group. NAFLD severity markers, APRI and FIB-4, and liver specific important laboratory values, AST, ALT, INR, cholesterol, triglyceride and low density lipoprotein show significant correlation with serum ferritin in NAFLD patients. Conclusion: Serum ferritin concentrations could be a candidate of useful severity marker in the pediatric NAFLD patients.
참고문헌 (24)
- Dowman JK, "Pathogenesis of non-alcoholic fatty liver disease", QJM, 103, pp.71~83 (2010)
- Siegel AB, "Metabolic syndrome and hepatocellular carcinoma: two growing epidemics with a potential link", Cancer, 115, pp.5651~5661 (2009)
- Fon Tacer K, "Nonalcoholic fatty liver disease:focus on lipoprotein and lipid deregulation", J Lipids, 2011, pp.783976~ (2011)
- Utzschneider KM, "Serum ferritin is associated with non-alcoholic fatty liver disease and decreased Β-cell function in non-diabetic men and women", J Diabetes Complications, 28, pp.177~184 (2014)
- Dowman JK, "Systematic review: the diagnosis and staging of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis", Aliment Pharmacol Ther, 33, pp.525~540 (2011)
- Lam B, "Treatment options for nonalcoholic fatty liver disease", Therap Adv Gastroenterol, 3, pp.121~137 (2010)
- Permutt Z, "Correlation between liver histology and novel magnetic resonance imaging in adult patients with non-alcoholic fatty liver disease - MRI accurately quantifies hepatic steatosis in NAFLD", Aliment Pharmacol Ther, 36, pp.22~29 (2012)
- Valenti L, "Diagnostic and therapeutic implications of the association between ferritin level and severity of nonalcoholic fatty liver disease", World J Gastroenterol, 18, pp.3782~3786 (2012)
- Angulo P, "The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD", Hepatology, 45, pp.846~854 (2007)
- Kowdley KV, "Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease", Hepatology, 55, pp.77~85 (2012)
- Castera L, "Noninvasive evaluation of NAFLD", Nat Rev Gastroenterol Hepatol, 10, pp.666~675 (2013)
- Manousou P, "Serum ferritin is a discriminant marker for both fibrosis and inflammation in histologically proven non-alcoholic fatty liver disease patients", Liver Int, 31, pp.730~739 (2011)
- Vallet-Pichard A, "FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest", Hepatology, 46, pp.32~36 (2007)
- Nelson JE, "Relationship between the pattern of hepatic iron deposition and histological severity in nonalcoholic fatty liver disease", Hepatology, 53, pp.448~457 (2011)
- Giorgio V, "Pediatric non alcoholic fatty liver disease: old and new concepts on development, progression, metabolic insight and potential treatment targets", BMC Pediatr, 13, pp.40~ (2013)
- Hashimoto E, "Characteristics and diagnosis of NAFLD", NASH, 2013, pp.28(4), 64~70
- McPherson S, "Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease", Gut, 59, pp.1265~1269 (2010)
- Shah AG, "Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 7, pp.1104~1112 (2009)
- Cusi K, "Limited value of plasma cytokeratin-18 as a biomarker for NASH and fibrosis in patients with non-alcoholic fatty liver disease", J Hepatol, 60, pp.167~174 (2014)
- Ballestri S, "Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD", Liver Int, 32, pp.1242~1252 (2012)
- 김영석, "Noninvasive predictors of nonalcoholic steatohepatitis in Korean patients with histologically proven nonalcoholic fatty liver disease", Clinical and Molecular Hepatology, 19(2), pp.120~130 (2013), 대한간학회[DOI]
- Feldstein AE, "Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis:a multicenter validation study", Hepatology, 50, pp.1072~1078 (2009)
- Fitzpatrick E, "Serum levels of CK18 M30 and leptin are useful predictors of steatohepatitis and fibrosis in paediatric NAFLD", J Pediatr Gastroenterol Nutr, 51, pp.500~506 (2010)
- Feldstein AE, "Serum cytokeratin-18 fragment levels are useful biomarkers for nonalcoholic steatohepatitis in children", Am J Gastroenterol, 108, pp.1526~1531 (2013)
