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Complications of Non-Alcoholic Fatty Liver Disease in Extrahepatic Organs
Article

Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study

1
Department of Nutrition, Food Sciences and Physiology and Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008 Pamplona, Spain
2
Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
3
Clinical Chemistry Department, Clinica Universidad de Navarra, 31008 Pamplona, Spain
4
Department of Radiology, Clinica Universidad de Navarra, 31008 Pamplona, Spain
5
Liver Unit, Clinica Universidad de Navarra, 31008 Pamplona, Spain
6
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), 28029 Madrid, Spain
7
Biomedical Research Centre Network in Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
8
Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & Balearic Islands Institute for Health Research (IDISBA), 07122 Palma, Spain
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Diagnostics 2020, 10(11), 917; https://doi.org/10.3390/diagnostics10110917
Received: 14 October 2020 / Revised: 3 November 2020 / Accepted: 7 November 2020 / Published: 8 November 2020
(This article belongs to the Special Issue Fatty Liver Disease: Diagnostic, Predictive and Prognostic Markers)
The identification of affordable noninvasive biomarkers for the diagnosis and characterization of nonalcoholic fatty liver disease (NAFLD) is a major challenge for the research community. This study aimed to explore the usefulness of ferritin as a proxy biomarker of NAFLD condition, alone or in combination with other routine biochemical parameters. Subjects with overweight/obesity and ultrasound-confirmed liver steatosis (n = 112) from the Fatty Liver in Obesity (FLiO) study were assessed. The hepatic evaluation considered magnetic resonance imaging, ultrasonography, and credited routine blood liver biomarkers. Anthropometry and body composition, dietary intake (by means of a validated 137-item food frequency questionnaire), and specific biochemical markers were also determined. Serum ferritin levels were analyzed using a chemiluminescent microparticle immunoassay kit. Lower serum ferritin concentrations were associated with general better liver health and nutritional status. The evaluation of ferritin as a surrogate of liver damage by means of quantile regression analyses showed a positive association with alanine aminotransferase (ALT) (β = 19.21; p ≤ 0.001), liver fat content (β = 8.70; p = 0.008), and hepatic iron (β = 3.76; p ≤ 0.001), after adjusting for potential confounders. In receiver operating characteristic (ROC) analyses, the panel combination of blood ferritin, glucose, and ALT showed the best prediction for liver fat mass (area under the curve (AUC) 0.82). A combination of ferritin and ALT showed the higher predictive ability for estimating liver iron content (AUC 0.73). This investigation demonstrated the association of serum ferritin with liver health as well as with glucose and lipid metabolism markers in subjects with NAFLD. Current findings led to the identification of ferritin as a potential noninvasive predictive biomarker of NAFLD, whose surrogate value increased when combined with other routine biochemical measurements (glucose/ALT). View Full-Text
Keywords: fatty liver; insulin resistance; iron; obesity; biomarker; metabolism fatty liver; insulin resistance; iron; obesity; biomarker; metabolism
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MDPI and ACS Style

Galarregui, C.; Marin-Alejandre, B.A.; Perez-Diaz-Del-Campo, N.; Cantero, I.; Monreal, J.I.; Elorz, M.; Benito-Boillos, A.; Herrero, J.I.; Tur, J.A.; Martínez, J.A.; Zulet, M.A.; Abete, I. Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study. Diagnostics 2020, 10, 917. https://doi.org/10.3390/diagnostics10110917

AMA Style

Galarregui C, Marin-Alejandre BA, Perez-Diaz-Del-Campo N, Cantero I, Monreal JI, Elorz M, Benito-Boillos A, Herrero JI, Tur JA, Martínez JA, Zulet MA, Abete I. Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study. Diagnostics. 2020; 10(11):917. https://doi.org/10.3390/diagnostics10110917

Chicago/Turabian Style

Galarregui, Cristina; Marin-Alejandre, Bertha A.; Perez-Diaz-Del-Campo, Nuria; Cantero, Irene; Monreal, J. I.; Elorz, Mariana; Benito-Boillos, Alberto; Herrero, José I.; Tur, Josep A.; Martínez, J. A.; Zulet, M. A.; Abete, Itziar. 2020. "Predictive Value of Serum Ferritin in Combination with Alanine Aminotransferase and Glucose Levels for Noninvasive Assessment of NAFLD: Fatty Liver in Obesity (FLiO) Study" Diagnostics 10, no. 11: 917. https://doi.org/10.3390/diagnostics10110917

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