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Elevated serum ferritin is associated with increased mortality in non-alcoholic fatty liver disease after 16 years of follow-up
Center for Digestive Diseases, Unit of Hepatology, Karolinska University Hospital, Stockholm, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
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2016 (Engelska)Ingår i: Liver international (Print), ISSN 1478-3223, E-ISSN 1478-3231, Vol. 36, nr 11, s. 1688-1695Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND AND AIMS: High levels of ferritin in patients with non-alcoholic fatty liver disease (NAFLD) are associated with significant fibrosis and higher NAFLD activity score (NAS). It is unclear if this association has an impact on mortality. We investigated if high levels of ferritin, with or without iron overload, were associated with an increased mortality in NAFLD.

METHODS: We included 222 patients between 1979 and 2009 with biopsy-proven NAFLD and available serum ferritin concentrations. The cohort was divided into "high" (n = 89) and "normal" (n = 133) ferritin values, using a cut-point of 350 μg/L in males, and 150 μg/L in females, and stratified upon iron overload status. Data on mortality was obtained from a national, population based register. Poisson regression was used to estimate hazard ratios for mortality. The estimates were adjusted for age at biopsy, sex, smoking, BMI, diabetes, hypertension, cardiovascular disease and fibrosis stage at the time of biopsy.

RESULTS: The median follow-up time was 15.6 years (range: 0.5-34.2). Patients with high ferritin had more advanced fibrosis and higher NAS than patients with normal ferritin (p < 0.05). Fifteen years after diagnosis, and after adjusting for confounders, the high-ferritin group showed an increasingly higher mortality that was statistically significant (Hazard ratio = 1.10 per year, 95% Confidence interval 1.01-1.21, p < 0.05). There was no difference in mortality between patients with different iron overload patterns.

CONCLUSIONS: High levels of ferritin are associated with a long-term increased risk of death. This article is protected by copyright. All rights reserved.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2016. Vol. 36, nr 11, s. 1688-1695
Nyckelord [en]
ferritin;fibrosis, long-term outcome, mortality, NAFLD activity score, non-alcoholic fatty liver disease
Nationell ämneskategori
Gastroenterologi
Identifikatorer
URN: urn:nbn:se:liu:diva-129955DOI: 10.1111/liv.13144ISI: 000385863400016PubMedID: 27064133OAI: oai:DiVA.org:liu-129955DiVA, id: diva2:945679
Anmärkning

Funding agencies:Stockholm County Council (ALF projects from the Swedish Society of Medicine [20140329, 20150403]; Ruth and Richard Julins Foundation; Medical Research Council of Southeast Sweden [311151]; ALF grants, Region Ostergotland, Sweden

Tillgänglig från: 2016-07-02 Skapad: 2016-07-02 Senast uppdaterad: 2017-11-28Bibliografiskt granskad

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