ONO Masafumi
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Clinical usage of serum ferritin to assess liver fibrosis in patients with non-alcoholic fatty liver disease: Proceed with caution.
Journal Formal name：Hepatology research : the official journal of the Japan Society of Hepatology
Abbreviation：Hepatol Res
ISSN code：13866346/13866346
Domestic / ForeginDomestic
Volume, Issue, Page 44(14),pp.E499-502
Author and coauthor Yoneda Masato, Thomas Emmanuel, Sumida Yoshio, Imajo Kento, Eguchi Yuichiro, Hyogo Hideyuki, Fujii Hideki, Ono Masafumi, Kawaguchi Takumi, Schiff Eugene R
Publication date 2014/12
Summary Serum ferritin was recently reported to have low diagnostic accuracy for the detection of advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). To corroborate these findings, we investigated the diagnostic accuracy of serum ferritin levels for detecting liver fibrosis in NAFLD patients utilizing a large Japanese cohort database. A total 1201 biopsy-proven NAFLD patients, seen between 2001 and 2013, were enrolled into the Japan Study Group of NAFLD. Analysis was performed on data from this cohort comparing between serum ferritin levels and hepatic histology. Serum ferritin increased with increasing histological grade of steatosis, lobular inflammation and ballooning. Multivariate analyses revealed that sex differences, steatotic grade and fibrotic stage were independently associated with serum ferritin levels (P < 0.0001, <0.0001, 0.0248, respectively). However, statistical analyses performed using serum ferritin levels demonstrated that the area under the receiver-operator curve for detecting fibrosis was not adequate for rigorous prediction. Several factors including sex differences, steatosis and fibrosis were found to correlate with serum ferritin levels. Therefore, serum ferritin may have low diagnostic accuracy for specifically detecting liver fibrosis in NAFLD patients due to the involvement of multiple hepatocellular processes.
DOI 10.1111/hepr.12327
PMID 24628717