Pediatr Gastroenterol Hepatol Nutr.  2014 Dec;17(4):248-256. 10.5223/pghn.2014.17.4.248.

The Clinical Significance of Serum Ferritin in Pediatric Non-Alcoholic Fatty Liver Disease

• Na JH
• Park SW
• Kang Y
• Koh H
• Kim S

• KMID: 2315499
• DOI: http://doi.org/10.5223/pghn.2014.17.4.248

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.

Keyword

Non-alcoholic fatty liver disease; Child; Ferritins; Biological markers; Obesity

MeSH Terms

Alanine Transaminase
Aspartate Aminotransferases
Bilirubin
Biomarkers
Blood Platelets
Child
Cholesterol
Fatty Liver*
Ferritins*
Humans
International Normalized Ratio
Lipoproteins
Liver
Magnetic Resonance Imaging
Obesity
Overweight
Platelet Count
Prevalence
Protons
Public Health
Triglycerides
Alanine Transaminase
Aspartate Aminotransferases
Bilirubin
Cholesterol
Ferritins
Lipoproteins
Protons

Figure

• 

  Fig. 1 (A) Scatter plot between APRI and serum ferritin. (B) Scatter plot between AAR and serum ferritin. (C) Scatter plot between FIB-4 and serum ferritin. The scatter plot of APRI and FIB-4 tended to increase as the serum ferritin increased significantly (p<0.0001 and p<0.0001, respectively). AST: aspartate aminotransferase, APRI: AST to platelet ratio index, ALT: alanine aminotransferase, AAR: AST/ALT ratio, FIB-4: fibrosis-4.

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