Endocrinol Metab.  2014 Dec;29(4):479-488. 10.3803/EnM.2014.29.4.479.

Comparison of Serum Ferritin and Vitamin D in Association with the Severity of Nonalcoholic Fatty Liver Disease in Korean Adults

• Jeong DW
• Lee HW
• Cho YH
• Yi DW
• Lee SY
• Son SM
• Kang YH

• KMID: 2384245
• DOI: http://doi.org/10.3803/EnM.2014.29.4.479

Abstract

BACKGROUND
Increased serum ferritin and decreased vitamin D levels associated with nonalcoholic fatty liver disease (NAFLD). However, their association with the severity of NAFLD has not been fully evaluated. The aim of this study was to compare the association of serum ferritin and 25(OH)D3 levels with the severity of ultrasonographically detected NAFLD (US-NAFLD) and hepatic steatosis defined by fatty liver index (FLI) in Korean adults.
METHODS
A cross-sectional analysis of clinical and anthropometric data, including serum ferritin and 25(OH)D3, from men (n=295) and women (n=263) who underwent a routine health check-up in 2012.
RESULTS
In men, with an increase in the quartile of serum ferritin level, the incidences of subjects with metabolic syndrome (P=0.002), US-NAFLD (P=0.041), and FLI > or =60 (P=0.010) were significantly elevated. In women, the incidence of subjects with US-NAFLD was also significantly elevated with increases in the serum ferritin quartile (P=0.012). Regarding 25(OH)D3, no statistical differences were observed among the different quartiles in either gender. Serum ferritin level significantly increased as the severity of US-NAFLD increased (P<0.001); however, no significant differences in 25(OH)D3 level were observed in men. No significant differences in either serum ferritin or 25(OH)D3 level were observed among women with different levels of severity of US-NAFLD.
CONCLUSION
Increased serum ferritin level showed a closer association with severity of NAFLD compared with level of serum vitamin D, suggesting that serum ferritin level may be a better marker than vitamin D level for predicting the severity of US-NAFLD and hepatic steatosis in a clinical setting.

Keyword

Ferritin; Vitamin D; Nonalcoholic fatty liver disease; Metabolic syndrome

MeSH Terms

Adult*
Cross-Sectional Studies
Fatty Liver*
Female
Ferritins*
Humans
Incidence
Male
Vitamin D*
Ferritins
Vitamin D

Figure

• 

  Fig. 1 Incidence of metabolic syndrome (MetS), ultrasonographically-detected nonalcoholic fatty liver disease (US-NAFLD), and fatty liver index (FLI) ≥60 by quartile rankings of serum ferritin and 25(OH)D3 levels. 1, first quartile; 2, second quartile; 3, third quartile; 4, fourth quartile. (A) With an increase in the quartile of ferritin level, the incidences of subjects with MetS, US-NAFLD, and FLI ≥ 60 were significantly increased in men. (B) With an increase in the quartile of vitamin D level, no statistical differences were observed among quartiles in men. (C) With an increase in the quartile of ferritin level, only the incidence of subjects with US-NAFLD increased significantly in women. (D) With an increase in the quartile of vitamin D level, no statistical differences were observed among quartiles in women. aP<0.05 compared with the first quartile using one-way analysis of variance analysis followed by post hoc testing with the S-N-K test.

• 

  Fig. 2 Serum ferritin and 25(OH)D3 levels according to the severity of ultrasonographically-detected nonalcoholic fatty liver disease (US-NAFLD). (A) Ferritin level was significantly increased as the severity of US-NAFLD increased from normal to severe in men. (B) No significant differences were observed in vitamin D level among men with different severities of US-NAFLD. (C) No significant differences in ferritin level were observed among women with different severities of US-NAFLD. (D) No significant differences in vitamin D level were observed among women with different severities of US-NAFLD. aP<0.001 compared with the first quartile using one-way analysis of variance analysis followed by post hoc testing with the S-N-K test.

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