Hyperferritinemia is a risk factor for steatosis in chronic liver disease

Table 1 Demographic, laboratory and histological features of 124 patients (mean ± SD)

Variable
Mean age (yr)	53.3 ± 1.2
Age (yr), n (%)
≤ 50	51 (41.2)
> 50	73 (58.8)
Sex, n (%)
Male	90 (72.5)
Female	34 (27.5)
BMI (kg/m2)
< 25	74 (59.6)
25-29.9	50 (40.3)
ALT-UNL	3.0 ± 1.0
AST-UNL	2.0 ± 1.0
GGT-UNL	2.0 ± 0.3
Ferritin (ng/mL)	799.7 ± 75.6
Serum iron (&mgr;g/dL)	126 ± 6.3
Platelet count × 103/cmm	186 ± 74.33
HOMA score	3.48 ± 1.80
Steatosis	92 (74.2)
Etiology
Anti-HCV	53 (42.7)
NAFLD	35 (28.2)
NAFLD/diabetes	11 (8.8)
NASH	11 (8.8)
Cryptogenic	14 (11.3)
Histology (54)
Chronic hepatitis C	27 (50)
Cirrhosis cryptogenic	9 (16.6)
NAFLD	7 (12.9)
NASH	11 (20.3)
HFE mutations	53 (42.7)
H63D heterozygous	49 (39.5)
C282Y heterozygous	2 (1.6)
C282Y/H63D compound het	2 (1.6)

ULN: Upper limit of normal.

Table 2 Univariate analysis of risk factors for absent/present liver steatosis in 124 patients with high serum level ferritin

Variable	Steatosis		P value
	Absent (n = 32)	Present (n = 92)
Age (yr)	50.9 ± 3.1	54.2 ± 1.3	0.06
Sex	18 (56.2)	72 (78.2)	0.14
BMI (kg/m2)	24.4 ± 3.2	25.2 ± 3.1	0.30
ALT-UNL	47.7 ± 7.7	117.5 ± 11.2	0.1
AST-UNL	35.7 ± 5.3	89 ± 10.8	0.3
GGT	93.1 ± 20.7	174.1 ± 19.7	0.03
Anti-HCV positivity	24 (75)	28 (30.4)	0.02
Ferritin (ng/mL)	464 ± 183	1060.8 ± 79	0.0006
Serum Iron (&mgr;g/dL)	96.3 ± 7.5	137 ± 7.7	0.8
Platelet count × 103/cmm	217.8 ± 16.1	176.9 ± 8.26	0.24
HOMA	3.0 ± 2.25	3.5 ± 2.8	0.23
HFE mutations	14 (43.7)	40 (43.4)	0.63
Diabetes	11 (34.3)	11 (12)	0.2

Table 3 Predictors of steatosis in 124 patients by logistic regression model

Predictor	Univariate analysis		Multivariate analysis
	OR (95% CI)	P value	OR (95% CI)	P value
Age (yr)	0.962 (0.923-1.002)	0.060	0.97 (0.94-1.14)	0.23
Sex	0.455 (0.160-1.297)	0.14	-	-
BMI (kg/m2)	1.050 (0.96-1.14)	0.23	-	-
ALT-UNL	0.997 (0.993-1.001)	0.12	-	-
AST-UNL	0.998 (0.994-1.002)	0.36	-	-
GGT-UNL	1.007 (1.001-1.013)	0.030	1.007 (1.003-1.014)	0.0043
Anti-HCV positivity	0.274 (0.110-0.682)	0.005	0.40 (0.20-1.10)	0.08
Platelet count × 103/cmm	1.000 (1.000-1.000)	0.24	-	-
Ferritin (ng/mL)	1.002 (1.001-1.004)	0.0006	1.003 (1.002-1.004)	0.0009
Serum Iron (&mgr;g/dL)	0.999 (0.991-1.008)	0.84	-	-
HFE mutations	0.796 (0.313-2.020)	0.63	-	-
Diabetes	0.995 (0.986-1.004)	0.28	-	-

Table 4 Multivariate analysis of risk factors for high serum ferritin levels in 124 patients by linear regression model

Variable	β	SE	P
Male	93.183	183.13	0.612
ALT-UNL	-0.07174	1.09734	0.948
AST-UNL	1.06027	1.05841	0.319
GGT-UNL	0.92457	0.5746	0.111
Anti-HCV positivity	521.964	169.40	0.0028
Platelet count × 103/cmm	-0.00250	0.0010	0.0161
Steatosis	933.7287	180.437	< 0.0001