scholarly journals Serum ferritin as a non-invasive marker in the prediction of hepatic fibrosis among Egyptian patients with non-alcoholic fatty liver disease

JGH Open ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. 112-119 ◽  
Author(s):  
Noha El Nakeeb ◽  
Shereen A Saleh ◽  
Yasmine M Massoud ◽  
Ahmed Hussein ◽  
Rana Hamed
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Hepatic Fibrosis ◽  
Serum Ferritin ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Egyptian Patients ◽  
Alcoholic Fatty Liver Disease

Elevated serum ferritin in non-alcoholic fatty liver disease is not predictive of fibrosis

2021 ◽  
Author(s):  
Roberto Trasolini ◽  
Ben Cox ◽  
Ciaran Galts ◽  
Eric M. Yoshida ◽  
Vladimir Marquez
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Serum Ferritin ◽  
Fatty Liver Disease ◽  
Significant Proportion ◽  
Liver Stiffness ◽  
Risk Scores ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Alcoholic Fatty Liver Disease

Non-Alcoholic fatty liver disease (NAFLD) is common with widely ranging severity. Non-invasive risk scores for risk stratification are recommended but misclassify a significant proportion of patients. In situations where non-invasive risk scores do not provide guidance, referral is typically made to a Hepatologist for transient elastography or liver biopsy. Serum ferritin is elevated in many patients with NAFLD related to dysmetabolic and inflammatory hyperferritinemia. Ferritin is widely available and part of a standard workup for chronic liver disease. Methods: To explore the association of ferritin and risk of fibrosis in NAFLD, we reviewed patients diagnosed with NAFLD at the hepatology clinic of the Vancouver General Hospital between the years of 2015–2018. We collected data on 317 patients retrospectively assessing for a relationship between serum ferritin and elastography score. Results: 224 patients were included in the final analysis. Median ferritin was 145 µg/L (IQR 249). Median liver stiffness was 5.2 kPa with 14.3% of patients having liver stiffness ≥8.7 kPa and 17.4% ≥ 8.0 kPa. ROC curve analysis using a liver stiffness ≥8.0kPa as a cutoff for F2 fibrosis showed an AUROC of 0.54 for serum ferritin levels. At a cut-off of both 300 µg/L and 450 µg/L median liver stiffness did not differ significantly in those with ferritin above the cutoff (ferritin ≥300 µg/L p = 0.099, ferritin ≥450 µg/L p = 0.12). Ferritin was significantly higher in male patients (198 µg/L vs 91 µg/L p = 0.0001). There was a weak linear association between AST and ferritin levels. Conclusion: In this cohort of 224 patients with NAFLD, serum ferritin was not predictive of significant liver fibrosis.

Non-Invasive Distinction of Non-Alcoholic Fatty Liver Disease using Urinary Volatile Organic Compound Analysis: Early Results

2015 ◽  
Vol 24 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Ramesh P. Arasaradnam ◽  
Michael McFarlane ◽  
Emma Daulton ◽  
Erik Westenbrink ◽  
Nicola O’Connell ◽  
...  
Keyword(s):  
Liver Disease ◽  
Pilot Study ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Diagnostic Methods ◽  
Screening Methods ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Volatile Organic ◽  
Alcoholic Fatty Liver Disease

Background & Aims: Non-Alcoholic Fatty Liver Disease (NAFLD) is the commonest cause of chronic liver disease in the western world. Current diagnostic methods including Fibroscan have limitations, thus there is a need for more robust non-invasive screening methods. The gut microbiome is altered in several gastrointestinal and hepatic disorders resulting in altered, unique gut fermentation patterns, detectable by analysis of volatile organic compounds (VOCs) in urine, breath and faeces. We performed a proof of principle pilot study to determine if progressive fatty liver disease produced an altered urinary VOC pattern; specifically NAFLD and Non-Alcoholic Steatohepatitis (NASH).Methods: 34 patients were recruited: 8 NASH cirrhotics (NASH-C); 7 non-cirrhotic NASH; 4 NAFLD and 15 controls. Urine was collected and stored frozen. For assay, the samples were defrosted and aliquoted into vials, which were heated to 40±0.1°C and the headspace analyzed by FAIMS (Field Asymmetric Ion Mobility Spectroscopy). A previously used data processing pipeline employing a Random Forrest classification algorithm and using a 10 fold cross validation method was applied.Results: Urinary VOC results demonstrated sensitivity of 0.58 (0.33 - 0.88), but specificity of 0.93 (0.68 - 1.00) and an Area Under Curve (AUC) 0.73 (0.55 -0.90) to distinguish between liver disease and controls. However, NASH/NASH-C was separated from the NAFLD/controls with a sensitivity of 0.73 (0.45 - 0.92), specificity of 0.79 (0.54 - 0.94) and AUC of 0.79 (0.64 - 0.95), respectively.Conclusions: This pilot study suggests that urinary VOCs detection may offer the potential for early non-invasive characterisation of liver disease using 'smell prints' to distinguish between NASH and NAFLD.

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