Relationship between serum ferritin and nonalcoholic fatty liver diseases in obese children

Abstract

Objective To investigate the relationship between serum ferritin and nonalcoholic fatty liver diseases in obese children. Methods Obese children aged 6 to 14 years old were enrolled. Duration of obesity, anthropometric parameters (height, body weight, waist circumference, hip circumference), bioelectrical impedance analysis (body fat), serological parameters (liver transaminases, lipid metabolism, fasting blood glucose, fasting insulin, serum ferritin) and liver ultrasonography were recorded. Insulin resistance (IR) index was calculated by homeostasis model assessment (HOMA). All subjects were divided into 3 groups according to liver ultrasound and liver transaminases: simple obese children (SOC) group, obese children with nonalcoholic simple fatty liver (NAFL) group and obese children with nonalcoholic steatohepatitis (NASH) group. Results 86 obese children entered the study, with a mean age of (10.4±1.9) years, including 26 in the SOC group, 28 in the NAFL group and 32 in the NASH group. Waist circumference standard deviation score (SDS or Z-score), waist-to-hip ratio, HOMA-IR index and serum ferritin in the NASH group were obviously higher than those in the NAFL group [2.3±0.3 vs. 2.1±0.3, P=0.020; 1.0±0.0 vs. 0.9±0.1, P=0.014; 4.0±1.7 vs. 2.9±1.8, P=0.006; (104.1±49.6)μg/L vs. (68.4±22.7)μg/L, P=0.004] and the SOC group [2.3±0.3 vs. 1.9±0.3, P=0.000; 1.0±0.0 vs. 0.9±0.1, P=0.012; 4.0±1.7 vs. 2.5±1.6, P=0.001; (104.1±49.6)μg/L vs. (59.2±28.9)μg/L, P=0.001], while there was no significant difference in body mass index Z-score [2.8±0.5 vs. 2.7±0.6, P=0.524; 2.8±0.5 vs. 2.7±0.6, P=0.662]. There were no significant differences between the NAFL group and the SOC group in the above indicators [2.1±0.3 vs. 1.9±0.3, P=0.260; 0.9±0.1 vs. 0.9±0.1, P=0.952; 2.9±1.8 vs. 2.5±1.6, P=0.283; (68.4±22.7)μg/L vs. (59.2±28.9)μg/L, P=0.161]. After controlling age, body mass index, waist circumference, waist-to-hip ratio, triglyceride, and HOMA-IR index, serum ferritin was still positively correlated with the magnitude of nonalcoholic fatty liver diseases in obese children (r=0.335, P=0.002). Conclusion Serum ferritin is probably an independent risk factor for NASH in obese children. Key words: Simple obesity; Children; Ferritin; Nonalcoholic fatty liver disease