Serum Ferritin and Cellular Reactive Protein (CRP) in Non Alcoholic Fatty liver Disease (NAFLD) and Non Alcoholic Steatohepatitis (NASH) Patients

Abstract

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and it comprises a spectrum of hepatic abnormalities from simple hepatic steatosis to steatohepatitis, fibrosis, cirrhosis, and liver cancer. Simple steatosis (i.e., NAFL) rarely progresses to advanced disease whereas, in approximately 20% of patients with NASH, it progresses to fibrosis and cirrhosis and potentially to hepatocellular carcinoma over a 15-year time period. Aim of the Work To study the relation between serum ferritin and CRP levels and severity of non- alcoholic fatty liver disease NAFLD and non-alcoholic steatohepatitis NASH. Patients and Methods This case control study was conducted on patients attending the Hepatology Outpatient Clinic at Ain Shams University Hospital between December 2019 to May 2020. Results In group A there is significant correlation between ferritin and age, ALT, AST, albumin, CRP, LDL, BMI, cholesterol, triglycerides and NAFLD fibrosis score. But there is no significant correlation between ferritin and Hb, platelets, HDL and fasting blood sugar FBS in group A. In group B there is significant correlation between ferritin and ALT. Ferritin has cutoff point of > 168 with 80% sensitivy & 80% specificity. In group A there is significant correlation between CRP and age, BMI, ALT,AST, albumin, LDL, cholesterole, triglycerides and NAFLD fibrosis score. In group A there is no significant correlation between CRP and Hb, platelets, FBS and HDL. While in group B there is significant correlation between CRP and BMI, ALT, albumin, LDL, cholesterole and triglycerides. CRP cutoff point of > 1.3 with specificity 90% but sensitivity 35%. Conclusion In conclusion, in this study we tried to find a relation between serum ferritin and CRP levels and severity of non-alcoholic fatty liver disease NAFLD and non-alcoholic steatohepatitis NASH. We found that s. ferritin and CRP are significantly elevated in NAFLD and more elevated in NASH with a link between serum ferritin and insulin resistance and the whole metabolic syndrome. Serum ferritin and CRP are related to disease progression with significant correlation with NAFLD fibrosis score.