METHODS: We analyzed data from the National Health and Nutritional Examination Survey (NHANES) 2017-2018 to evaluate the association between serum iron metabolism indicators (ferritin, serum iron, unsaturated iron-binding capacity [UIBC], total iron-binding capacity [TIBC], transferrin saturation, and transferrin receptor) and NAFLD/non-alcoholic steatohepatitis (NASH). Mediation analysis was conducted to explore the role of IR played in these relationship.
RESULTS: A total of 4812 participants were included, among whom 43.7% were diagnosed with NAFLD and 13.2% were further diagnosed with NASH. After adjusting the covariates, the risk of NAFLD increases with increasing serum ferritin (adjusted odds ratio [aOR] 1.71, 95% confidence interval [CI] 1.37-2.14), UIBC (aOR 1.45, 95% CI 1.17-1.79), and TIBC (aOR 1.36, 95% CI 1.11-1.68). Higher levels of serum ferritin (aOR 3.70, 95% CI 2.25-6.19) and TIBC (aOR 1.69, 95% CI 1.13-2.56) were also positively associated with NASH. Participants with IR were more likely to have NAFLD/NASH. Moreover, IR-mediated efficacy accounted for 85.85% and 64.51% between ferritin and NAFLD and NASH, respectively.
CONCLUSIONS: Higher levels of serum ferritin and TIBC are closely associated with the occurrence of NAFLD and NASH. IR may be considered a possible link between NAFLD or NASH and increased serum ferritin levels.
方法:我们分析了2017-2018年国家健康和营养检查调查(NHANES)的数据,以评估血清铁代谢指标(铁蛋白,血清铁,不饱和铁结合能力[UIBC],总铁结合能力[TIBC],转铁蛋白饱和度,和转铁蛋白受体)和NAFLD/非酒精性脂肪性肝炎(NASH)。进行中介分析以探讨IR在这些关系中的作用。
结果:共包括4812名参与者,其中43.7%诊断为NAFLD,13.2%进一步诊断为NASH.调整协变量后,NAFLD的风险随着血清铁蛋白的增加而增加(调整比值比[aOR]1.71,95%置信区间[CI]1.37-2.14),UIBC(aOR1.45,95%CI1.17-1.79),和TIBC(aOR1.36,95%CI1.11-1.68)。血清铁蛋白水平(aOR3.70,95%CI2.25-6.19)和TIBC(aOR1.69,95%CI1.13-2.56)也与NASH呈正相关。患有IR的参与者更有可能患有NAFLD/NASH。此外,IR介导的疗效在铁蛋白与NAFLD和NASH之间分别占85.85%和64.51%,分别。
结论:血清铁蛋白和TIBC水平升高与NAFLD和NASH的发生密切相关。IR可能被认为是NAFLD或NASH与血清铁蛋白水平升高之间的可能联系。