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Serum ferritin levels can predict long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease

Armandi, Angelo (author)
Univ Turin, Italy; Univ Med Ctr, Germany
Sanavia, Tiziana (author)
Univ Turin, Italy
Younes, Ramy (author)
Boehringer Ingelheim Int GmbH, Germany
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Caviglia, Gian Paolo (author)
Univ Turin, Italy
Rosso, Chiara (author)
Univ Turin, Italy
Govaere, Olivier (author)
Newcastle Univ, England
Liguori, Antonio (author)
Fdn Policlin Univ A Gemelli IRCCS, Italy; Fdn Policlin Univ A Gemelli IRCCS, Italy; Univ Cattolica Sacro Cuore, Italy
Francione, Paolo (author)
Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy
Gallego-Duran, Rocio (author)
Virgen Rocio Univ Hosp, Spain
Ampuero, Javier (author)
Virgen Rocio Univ Hosp, Spain
Pennisi, Grazia (author)
Univ Palermo, Italy
Aller, Rocio (author)
Hosp Clin Valladolid, Spain
Tiniakos, Dina (author)
Newcastle Univ, England; Natl & Kapodistrian Univ Athens, Greece
Burt, Alastair (author)
Newcastle Univ, England
David, Ezio (author)
Univ Turin, Italy
Vecchio, Fabio (author)
Dipartimento Univ Med & Chirurg Traslazionale, Italy
Maggioni, Marco (author)
Ca Granda IRCCS Fdn, Italy
Cabibi, Daniela (author)
Univ Palermo, Italy
Mcleod, Duncan (author)
Westmead Hosp, Australia
Pareja, Maria Jesus (author)
Hosp Univ Valme, Spain
Zaki, Marco Y. W. (author)
Newcastle Univ, England; Minia Univ, Egypt
Stal, Per (author)
Karolinska Univ Hosp, Sweden; Huddinge Karolinska Inst, Sweden
Kechagias, Stergios (author)
Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
Fracanzani, Anna Ludovica (author)
Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy; Univ Milan, Italy
Valenti, Luca (author)
Univ Milan, Italy; Fdn IRCCS Ca Granda Osped Maggiore Policlin Milano, Italy
Grieco, Antonio (author)
Dipartimento Univ Med & Chirurg Traslazionale, Italy
Miele, Luca (author)
Fdn Policlin Univ A Gemelli IRCCS, Italy; Fdn Policlin Univ A Gemelli IRCCS, Italy; Univ Cattolica Sacro Cuore, Italy
Fariselli, Piero (author)
Univ Turin, Italy
Eslam, Mohammed (author)
Univ Sydney, Australia
Petta, Salvatore (author)
Univ Palermo, Italy
Hagstroem, Hannes (author)
Karolinska Univ Hosp, Sweden; Huddinge Karolinska Inst, Sweden
George, Jacob (author)
Univ Sydney, Australia
Schattenberg, Joern M. (author)
Univ Med Ctr, Germany; Saarland Univ, Germany
Romero-Gomez, Manuel (author)
Virgen Rocio Univ Hosp, Spain
Anstee, Quentin Mark (author)
Newcastle Univ, England; Newcastle Tyne Hosp NHS Fdn Trust, England
Bugianesi, Elisabetta (author)
Univ Turin, Italy
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 (creator_code:org_t)
2024
2024
English.
In: Gut. - : BMJ PUBLISHING GROUP. - 0017-5749 .- 1468-3288.
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Objective Hyperferritinaemia is associated with liver fibrosis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), but the longitudinal implications have not been thoroughly investigated. We assessed the role of serum ferritin in predicting long-term outcomes or death. Design We evaluated the relationship between baseline serum ferritin and longitudinal events in a multicentre cohort of 1342 patients. Four survival models considering ferritin with confounders or non-invasive scoring systems were applied with repeated five-fold cross-validation schema. Prediction performance was evaluated in terms of Harrell's C-index and its improvement by including ferritin as a covariate. Results Median follow-up time was 96 months. Liver-related events occurred in 7.7%, hepatocellular carcinoma in 1.9%, cardiovascular events in 10.9%, extrahepatic cancers in 8.3% and all-cause mortality in 5.8%. Hyperferritinaemia was associated with a 50% increased risk of liver-related events and 27% of all-cause mortality. A stepwise increase in baseline ferritin thresholds was associated with a statistical increase in C-index, ranging between 0.02 (lasso-penalised Cox regression) and 0.03 (ridge-penalised Cox regression); the risk of developing liver-related events mainly increased from threshold 215.5 mu g/L (median HR=1.71 and C-index=0.71) and the risk of overall mortality from threshold 272 mu g/L (median HR=1.49 and C-index=0.70). The inclusion of serum ferritin thresholds (215.5 mu g/L and 272 mu g/L) in predictive models increased the performance of Fibrosis-4 and Non-Alcoholic Fatty Liver Disease Fibrosis Score in the longitudinal risk assessment of liver-related events (C-indices>0.71) and overall mortality (C-indices>0.65). Conclusions This study supports the potential use of serum ferritin values for predicting the long-term prognosis of patients with MASLD.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Keyword

NONALCOHOLIC STEATOHEPATITIS; FIBROSIS

Publication and Content Type

ref (subject category)
art (subject category)

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