Details

Autor(en) / Beteiligte

• Armandi, Angelo
• Sanavia, Tiziana
• Younes, Ramy
• Caviglia, Gian Paolo
• Rosso, Chiara
• Govaere, Olivier
• Liguori, Antonio
• Francione, Paolo
• Gallego-Duràn, Rocìo
• Ampuero, Javier
• Pennisi, Grazia
• Aller, Rocio
• Tiniakos, Dina
• Burt, Alastair
• David, Ezio
• Vecchio, Fabio
• Maggioni, Marco
• Cabibi, Daniela
• McLeod, Duncan
• Pareja, Maria Jesus
• Zaki, Marco Y W
• Grieco, Antonio
• Stål, Per
• Kechagias, Stergios
• Fracanzani, Anna Ludovica
• Valenti, Luca
• Miele, Luca
• Fariselli, Piero
• Eslam, Mohammed
• Petta, Salvatore
• Hagström, Hannes
• George, Jacob
• Schattenberg, Jörn M
• Romero-Gómez, Manuel
• Anstee, Quentin Mark
• Bugianesi, Elisabetta

Titel

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

Ist Teil von

• Gut, 2024, Vol.73 (5), p.825-834

Ort / Verlag

England: BMJ Publishing Group Ltd and British Society of Gastroenterology

Erscheinungsjahr

2024

Beschreibungen/Notizen

• ObjectiveHyperferritinaemia 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.DesignWe 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.ResultsMedian 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 µg/L (median HR=1.71 and C-index=0.71) and the risk of overall mortality from threshold 272 µg/L (median HR=1.49 and C-index=0.70). The inclusion of serum ferritin thresholds (215.5 µg/L and 272 µg/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).ConclusionsThis study supports the potential use of serum ferritin values for predicting the long-term prognosis of patients with MASLD.