الفهرس 
Nonalcoholic fatty liver diseaseOnly 14 pages are availabe for public view
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Abstract
Background
Nonalcoholic fatty liver disease (NAFLD) has become the most prevalent cause of liver disease in western countries. The development of fibrosis identifies the risk group with an increased incidence of liver-related deaths.
Aim
The aim of the present study is to assess the value of serum ferritin in prediction of hepatic fibrosis in NAFLD.
Methods
The study included 113patients who were classified into 3 groups: group I: 30 healthy subjects as control with no evidence of NAFLD.group II: 31 NAFLD patients without fibrosis group III: 52 patients with hepatic fibrosis on top of NAFLD.patients under study were subjected to detailed History taking, full physical examination and laboratory investigations. FIB4 was calculated and liver biopsy was done for all patients.In addition, all patients and controls were assessed for serum ferritin level using a commercially available ELISA kit.
Results
The study has demonstrated that hepatic fibrosis patients on top of NAFLD had a highly significant increase serum ferritin levels in hepatic fibrosis patients than controls while there is no significant difference in serum ferritin level among NAFLD patients than controls.
Diagnostic performance study using ROC curve analysis and multiple cut-off levels of serum ferritin for discriminating NAFLD patients from those controls revealed that an optimum cut-off level of 39.5 ng/ml was the best to predict NAFLD with diagnostic sensitivity and specificity of (74%, 33% respectively) and area under the curve=0.642.
Another diagnostic performance study using ROC curve analysis and multiple cut-off levels of serum ferritin for discriminating NAFLD patients with fibrosis from those without fibrosis revealed that an optimum cut-off level of 51.95 ng/ml was the best to predict fibrosis on top of NAFLD with diagnostic sensitivity and specificity of (65%, 60% respectively) and area under the curve=0.658.
BMI, TLC and Alkaline phosphatase were independent predictors of occurrence of NAFLD and TLC was independent predictor of occurrence of fibrosis on top of NAFLD.
Conclusion
The present study suggests a role for serum ferritin as an indicator of fibrosis in Non-alcoholic fatty liver disease as it plays a role in the pathogenesis of metabolic syndrome, NAFLD and fibrosis. Serum ferritin was found to be a predictor of fibrosis on top of NAFLD with moderate sensitivity and specificity, which necessitates further studies on larger scale that could promise to put serum ferritin for longitudinal assessment of NAFLD and as a candidate drug target where iron depletion and phlebotomy could be used for the treatment of fibrosis on top of NAFLD.