{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:13:46Z","timestamp":1791818026561,"version":"4.3.4"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":1339,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:bold>Serum ferritin (SF) levels are commonly elevated in patients with nonalcoholic fatty liver disease (NAFLD) because of systemic inflammation, increased iron stores, or both. The aim of this study was to examine the relationship between elevated SF and NAFLD severity. Demographic, clinical, histologic, laboratory, and anthropometric data were analyzed in 628 adult patients with NAFLD (age, \u226518 years) with biopsy\u2013proven NAFLD and an SF measurement within 6 months of their liver biopsy. A threshold SF &gt;1.5 \u00d7 upper limit of normal (ULN) (i.e., &gt;300 ng\/mL in women and &gt;450 ng\/mL in men) was significantly associated with male sex, elevated serum alanine aminotransferase, aspartate aminotransferase, iron, transferrin\u2013iron saturation, iron stain grade, and decreased platelets (<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>&lt; 0.01). Histologic features of NAFLD were more severe among patients with SF &gt;1.5 \u00d7 ULN, including steatosis, fibrosis, hepatocellular ballooning, and diagnosis of NASH (<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>&lt; 0.026). On multiple regression analysis, SF &gt;1.5 \u00d7 ULN was independently associated with advanced hepatic fibrosis (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.05\u20132.62;<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>= 0.028) and increased NAFLD Activity Score (NAS) (OR, 1.99; 95% CI, 1.06\u20133.75;<\/jats:bold>\n                      <jats:bold>P<\/jats:bold>\n                      <jats:bold>= 0.033).<\/jats:bold>\n                      <jats:bold>Conclusions:<\/jats:bold>\n                      <jats:bold>A SF &gt;1.5 \u00d7 ULN is associated with hepatic iron deposition, a diagnosis of NASH, and worsened histologic activity and is an independent predictor of advanced hepatic fibrosis among patients with NAFLD. Furthermore, elevated SF is independently associated with higher NAS, even among patients without hepatic iron deposition. We conclude that SF is useful to identify NAFLD patients at risk for NASH and advanced fibrosis. 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