{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T04:16:00Z","timestamp":1750306560805,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":61,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772170"],"award-info":[{"award-number":["81772170"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Iron metabolism and insulin resistance (IR) are closely related to non\u2010alcoholic fatty liver disease (NAFLD). However, the interplay between them on the occurrence and progression of NAFLD is not fully understood. We aimed to disentangle the crosstalk between iron metabolism and IR and explore its impact on NAFLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed data from the National Health and Nutritional Examination Survey (NHANES) 2017\u20132018 to evaluate the association between serum iron metabolism indicators (ferritin, serum iron, unsaturated iron\u2010binding capacity [UIBC], total iron\u2010binding capacity [TIBC], transferrin saturation, and transferrin receptor) and NAFLD\/non\u2010alcoholic steatohepatitis (NASH). Mediation analysis was conducted to explore the role of IR played in these relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u20132.14), UIBC (aOR\u20091.45, 95% CI 1.17\u20131.79), and TIBC (aOR\u20091.36, 95% CI 1.11\u20131.68). Higher levels of serum ferritin (aOR 3.70, 95% CI 2.25\u20136.19) and TIBC (aOR 1.69, 95% CI 1.13\u20132.56) were also positively associated with NASH. Participants with IR were more likely to have NAFLD\/NASH. Moreover, IR\u2010mediated efficacy accounted for 85.85% and 64.51% between ferritin and NAFLD and NASH, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Higher levels of\u00a0serum 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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1751-2980.13292","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:29:04Z","timestamp":1719826144000},"page":"285-297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Potential mediation effect of insulin resistance on the association between iron metabolism indicators and non\u2010alcoholic fatty liver disease"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4230-4059","authenticated-orcid":false,"given":"Xin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health Fudan University  Shanghai China"},{"name":"Key Laboratory of Public Health Safety (Fudan University), Ministry of Education  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin Yu","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health Fudan University  Shanghai China"},{"name":"Key Laboratory of Public Health Safety (Fudan University), Ministry of Education  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health Fudan University  Shanghai China"},{"name":"Key Laboratory of Public Health Safety (Fudan University), Ministry of Education  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng Nan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health Fudan University  Shanghai China"},{"name":"Key Laboratory of Public Health Safety (Fudan University), Ministry of Education  Shanghai 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Jiangsu Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tie Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health Fudan University  Shanghai China"},{"name":"Key Laboratory of Public Health Safety (Fudan University), Ministry of Education  Shanghai China"},{"name":"Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health Fudan University  Shanghai China"},{"name":"Yiwu Research Institute Fudan University  Yiwu Zhejiang Province 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