{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:20:37Z","timestamp":1783070437193,"version":"3.54.6"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Currently, there is no information about the association between circulating levels of ferritin and hepcidin and liver fibrosis in patients with type 2 diabetes mellitus (T2DM) and non\u2010alcoholic fatty liver disease (NAFLD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 153 patients with T2DM with no known liver diseases, who consecutively attended our diabetes outpatient service and who underwent liver ultrasonography and liver stiffness measurement (LSM) by vibration\u2010controlled transient elastography (Fibroscan<jats:sup>\u00ae<\/jats:sup> for the non\u2010invasive assessment of liver fibrosis). Plasma ferritin and hepcidin concentrations were measured with an electrochemiluminescence immunoassay and mass spectrometry\u2010based assay, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After stratification of patients by LSM tertiles [1st tertile median LSM: 3.6 (interquartile range: 3.3\u20134.0) kPa, 2nd tertile: 5.3 (4.9\u20135.9) kPa and 3rd tertile: 7.9 (6.7\u20139.4) kPa], we found that plasma ferritin and hepcidin concentrations increased across LSM tertiles [median ferritin: 68.7 (interquartile range: 25.1\u2013147) vs. 85.8 (48.3\u2013139) vs. 111 (59.3\u2013203) \u03bcg\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.021; median hepcidin: 2.5 (1.1\u20135.2) vs. 4.4 (2.5\u20137.3) vs. 4.1 (1.9\u20136.8) nmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.032]. After adjustment for age, sex, diabetes duration, waist circumference, haemoglobin A1c, HOMA\u2010insulin resistance score, triglycerides, haemoglobin, presence of hepatic steatosis on ultrasonography and patatin\u2010like phospholipase domain\u2010containing\u20103 (<jats:italic>PNPLA3<\/jats:italic>) rs738409 genetic variant, higher plasma ferritin levels were associated with greater LSM values (adjusted\u2010odds ratio 2.10, 95% confidence interval 1.23\u20133.57, <jats:italic>p<\/jats:italic>\u2009=\u20090.005). Higher plasma hepcidin levels were also associated with greater LSM values (adjusted\u2010odds ratio 1.90, 95% confidence interval 1.15\u20133.13, <jats:italic>p<\/jats:italic>\u2009=\u20090.013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Higher levels of plasma ferritin and hepcidin were associated with greater NAFLD\u2010related liver fibrosis (assessed by LSM) in patients with T2DM, even after adjustment for established cardiometabolic risk factors, diabetes\u2010related variables and other potential confounders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15649","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T07:00:33Z","timestamp":1686726033000},"page":"2434-2444","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Associations between higher plasma ferritin and hepcidin levels with liver stiffness in patients with type 2 diabetes: An exploratory study"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6329","authenticated-orcid":false,"given":"Alessandro","family":"Mantovani","sequence":"first","affiliation":[{"name":"Section of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3420-4998","authenticated-orcid":false,"given":"Alessandro","family":"Csermely","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Castagna","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Internal Medicine, EuroBloodNet Center University of Verona and Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Antinori","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Internal Medicine, EuroBloodNet Center University of Verona and Azienda Ospedaliera Universitaria Integrata Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Danese","sequence":"additional","affiliation":[{"name":"Section of Clinical Biochemistry, Department of Engineering for Innovation Medicine University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Zusi","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Sciences, Dentistry, Pediatrics and Gynaecology University Hospital of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Sani","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, Diabetes and Metabolism, Department of Medicine University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1142-8585","authenticated-orcid":false,"given":"Federico","family":"Ravaioli","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Specialities University Hospital of Modena, University of Modena &amp; Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Medical Specialities University Hospital of Modena, University of Modena &amp; Reggio Emilia  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-4404","authenticated-orcid":false,"given":"Claudio","family":"Maffeis","sequence":"additional","affiliation":[{"name":"Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Sciences, Dentistry, Pediatrics and Gynaecology University Hospital of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8909-0345","authenticated-orcid":false,"given":"Luca","family":"Valenti","sequence":"additional","affiliation":[{"name":"Precision Medicine\u2014Biological Resource Center, Transfusion Medicine Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico Milano  Milan Italy"},{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan 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