{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:05:48Z","timestamp":1789758348444,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Hyperferritinemia (HF), defined as elevated serum ferritin (SF) levels, can reflect iron stores and chronic inflammation. However, the prevalence and clinical features of HF in metabolic dysfunction\u2010associated steatotic liver disease (MASLD) have not been systematically evaluated. This systematic review and meta\u2010analysis aimed to examine this topic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and Embase were searched from inception to December 2, 2024 for observational studies reporting the prevalence and\/or impact of HF (under any definition) in MASLD diagnosed by liver biopsy, imaging, or biomarkers. Meta\u2010analysis was performed using random\u2010effects modelling to obtain pooled proportions, odds\/hazard ratios (HRs), and mean differences. PROSPERO ID: CRD420250656514.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 16 studies, involving 49\u2009754 patients with MASLD. The pooled prevalence of HF in MASLD was 26.36% (95% CI 21.03 to 32.49,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999.2%), highest in Asia (30.89%) and lowest in North America (20.22%). Prevalence was greater among biopsy\u2010proven MASLD (32.61%) and similar (24.87%) when restricted to studies using the consensus definition of HF. Compared with non\u2010HF patients, MASLD\u2010HF patients were more likely to be male and exhibited higher levels of triglycerides, HbA1c, insulin resistance, and liver enzymes. HF was associated with features of advanced liver disease, including steatohepatitis and significant fibrosis, and was associated with a higher incidence of liver\u2010related events (HR 2.02, 95% CI 1.50 to 2.71;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HF is present in approximately one in four patients with MASLD and identifies a subgroup with more severe metabolic dysfunction and liver injury. These data highlight SF as a simple, accessible biomarker that may help identify higher\u2010risk MASLD phenotypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70569","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T09:05:21Z","timestamp":1774343121000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and Characteristics of Hyperferritinemia in Metabolic Dysfunction\u2010Associated Steatotic Liver Disease: A Meta\u2010Analysis"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3695-9701","authenticated-orcid":false,"given":"Matheus","family":"Souza","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Federal University of Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2019-4589","authenticated-orcid":false,"given":"Luan C. 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