Potential mediation effect of insulin resistance on the association between iron metabolism indicators and non‐alcoholic fatty liver disease

内科学 医学 脂肪肝 胰岛素抵抗 转铁蛋白饱和度 优势比 铁蛋白 总铁结合能力 全国健康与营养检查调查 内分泌学 胃肠病学 血清铁 置信区间 转铁蛋白 胰岛素 疾病 人口 贫血 环境卫生 血清铁蛋白
作者
Xin Zhang,Xin Han,Hong Fan,Cheng Nan Guo,Yi Li,Hai Li Wang,Zhen Qiu Liu,Tiejun Zhang
出处
期刊:Journal of Digestive Diseases [Wiley]
卷期号:25 (5): 285-297
标识
DOI:10.1111/1751-2980.13292
摘要

Objectives Iron metabolism and insulin resistance (IR) are closely related to non‐alcoholic 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. Methods We analyzed data from the National Health and Nutritional Examination Survey (NHANES) 2017–2018 to evaluate the association between serum iron metabolism indicators (ferritin, serum iron, unsaturated iron‐binding capacity [UIBC], total iron‐binding capacity [TIBC], transferrin saturation, and transferrin receptor) and NAFLD/non‐alcoholic steatohepatitis (NASH). Mediation analysis was conducted to explore the role of IR played in these relationship. Results 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] 1.37–2.14), UIBC (aOR 1.45, 95% CI 1.17–1.79), and TIBC (aOR 1.36, 95% CI 1.11–1.68). Higher levels of serum ferritin (aOR 3.70, 95% CI 2.25–6.19) and TIBC (aOR 1.69, 95% CI 1.13–2.56) were also positively associated with NASH. Participants with IR were more likely to have NAFLD/NASH. Moreover, IR‐mediated efficacy accounted for 85.85% and 64.51% between ferritin and NAFLD and NASH, respectively. Conclusion Higher levels of serum 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.
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