High serum ferritin, being a hallmark of hereditary hemochromatosis , is frequently found in chronic hepatitis C, alcoholic or non-alcoholic steatohepatitis and non-alcoholic fatty liver disease patients . A study in Italy has investigated the link between ferritin and steatosis in a non-obese cohort of non-alcoholic patients. In southern European populations, high ferritin levels, after exclusion of diagnosis of HH, represent a risk factor for steatosis and clinical relevance, being associated with low platelet count.
Patients with chronic hepatitis C virus (HCV) infection often have elevated serum iron indices, but these do not accurately reflect hepatic iron content, nor are they able to predict clinically important endpoints, such as progression of fibrosis and responsiveness to interferon-based regimens. Studies that attempt to link iron and the course of chronic hepatitis C have been inconclusive. In chronic hepatitis C, steatosis is a common histological finding, occurring in 30%-70% of such patients. The biological mechanism underlying steatosis in HCV infection is not definitively understood, and is considered to be multifactorial with metabolic mechanisms, including insulin resistance and iron overload.
A research article to be published on May 7, 2009 in the World Journal of Gastroenterology addresses this question. The research team led by Professor Licata from Gastroenterology and Hepatology Unit of Palermo University analyzed in a cross-sectional study, a cohort of non-obese, non-alcoholic patients with compensated chronic liver disease characterized by elevated serum ferritin levels, of varying etiology, excluding hemochromatosis, to reassess the link between hyperferritinemia and other markers of the metabolic syndrome, mainly steatosis. All data provide further evidence that hyperferritinemia might be another surrogate marker of advanced liver disease of any etiology.