Format

Send to

Choose Destination
J Hepatol. 2011 Sep;55(3):647-653. doi: 10.1016/j.jhep.2010.12.007. Epub 2010 Dec 17.

Early interplay of intra-hepatic iron and insulin resistance in children with non-alcoholic fatty liver disease.

Author information

1
Laboratorio di Malattie Epatiche Auto-Immuni e Metaboliche, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italy. Electronic address: melania.manco@opbg.net.
2
Laboratorio di Malattie Epatiche Auto-Immuni e Metaboliche, Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italy.
3
Section of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomédica de Girona and CIBER Fisiopatología de la Obesidad y Nutrición, Girona, Spain.
4
Unità di Medicina Trasfusionale ed Immuno-Ematologia, Ospedale Santa Maria Goretti, Latina, Italy.
5
Dipartimento di Medicina Interna, Università degli Studi di Milano, Ospedale Maggiore "Ca' Granda", IRCCS, Milano, Italy.

Abstract

BACKGROUND & AIMS:

The liver is a crucial organ at the crossroads of iron and glucose metabolism. The aim of the study was to assess intra-hepatic iron in young patients with non-alcoholic fatty liver disease (NAFLD) and its association with insulin resistance and severity of liver damage.

METHODS:

Intrahepatic iron content was assessed (Pearl's stain grade) in 66 patients (41 males, age 3.3-17.6years) with biopsy-proven NAFLD. Mutations of the Hereditary Hemochromatosis (HFE) gene were determined by sequence allele-specific polymerase chain reaction. Insulin resistance was estimated by means of the Oral Glucose Tolerance Test and the Insulin Sensitivity Index (ISI); the Insulino-Genic Index was also calculated. Tumor necrosis factor-alpha and interleukin-6 were measured.

RESULTS:

Low-mild intra-hepatic iron deposition was observed in one out of five children (n=15, 22%), and it was not associated with HFE mutations, carried by 17 patients (26%). Among carriers of HFE mutations, four had siderosis. No abnormalities were observed in systemic indices of iron balance. Serum ferritin was within normal adult ranges in all patients (33.6±7.6ng/ml), but it was correlated with ISI (r(o)=-0.361; p=0.003). No significant difference was observed in insulin sensitivity, iron balance, inflammatory milieu, and liver histology between patients with and without hepatic siderosis.

CONCLUSIONS:

In young obese individuals with NAFLD, despite normal peripheral iron parameters, mild intra-hepatic iron deposition is a frequent finding, but it is not associated with insulin resistance or severity of liver damage. Longitudinal studies are required to define the long-term relevance of these findings.

PMID:
21168460
DOI:
10.1016/j.jhep.2010.12.007
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center