Exploring the relationship between serum ferritin and metabolic-associated fatty liver disease in adolescents based on NHANES database

Corresponding author: Xu Xiahong, lmm02075@glhospital.com

DOI: 10.12201/bmr.202503.00012

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  Abstract: Objective To investigate the relationship between serum ferritin and metabolic-associated fatty liver disease (MAFLD) in adolescents. Methods This study utilized data from the 2017~2020 NHANES database, ultimately including 559 adolescents aged 12~18 years, divided into the MAFLD group (119 cases) and the non-MAFLD group (440 cases). Data on demographic characteristics, serum iron metabolism indicators, liver function, lipid profiles, glucose levels, and other relevant parameters were collected. Liver steatosis and fibrosis were assessed using vibration-controlled transient elastography (VCTE). Pearson correlation and logistic regression analyses were performed to evaluate the relationship between serum ferritin and MAFLD. Results Serum ferritin levels were significantly higher in the MAFLD group compared to the non-MAFLD group (P<0.05). Pearson correlation analysis indicated that serum ferritin was positively correlated with the controlled attenuation parameter (CAP), liver stiffness measurement (LSM), body mass index (BMI), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), triglycerides, and uric acid levels (P<0.05), but negatively correlated with high-density lipoprotein cholesterol levels (P<0.05). Logistic regression analysis revealed that while the risk of MAFLD significantly increased in the highest quartile of serum ferritin (Q4) without adjusting for covariates, this association disappeared after adjusting for gender, age, race, BMI, and other factors. BMI (OR=1.250, 95%CI=1.176~1.329), globulin (OR=2.991, 95%CI=1.218~7.343), ALT (OR=1.052, 95%CI=1.003~1.104), and white blood cell count (OR=1.225, 95% CI=1.041~1.441) were identified as independent risk factors for MAFLD. Conclusion Serum ferritin levels are significantly elevated in adolescents with MAFLD but are not independently associated with the occurrence of MAFLD. BMI, globulin, ALT, and white blood cell count are important risk factors for adolescent MAFLD.

  Key words: Metabolic-associated fatty liver disease; serum ferritin; Adolescents

  Submit time: 5 March 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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