Cargando…
Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease
BACKGROUND & AIMS: Approximately one‐third of patients with non‐alcoholic fatty liver disease (NAFLD) show signs of mild‐to‐moderate iron overload. The impact of histological iron deposition on the clinical course of patients with NAFLD has not been established. METHODS & RESULTS: For this r...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496452/ https://www.ncbi.nlm.nih.gov/pubmed/32378295 http://dx.doi.org/10.1111/liv.14503 |
_version_ | 1783583100009185280 |
---|---|
author | Eder, Sebastian K. Feldman, Alexandra Strebinger, Georg Kemnitz, Jana Zandanell, Stephan Niederseer, David Strasser, Michael Haufe, Heike Sotlar, Karl Stickel, Felix Paulweber, Bernhard Datz, Christian Aigner, Elmar |
author_facet | Eder, Sebastian K. Feldman, Alexandra Strebinger, Georg Kemnitz, Jana Zandanell, Stephan Niederseer, David Strasser, Michael Haufe, Heike Sotlar, Karl Stickel, Felix Paulweber, Bernhard Datz, Christian Aigner, Elmar |
author_sort | Eder, Sebastian K. |
collection | PubMed |
description | BACKGROUND & AIMS: Approximately one‐third of patients with non‐alcoholic fatty liver disease (NAFLD) show signs of mild‐to‐moderate iron overload. The impact of histological iron deposition on the clinical course of patients with NAFLD has not been established. METHODS & RESULTS: For this retrospective study, 299 consecutive patients with biopsy‐proven NAFLD and a mean follow‐up of 8.4 (±4.1; range: 0.3‐18.0) years were allocated to one of four groups according to presence of hepatic iron in the reticuloendothelial system (RES) and/or hepatocytes (HC): 156 subjects (52%) showed no stainable iron (NONE), 58 (19%) exclusively reticuloendothelial (xRES), 19 (6%) exclusively hepatocellular (xHC) and 66 (22%) showed a mixed (HC/RES) pattern of iron deposition. A long‐term analysis for overall survival, hepatic, cardiovascular or extrahepatic‐malignant events was conducted. Based on multivariate Cox proportional hazards models any reticuloendothelial iron was associated with fatal and non‐fatal hepatic events. Specifically, xRES showed a cause‐specific hazard ratio (csHR) of 2.4 (95%‐CI, 1.0‐5.8; P = .048) for hepatic as well as cardiovascular fatal and non‐fatal events combined (csHR 3.2; 95%‐CI, 1.2‐8.2; P = .015). Furthermore, the mixed HC/RES iron pattern showed a higher rate of combined hepatic fatal and non‐fatal events (csHR 3.6; 95%‐CI, 1.4‐9.5; P = .010), while xHC iron deposition was not associated with any defined events. CONCLUSIONS: The presence of reticuloendothelial‐accentuated hepatic iron distribution patterns is associated with detrimental long‐term outcomes reflected in a higher rate of both liver‐related and cardiovascular fatal and non‐fatal events. |
format | Online Article Text |
id | pubmed-7496452 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74964522020-09-25 Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease Eder, Sebastian K. Feldman, Alexandra Strebinger, Georg Kemnitz, Jana Zandanell, Stephan Niederseer, David Strasser, Michael Haufe, Heike Sotlar, Karl Stickel, Felix Paulweber, Bernhard Datz, Christian Aigner, Elmar Liver Int Metabolic & Toxic Liver Diseases BACKGROUND & AIMS: Approximately one‐third of patients with non‐alcoholic fatty liver disease (NAFLD) show signs of mild‐to‐moderate iron overload. The impact of histological iron deposition on the clinical course of patients with NAFLD has not been established. METHODS & RESULTS: For this retrospective study, 299 consecutive patients with biopsy‐proven NAFLD and a mean follow‐up of 8.4 (±4.1; range: 0.3‐18.0) years were allocated to one of four groups according to presence of hepatic iron in the reticuloendothelial system (RES) and/or hepatocytes (HC): 156 subjects (52%) showed no stainable iron (NONE), 58 (19%) exclusively reticuloendothelial (xRES), 19 (6%) exclusively hepatocellular (xHC) and 66 (22%) showed a mixed (HC/RES) pattern of iron deposition. A long‐term analysis for overall survival, hepatic, cardiovascular or extrahepatic‐malignant events was conducted. Based on multivariate Cox proportional hazards models any reticuloendothelial iron was associated with fatal and non‐fatal hepatic events. Specifically, xRES showed a cause‐specific hazard ratio (csHR) of 2.4 (95%‐CI, 1.0‐5.8; P = .048) for hepatic as well as cardiovascular fatal and non‐fatal events combined (csHR 3.2; 95%‐CI, 1.2‐8.2; P = .015). Furthermore, the mixed HC/RES iron pattern showed a higher rate of combined hepatic fatal and non‐fatal events (csHR 3.6; 95%‐CI, 1.4‐9.5; P = .010), while xHC iron deposition was not associated with any defined events. CONCLUSIONS: The presence of reticuloendothelial‐accentuated hepatic iron distribution patterns is associated with detrimental long‐term outcomes reflected in a higher rate of both liver‐related and cardiovascular fatal and non‐fatal events. John Wiley and Sons Inc. 2020-05-28 2020-08 /pmc/articles/PMC7496452/ /pubmed/32378295 http://dx.doi.org/10.1111/liv.14503 Text en © 2020 The Authors. Liver International published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Metabolic & Toxic Liver Diseases Eder, Sebastian K. Feldman, Alexandra Strebinger, Georg Kemnitz, Jana Zandanell, Stephan Niederseer, David Strasser, Michael Haufe, Heike Sotlar, Karl Stickel, Felix Paulweber, Bernhard Datz, Christian Aigner, Elmar Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
title | Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
title_full | Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
title_fullStr | Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
title_full_unstemmed | Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
title_short | Mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
title_sort | mesenchymal iron deposition is associated with adverse long‐term outcome in non‐alcoholic fatty liver disease |
topic | Metabolic & Toxic Liver Diseases |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496452/ https://www.ncbi.nlm.nih.gov/pubmed/32378295 http://dx.doi.org/10.1111/liv.14503 |
work_keys_str_mv | AT edersebastiank mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT feldmanalexandra mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT strebingergeorg mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT kemnitzjana mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT zandanellstephan mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT niederseerdavid mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT strassermichael mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT haufeheike mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT sotlarkarl mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT stickelfelix mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT paulweberbernhard mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT datzchristian mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease AT aignerelmar mesenchymalirondepositionisassociatedwithadverselongtermoutcomeinnonalcoholicfattyliverdisease |