The association between non‐alcoholic fatty liver disease and serum ferritin levels in American adults

BACKGROUND: Elevated serum ferritin levels (SFLs) was previously reported to be related with hepatic histologic severity and advanced liver fibrosis among non‐alcoholic fatty liver disease (NAFLD) patients. However, whether NAFLD influences SFLs remains uncertain and needs more clinical evidences. This study explored the differences of SFLs in US adults with or without NAFLD. METHODS: We conducted a cross‐sectional study of 3689 participants aged 18–80 years using the National Health and Nutrition Examination Survey (NHANES) 2017–2018 cycle. NAFLD status was confirmed based on controlled attenuation parameter (CAP) values ≥274 dB/m through vibration controlled and transient elastography (VCTE). We performed weighted multivariable logistic regression models to evaluate the associations between NAFLD and SFLs in different age and gender. RESULTS: There was a positive association between NAFLD and SFLs in all three models (model 1:β = 23.07, 95% CI: 10.32, 35.81; model 2:β = 23.68, 95% CI: 10.86, 36.50; model 3:β = 13.86, 95% CI: 0.29, 27.43). After adjusting for the covariates, this positive association persisted in females (β = 16.22, 95% CI: 2.81, 29.62). Further, relationships between NAFLD and SFLs were significantly different in various age groups. In the subgroup stratified by gender, their associations further differed. In males, the positive association was more prominent in 50–64 age group (β = 70.89, 95% CI: 25.14, 116.64). In females, this positive association was more prominent in 18–34 age group (β = 20.72, 95% CI: 7.45, 33.99). However, no correlations between severe steatosis, significant fibrosis, advanced fibrosis, cirrhosis, and SFLs in adults with NAFLD were found. CONCLUSION: This study indicated that US adults suffered with NAFLD had significantly higher SFLs compared with their counterparts in non‐NAFLD group. Moreover, the associations between NAFLD and SFLs further differed by age and gender.