Objective: To analyze the correlation between serum ferritin and steatosis in non-alcoholic fatty liver disease. Methods: Data of 167 cases who underwent liver biopsy in the Affiliated Hospital of Hangzhou Normal University were collected. Hydrogen proton magnetic resonance spectroscopy were performed within one week. The pathological results of liver biopsy were used as the gold standard to analyze the case data, serological indicators, magnetic resonance spectroscopy-proton density fat fraction. Results: Pathological monitoring result showed that the serum ferritin in patients without steatosis, and with mild, moderate and severe steatosis were (206.20 ± 189.83), (286.65 ± 200.80), (326.55 ± 214.71), (391.50 ± 184.93) ng/ml, respectively, P < 0.005. Serum ferritin was correlated to body mass index, PDFF, alanine aminotransferase, gamma glutamyltransferase, low-density lipoprotein, high-density lipoprotein. The area under the receiver operating characteristic curve with ferritin for the diagnosis of non-alcoholic fatty liver disease was 0.716, and the optimal diagnostic threshold was 214.56 ng/ml. The sensitivity and specificity were 80.1%, and 68.8%, respectively. There was no statistically significant difference between the intralobular inflammation, fibrosis, and ferritin. Prussian blue iron staining had no apparent deposition of iron particles. Conclusion: Ferritin has significant positive correlation with the results of pathological and magnetic resonance imaging for liver steatosis. Therefore, it can be used as a non-invasive diagnostic method for liver steatosis evaluation.
目的: 血清铁蛋白和非酒精性脂肪性肝病脂肪变的相关性分析。 方法: 收集167例杭州师范大学附属医院行肝穿刺活组织检查患者资料,1周内行氢质子磁共振波谱检查,以肝活组织检查病理结果为金标准分析病例资料、血清学指标、磁共振波谱质子密度脂肪分数。 结果: 病理检测结果显示无脂肪变、轻度、中度、重度脂肪变患者血清铁蛋白分别是(206.20±189.83)、(286.65±200.80)、(326.55±214.71)、(391.50±184.93)ng/ml,P < 0.005。和血清铁蛋白有相关性的分别是人体质量指数、PDFF、丙氨酸转氨酶、γ-谷氨酰转移酶、低密度脂蛋白、高密度脂蛋白。应用铁蛋白诊断非酒精性脂肪性肝病的受试者操作特征曲线面积为0.716,最佳诊断阈值为214.56 ng/ml,敏感度为80.1%,特异度为68.8%,小叶内炎症以及纤维化与铁蛋白之间差异无统计学意义,普鲁士蓝特殊染色未见明显铁沉积颗粒。 结论: 铁蛋白与肝脏脂肪变性的病理脂肪变结果和磁共振检测结果具有明显正相关,可作为肝脂肪变性的非侵入性诊断方法进行评估。.
Keywords: Ferritin; Magnetic resonance spectroscopy; Non-alcoholic fatty liver disease; Pathology.