Steatohepatitis/Metabolic Liver Disease
Article first published online: 29 NOV 2010
Copyright © 2010 American Association for the Study of Liver Diseases
Volume 53, Issue 2, pages 448–457, February 2011
How to Cite
Nelson, J. E., Wilson, L., Brunt, E. M., Yeh, M. M., Kleiner, D. E., Unalp-Arida, A. and Kowdley, K. V. (2011), Relationship between the pattern of hepatic iron deposition and histological severity in nonalcoholic fatty liver disease. Hepatology, 53: 448–457. doi: 10.1002/hep.24038
Potential conflict of interest: Nothing to report.
A list of the members of the Nonalcoholic Steatohepatitis Clinical Research Network can be found in the supporting information.
- Issue published online: 27 JAN 2011
- Article first published online: 29 NOV 2010
- Accepted manuscript online: 11 OCT 2010 10:06AM EST
- Manuscript Accepted: 10 SEP 2010
- Manuscript Received: 13 JUL 2010
- Intramural Research Program of the National Cancer Institute
Previous studies examining the relationship between hepatic iron deposition and histological severity in nonalcoholic fatty liver disease (NAFLD) have been inconclusive. The goal of this study was to examine the relationship between hepatic iron deposition and liver histology in 849 patients enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network. Hepatic iron staining was performed in a central laboratory, and the stains were scored for grade and cellular and parenchymal localization by a central pathology committee; the relationship between the grade and pattern of iron deposition and the clinical, laboratory, and histological variables was examined with univariate and multivariate analyses. Stainable hepatic iron was present in 293 of 849 patients (34.5%) in one of three histological patterns: a hepatocellular (HC) pattern [63/849 (7.4%)], a reticuloendothelial system (RES) cell pattern [91/849 (10.7%)], or a mixed RES/HC pattern [139/849 (16.4%)]. Patients with the RES iron-staining pattern were more likely to have advanced fibrosis compared to those with those with HC iron (P = 0.01). Patients with RES iron were also more likely to have advanced histological features such as fibrosis (P = 0.049), portal inflammation (P = 0.002), HC ballooning (P = 0.006), and definite nonalcoholic steatohepatitis (P = 0.007) compared to those with patients with HC or mixed iron patterns. The presence of RES iron (odds ratio = 1.60, 95% confidence interval = 1.10-2.33, P = 0.015) was independently associated with advanced hepatic fibrosis on multiple regression analysis after adjustments for age, gender, diabetes status, and body mass index. Conclusion: The presence and pattern of hepatic iron deposition are associated with distinct histological features in patients with NAFLD and may have implications for pathophysiology and therapy. (HEPATOLOGY 2011;53:448-457)