Serum ferritin level is associated with liver fibrosis and incident liver-related outcomes independent of genotype in the general population.

Background & Aims: Hyperferritinemia reflects iron accumulation in the body and has been associated with metabolic disturbances and alcohol use, and is also a common finding in individuals diagnosed with liver disease. The major genetic regulator of iron metabolism is the gene.

Methods: The aim of this this study was to investigate the association between serum ferritin and liver fibrosis using the enhanced liver fibrosis (ELF) test, and the association between ferritin and liver-related outcomes in a Finnish population-based cohort of 6194 individuals (45% male, mean [± standard deviation] age, 52.9 ± 14.9 years; body mass index 26.9 ± 4.7 kg/m). The effects of variants on these associations were also evaluated.

Results: Serum ferritin levels were significantly associated with liver fibrosis, as estimated by enhanced liver fibrosis (ELF) test in weighted linear regression analysis. Serum ferritin was significantly associated with both all liver-related outcomes ( = 92) and severe liver-related outcomes ( = 54) in weighted Cox regression analysis (hazard ratio [HR] per 1 SD, 1.11 [95% confidence interval (CI) 1.02-1.21];  = 0.012 and HR 1.11 [95% CI 1.02-1.21];  = 0.013, respectively). However, there was association neither between risk variants and ELF test nor between risk variants and liver-related outcomes.

Conclusion: Serum ferritin levels were associated with liver fibrosis and incident liver disease, independent of genotype in the general population. Furthermore, data demonstrated that metabolic disturbances and alcohol use were major risk factors for hyperferritinemia.