title: Inflammation is not the cause of an elevated serum ferritin in non-alcoholic fatty liver disease.
abstract: BACKGROUND
  In non-alcoholic fatty liver disease (NALFD), it has often been assumed that an elevation in serum ferritin is likely related to inflammation rather than iron overload.
  
  
  METHODS
  Patients referred with NAFLD were entered into a clinical study of phlebotomy therapy. A liver biopsy with liver iron concentration was done at entry and 6 months after phlebotomy (n = 56) until the patient had a low serum ferritin or developed anemia. Serum ferritin was compared to liver iron concentration, ESR, CRP, BMI and grade of inflammation on liver biopsy.
  
  
  RESULTS
  Iron removed by phlebotomy in NAFLD correlated with the decrease in serum ferritin (r = 0.57, p = 0.0014) and liver iron concentration (r = 0.57, p = 0.0013). There was no significant correlations between serum ferritin and ESR, CRP or grade of liver inflammation.
  
  
  CONCLUSIONS
  Serum ferritin is related to liver iron storage in NAFLD and decreasing body iron stores by phlebotomy is reflected by an appropriate decrease in serum ferritin. Inflammation is not the cause of the elevated serum ferritin in fatty liver disease.
authors.affiliation: Departments of Medicine Western University, London, Ontario, Canada.
authors.forename: Melanie D
authors.initials: MD
authors.lastname: Beaton
authors.affiliation: Department of Pathology, Western University, London, Ontario, Canada.
authors.forename: Subrata
authors.initials: S
authors.lastname: Chakrabarti
authors.affiliation: Department of Medicine Western University, London, Ontario, Canada.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Adams
mesh_terms: D000328:Adult; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000276:immunology; D005260:Female; D005293:Ferritins / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000276:immunology; D007501:Iron / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D019190:Iron Overload / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D008099:Liver / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D018962:Phlebotomy
chemical_list: D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron