BackgroundElevated levels of serum ferritin, a marker of hepatic iron overload and inflammation, may be associated with metabolic dysfunction‐associated steatotic liver disease (MASLD) and hepatic fibrosis.AimTo determine the prevalence of MASLD and significant hepatic fibrosis among patients with type 2 diabetes mellitus (T2DM) and hyperferritinaemia.MethodsThis is a cross‐sectional analysis of a prospective cohort of 523 adults (64% female) aged 50–80 with T2DM and without a diagnosis of haemochromatosis. MASLD and significant fibrosis were defined as magnetic resonance imaging‐proton density fat fraction (MRI‐PDFF) ≥ 5% and magnetic resonance elastography (MRE) ≥ 3.0 kPa, respectively. Hyperferritinaemia was defined as serum ferritin ≥ 200 ng/mL in females or ≥ 300 ng/mL in males. The primary objective was to determine the prevalence of MASLD and significant fibrosis in hyperferritinaemia.ResultsThe mean age and body mass index were 64.1 (±8.1) years and 31.5 (±5.9) kg/m2, respectively. The overall prevalence of hyperferritinaemia was 20.5% (n = 107). The prevalence of MASLD (78.5% vs. 62.1%, p = 0.001) and significant fibrosis (35.5% vs. 22.1%, p = 0.002) were higher in participants with hyperferritinaemia than those without. Hyperferritinaemia remained an independent predictor of MASLD (OR 2.01; 95% CI 1.19–3.39; p = 0.009) and significant fibrosis (OR 2.33; CI 1.43–3.77; p = 0.001), even after adjustment for age, sex, obesity and insulin use.ConclusionApproximately 80% of people with hyperferritinaemia and T2DM have MASLD, and more than a third have significant hepatic fibrosis. Hyperferritinaemia may be a useful biomarker for MASLD and significant fibrosis in people with T2DM.

中文翻译：

---

2 型糖尿病和高铁蛋白血症患者 MASLD 患病率的前瞻性研究


背景血清铁蛋白水平升高是肝铁超负荷和炎症的标志物，可能与代谢功能障碍相关脂肪性肝病 （MASLD） 和肝纤维化有关。目的确定 2 型糖尿病 （T2DM） 和高铁蛋白血症患者中 MASLD 和显着肝纤维化的患病率。方法这是对 523 名年龄在 50-80 岁之间且未诊断为血色病的 T2DM 成人（64% 女性）的前瞻性队列进行的横断面分析。MASLD 和显着纤维化定义为磁共振成像-质子密度脂肪分数 （MRI-PDFF） ≥ 5% 和磁共振弹性成像 （MRE） ≥ 3.0 kPa。高铁蛋白血症定义为女性血清铁蛋白 ≥ 200 ng/mL 或男性血清铁蛋白 ≥ 300 ng/mL。主要目的是确定高铁蛋白血症中 MASLD 和显着纤维化的患病率。结果平均年龄和体重指数分别为 64.1 （±8.1） 岁和 31.5 （±5.9） kg/m2。高铁蛋白血症的总体患病率为 20.5% （n = 107）。高铁蛋白血症参与者的 MASLD 患病率 （78.5% vs. 62.1%，p = 0.001） 和显著纤维化 （35.5% vs. 22.1%，p = 0.002） 高于非高铁蛋白血症参与者。高铁蛋白血症仍然是 MASLD （OR 2.01;95% CI 1.19-3.39;p = 0.009） 和显著纤维化 （OR 2.33;CI 1.43–3.77;p = 0.001），即使在调整了年龄、性别、肥胖和胰岛素使用后也是如此。结论大约 80% 的高铁蛋白血症和 T2DM 患者患有 MASLD，超过 3% 的人患有明显的肝纤维化。高铁蛋白血症可能是 MASLD 和 T2DM 患者严重纤维化的有用生物标志物。