SERUM HEPCIDIN LEVEL AND IRON PROFILE IN OBESE PATIENTS WITH NON ALCOHOLIC FATTY LIVER DISEASE

Abstract

NAFLD is the most common cause of chronic liver injury worldwide. It has been documented in 10 to 15 percent of normal individuals and 70 to 80 percent of obese individuals (Bellentani et al., 2000). The prevalence of NAFLD has doubled during last 20 years and is the leading cause of liver disease in the western countries, but recent data confirmed that NAFLD play an equally important role worldwide and it is the third most common risk factor for HCC after viral infection and alcohol (LaBrecque et al., 2014). The liver has important role in the regulation of iron homeostasis. Primarily, it is one of the major storage sites of iron. Additionally, it produces transferrin, iron carrier glycoprotein in the plasma and hepcidin, the key hormone regulating the systemic iron homeostasis (Park et al., 2001). Hepcidin controls plasma iron concentration and tissue distribution of iron by inhibiting intestinal and macrophage iron efflux. Iron per se has also been shown to modulate hepcidin levels, thus hepcidin is now considered as the iron hormone (Kemna et al., 2007).

In this case-control study, 60 obese individuals with BMI <30 kg/m2 participated in the study in the period extended from March 2016 to November 2016 in Internal Medicine clinic at Air Force General Hospital, Egypt. we included both gender aging more than 18 years old and we excluded positive patients for HCVAb or HBsAg, history of alcoholic patients, patients with History of hepatotoxic drugs intake and Patients with (Autoimmune hepatitis, Hemochromatosis, Wilson’s disease and Alpha-1 antitrypsin deficiency). All candidates were informed about the purpose and nature of the study, written and informed consent was obtained, all subjects underwent ultrasonography of the liver. Fatty liver was diagnosed in the presence of two of the three following criteria: Increased hepatic echogenicity compared to the spleen or the kidney, Blurring of liver vasculature and deep attenuation of the ultrasonographic signal. NAFLD was diagnosed in subjects who fulfilled ultrasonographic criteria for fatty liver, and who did not report alcohol consumption above the safe limit and their investigations were negative for other causes of chronic liver disease, all individuals were subjected to complete medical history. Full physical examination including anthropometry: Weight (Kg), height (cm), BMI (Kg/m²), abdominal ultrasonography, CBC, liver function tests (ALT, AST, total bilirubin, direct bilirubin, total protein and serum albumin), kidney function tests (serum urea, serum uric acid and serum creatinine), viral markers (HCVAb and HBsAg), lipid profile (cholesterol, triglycerides, VLDL. LDL and HDL), complete iron study (serum iron, serum ferritin, total iron binding capacity and transferrin saturation) and serum hepcidin level measured by a commercially available ELISA kit.