Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease
ObjectiveTo assess the prevalence of pancreatic steatosis and iron overload in non-alcoholic fatty liver disease (NAFLD) and their correlation with liver histology severity and the risk of cardiometabolic diseases.MethodA prospective, multicenter study including NAFLD patients with biopsy and paired...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1213441/full |
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| author | David Marti-Aguado David Marti-Aguado Amadeo Ten-Esteve Amadeo Ten-Esteve Carlos Manuel Baracaldo-Silva Ana Crespo Elena Coello Víctor Merino-Murgui Matias Fernandez-Paton Clara Alfaro-Cervello Clara Alfaro-Cervello Alba Sánchez-Martín Mónica Bauza Ana Jimenez-Pastor Ana Jimenez-Pastor Alexandre Perez-Girbes Salvador Benlloch Salvador Benlloch Judith Pérez-Rojas Víctor Puglia Antonio Ferrández Antonio Ferrández Victoria Aguilera Victoria Aguilera Mercedes Latorre Cristina Monton Desamparados Escudero-García Desamparados Escudero-García Ignacio Bosch-Roig Ángel Alberich-Bayarri Ángel Alberich-Bayarri Luis Marti-Bonmati Luis Marti-Bonmati |
| author_facet | David Marti-Aguado David Marti-Aguado Amadeo Ten-Esteve Amadeo Ten-Esteve Carlos Manuel Baracaldo-Silva Ana Crespo Elena Coello Víctor Merino-Murgui Matias Fernandez-Paton Clara Alfaro-Cervello Clara Alfaro-Cervello Alba Sánchez-Martín Mónica Bauza Ana Jimenez-Pastor Ana Jimenez-Pastor Alexandre Perez-Girbes Salvador Benlloch Salvador Benlloch Judith Pérez-Rojas Víctor Puglia Antonio Ferrández Antonio Ferrández Victoria Aguilera Victoria Aguilera Mercedes Latorre Cristina Monton Desamparados Escudero-García Desamparados Escudero-García Ignacio Bosch-Roig Ángel Alberich-Bayarri Ángel Alberich-Bayarri Luis Marti-Bonmati Luis Marti-Bonmati |
| author_sort | David Marti-Aguado |
| collection | DOAJ |
| description | ObjectiveTo assess the prevalence of pancreatic steatosis and iron overload in non-alcoholic fatty liver disease (NAFLD) and their correlation with liver histology severity and the risk of cardiometabolic diseases.MethodA prospective, multicenter study including NAFLD patients with biopsy and paired Magnetic Resonance Imaging (MRI) was performed. Liver biopsies were evaluated according to NASH Clinical Research Network, hepatic iron storages were scored, and digital pathology quantified the tissue proportionate areas of fat and iron. MRI-biomarkers of fat fraction (PDFF) and iron accumulation (R2*) were obtained from the liver and pancreas. Different metabolic traits were evaluated, cardiovascular disease (CVD) risk was estimated with the atherosclerotic CVD score, and the severity of iron metabolism alteration was determined by grading metabolic hiperferritinemia (MHF). Associations between CVD, histology and MRI were investigated.ResultsIn total, 324 patients were included. MRI-determined pancreatic iron overload and moderate-to severe steatosis were present in 45% and 25%, respectively. Liver and pancreatic MRI-biomarkers showed a weak correlation (r=0.32 for PDFF, r=0.17 for R2*). Pancreatic PDFF increased with hepatic histologic steatosis grades and NASH diagnosis (p<0.001). Prevalence of pancreatic steatosis and iron overload increased with the number of metabolic traits (p<0.001). Liver R2* significantly correlated with MHF (AUC=0.77 [0.72-0.82]). MRI-determined pancreatic steatosis (OR=3.15 [1.63-6.09]), and iron overload (OR=2.39 [1.32-4.37]) were independently associated with high-risk CVD. Histologic diagnosis of NASH and advanced fibrosis were also associated with high-risk CVD.ConclusionPancreatic steatosis and iron overload could be of utility in clinical decision-making and prognostication of NAFLD. |
| first_indexed | 2024-03-12T17:42:38Z |
| format | Article |
| id | doaj.art-5751656d58b14863a1f7f8d230f1d452 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-12T17:42:38Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-5751656d58b14863a1f7f8d230f1d4522023-08-04T01:23:17ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-08-011410.3389/fendo.2023.12134411213441Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver diseaseDavid Marti-Aguado0David Marti-Aguado1Amadeo Ten-Esteve2Amadeo Ten-Esteve3Carlos Manuel Baracaldo-Silva4Ana Crespo5Elena Coello6Víctor Merino-Murgui7Matias Fernandez-Paton8Clara Alfaro-Cervello9Clara Alfaro-Cervello10Alba Sánchez-Martín11Mónica Bauza12Ana Jimenez-Pastor13Ana Jimenez-Pastor14Alexandre Perez-Girbes15Salvador Benlloch16Salvador Benlloch17Judith Pérez-Rojas18Víctor Puglia19Antonio Ferrández20Antonio Ferrández21Victoria Aguilera22Victoria Aguilera23Mercedes Latorre24Cristina Monton25Desamparados Escudero-García26Desamparados Escudero-García27Ignacio Bosch-Roig28Ángel Alberich-Bayarri29Ángel Alberich-Bayarri30Luis Marti-Bonmati31Luis Marti-Bonmati32Digestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainBiomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, SpainBiomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, SpainDepartment of Technologies for Health and Well-Being, Polytechnic University of Valencia, Valencia, SpainRadiology Department, La Fe University and Polytechnic Hospital, Valencia, SpainDigestive Disease Department, Hospital Arnau de Vilanova, Valencia, SpainHepatology and Liver Transplantation Unit, La Fe University and Polytechnic Hospital, Valencia, SpainDigestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainBiomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, SpainPathology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainFaculty of Medicine, University of Valencia, Valencia, SpainPathology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainPathology Department, La Fe University and Polytechnic Hospital, Valencia, SpainBiomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain0Quantitative Imaging Biomarkers in Medicine, QUIBIM SL, Valencia, SpainRadiology Department, La Fe University and Polytechnic Hospital, Valencia, SpainDigestive Disease Department, Hospital Arnau de Vilanova, Valencia, Spain1CIBERehd, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, SpainPathology Department, La Fe University and Polytechnic Hospital, Valencia, Spain2Pathology Department, Hospital Arnau de Vilanova, Valencia, SpainPathology Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainFaculty of Medicine, University of Valencia, Valencia, SpainHepatology and Liver Transplantation Unit, La Fe University and Polytechnic Hospital, Valencia, Spain1CIBERehd, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain3Hepatology Unit, Consorcio Hospital General Universitario de Valencia, Valencia, SpainDigestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainDigestive Disease Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, SpainFaculty of Medicine, University of Valencia, Valencia, Spain4Universitat Politècnica de València, Institute of Telecommunications and Multimedia Applications (iTEAM), Valencia, SpainBiomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, Spain0Quantitative Imaging Biomarkers in Medicine, QUIBIM SL, Valencia, SpainBiomedical Imaging Research Group (GIBI230), La Fe Health Research Institute, and Imaging La Fe node at Distributed Network for Biomedical Imaging (ReDIB) Unique Scientific and Technical Infrastructures (ICTS), Valencia, SpainRadiology Department, La Fe University and Polytechnic Hospital, Valencia, SpainObjectiveTo assess the prevalence of pancreatic steatosis and iron overload in non-alcoholic fatty liver disease (NAFLD) and their correlation with liver histology severity and the risk of cardiometabolic diseases.MethodA prospective, multicenter study including NAFLD patients with biopsy and paired Magnetic Resonance Imaging (MRI) was performed. Liver biopsies were evaluated according to NASH Clinical Research Network, hepatic iron storages were scored, and digital pathology quantified the tissue proportionate areas of fat and iron. MRI-biomarkers of fat fraction (PDFF) and iron accumulation (R2*) were obtained from the liver and pancreas. Different metabolic traits were evaluated, cardiovascular disease (CVD) risk was estimated with the atherosclerotic CVD score, and the severity of iron metabolism alteration was determined by grading metabolic hiperferritinemia (MHF). Associations between CVD, histology and MRI were investigated.ResultsIn total, 324 patients were included. MRI-determined pancreatic iron overload and moderate-to severe steatosis were present in 45% and 25%, respectively. Liver and pancreatic MRI-biomarkers showed a weak correlation (r=0.32 for PDFF, r=0.17 for R2*). Pancreatic PDFF increased with hepatic histologic steatosis grades and NASH diagnosis (p<0.001). Prevalence of pancreatic steatosis and iron overload increased with the number of metabolic traits (p<0.001). Liver R2* significantly correlated with MHF (AUC=0.77 [0.72-0.82]). MRI-determined pancreatic steatosis (OR=3.15 [1.63-6.09]), and iron overload (OR=2.39 [1.32-4.37]) were independently associated with high-risk CVD. Histologic diagnosis of NASH and advanced fibrosis were also associated with high-risk CVD.ConclusionPancreatic steatosis and iron overload could be of utility in clinical decision-making and prognostication of NAFLD.https://www.frontiersin.org/articles/10.3389/fendo.2023.1213441/fullnon-alcoholic fatty liver disease (NAFLD)magnetic resonance imaging (MRI)proton density fat fraction (PDFF)pancreatic steatosisiron overloadcardiovascular risk |
| spellingShingle | David Marti-Aguado David Marti-Aguado Amadeo Ten-Esteve Amadeo Ten-Esteve Carlos Manuel Baracaldo-Silva Ana Crespo Elena Coello Víctor Merino-Murgui Matias Fernandez-Paton Clara Alfaro-Cervello Clara Alfaro-Cervello Alba Sánchez-Martín Mónica Bauza Ana Jimenez-Pastor Ana Jimenez-Pastor Alexandre Perez-Girbes Salvador Benlloch Salvador Benlloch Judith Pérez-Rojas Víctor Puglia Antonio Ferrández Antonio Ferrández Victoria Aguilera Victoria Aguilera Mercedes Latorre Cristina Monton Desamparados Escudero-García Desamparados Escudero-García Ignacio Bosch-Roig Ángel Alberich-Bayarri Ángel Alberich-Bayarri Luis Marti-Bonmati Luis Marti-Bonmati Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease Frontiers in Endocrinology non-alcoholic fatty liver disease (NAFLD) magnetic resonance imaging (MRI) proton density fat fraction (PDFF) pancreatic steatosis iron overload cardiovascular risk |
| title | Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease |
| title_full | Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease |
| title_fullStr | Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease |
| title_full_unstemmed | Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease |
| title_short | Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease |
| title_sort | pancreatic steatosis and iron overload increases cardiovascular risk in non alcoholic fatty liver disease |
| topic | non-alcoholic fatty liver disease (NAFLD) magnetic resonance imaging (MRI) proton density fat fraction (PDFF) pancreatic steatosis iron overload cardiovascular risk |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1213441/full |
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