Assessment of serum ferritin levels in patients with chronic hepatitis B against the background of metabolic syndrome
The objective. To assess the prevalence of hyperferritinemia in patients with chronic hepatitis B (CHB) against the background of metabolic syndrome and insulin resistance. To reveal interrelation between an increase of ferritin and histological activity and development of liver fibrosis. Patients and methods. The study included 53 patients with CHB. The severity of fibrosis, presence of metabolic syndrome, abdominal obesity, insulin resistance (IR) and increased ferritin levels were examined in patients with CHB. Results. Of 53 examined patients with CHB enhanced ferritin values were found in 18 individuals (33.9%) with normal serum iron values. Metabolic syndrome and IR (НОМА-IR > 2.77) were observed in 22.6% of patients. Serum ferritin levels did not depend on viral load, histological activity index and HBeAg status. Enhanced serum ferritin was observed in: decreased HDLp, hypertriglyceridemia, arterial hypertension, and IR. Higher serum ferritin levels were associated with: IR, steatosis, diabetes mellitus, metabolic syndrome, viral load ≥20 000 ME/ml, fibrosis index F > 3 METAVIR, and ALT activity >2N. Conclusion. In obese patients with CHB having low viral load, low biochemical activity and fibrosis index F < 3 scores an increase of serum ferritin might be used as an additional criterion of metabolic syndrome and IR.