Non-alcoholic fatty liver disease: Is iron relevant?

O'Brien, Julia and Powell, Lawrie W. (2012) Non-alcoholic fatty liver disease: Is iron relevant?. Hepatology International, 6 1: 332-341. doi:10.1007/s12072-011-9304-9

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Author O'Brien, Julia
Powell, Lawrie W.
Title Non-alcoholic fatty liver disease: Is iron relevant?
Journal name Hepatology International   Check publisher's open access policy
ISSN 1936-0533
Publication date 2012-01
Year available 2011
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/s12072-011-9304-9
Volume 6
Issue 1
Start page 332
End page 341
Total pages 10
Place of publication New Delhi, India
Publisher Springer
Collection year 2013
Language eng
Abstract Non-alcoholic fatty liver disease (NAFLD) is a common and ubiquitous disorder (Bedogni et al. in Hepatology 42:44-52, 2005; Bellentani et al. in Ann Intern Med 132:112-117, 2000) which in a proportion of subjects leads to non-alcoholic steatohepatitis (NASH), advanced liver disease and hepatocellular carcinoma. Although the factors responsible for progression of disease are still uncertain, there is evidence that insulin resistance (IR) is a key operative mechanism (Angulo et al. in Hepatology 30:1356-1362, 1999) and that two stages are involved. The first is the accumulation of triglycerides in hepatocytes followed by a "second hit" which promotes cellular oxidative stress. Several factors may be responsible for the induction of oxidative stress but hepatic iron has been implicated in various studies. The topic is controversial, however, with early studies showing an association between hepatic iron (with or without hemochromatosis gene mutations) and the progression to hepatic fibrosis. Subsequent studies, however, could not confirm an association between the presence of hepatic iron and any of the histological determinants of NAFLD or NASH. Recent studies have reactivated interest in this subject firstly, with the demonstration that hepatic iron loading increases liver cholesterol synthesis with increased lipid deposition in the liver increasing the cellular lipid burden and secondly, a large clinical study has concluded that hepatocellular iron deposition is associated with an increased risk of hepatic fibrosis, thus, strongly supporting the original observation made over a decade ago. An improvement in insulin sensitivity has been demonstrated following phlebotomy therapy but a suitably powered controlled clinical trial is required before this treatment can be implemented.
Keyword Fatty liver disease
Iron overload
Insulin-Resistance Syndrome
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 12 August 2011

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
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