Hyperferritinemia and liver iron content determined with MRI: Reintroduction of the liver iron index
BACKGROUND: Hyperferritinemia is found in around 12 % of the general population. Analyzing the cause can be difficult. In case of doubt about the presence of major iron overload most guidelines advice to perform a MRI as a reliable non-invasive marker to measure liver iron concentration (LIC). In ge...
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| Veröffentlicht in: | CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY 2023-12, Vol.47 (10) |
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| container_title | CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY |
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| creator | Moris, Wenke Verbeek, Jef Bakers, Frans C Rombout-Sestrienkova, Eva Innocenti, Francesco Masclee, Ad A.M Koek, Ger H van Deursen, Cees Th B.M |
| description | BACKGROUND: Hyperferritinemia is found in around 12 % of the general population. Analyzing the cause can be difficult. In case of doubt about the presence of major iron overload most guidelines advice to perform a MRI as a reliable non-invasive marker to measure liver iron concentration (LIC). In general, a LIC of ≥ 36 µmol/g dw is considered the be elevated however in hyperferritinemia associated with, for example, obesity or alcohol (over)consumption the LIC can be ≥ 36 µmol/g dw in abscence of major iron overload. So, unfortunately a clear cut-off value to differentiate iron overload from normal iron content is lacking. Previously the liver iron index (LII) (LIC measured in liver biopsy (LIC-b)/age (years)), was introduced to differentiate between patients with major (LII ≥ 2) and minor or no iron overload (LII |
| format | Article |
| fullrecord | <record><control><sourceid>kuleuven</sourceid><recordid>TN_cdi_kuleuven_dspace_20_500_12942_733038</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>20_500_12942_733038</sourcerecordid><originalsourceid>FETCH-kuleuven_dspace_20_500_12942_7330383</originalsourceid><addsrcrecordid>eNqVyz0PgjAUheEOmmjU_3BnE01pIaCr0eDgQtwbQi_xKhRSLn78exkcHPUs7_KckZgqFchVHMpgIhZdd5XDwkgmcTAVNn216Ev0npgc1pRD7ixUdEcP5BsHReMYHYNFRl8PxsKD-AKn7LiFDMmxb2xfMA22KYEv-P0mZ_E5F-MyrzpcfDoTy8P-vEtXt77C_o7O2K7NCzRKmkhKE6hNqEystdSJ_hOvf8aGn6zfnWlX4A</addsrcrecordid><sourcetype>Institutional Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Hyperferritinemia and liver iron content determined with MRI: Reintroduction of the liver iron index</title><source>Elsevier ScienceDirect Journals Complete - AutoHoldings</source><source>Lirias (KU Leuven Association)</source><creator>Moris, Wenke ; Verbeek, Jef ; Bakers, Frans C ; Rombout-Sestrienkova, Eva ; Innocenti, Francesco ; Masclee, Ad A.M ; Koek, Ger H ; van Deursen, Cees Th B.M</creator><creatorcontrib>Moris, Wenke ; Verbeek, Jef ; Bakers, Frans C ; Rombout-Sestrienkova, Eva ; Innocenti, Francesco ; Masclee, Ad A.M ; Koek, Ger H ; van Deursen, Cees Th B.M</creatorcontrib><description>BACKGROUND: Hyperferritinemia is found in around 12 % of the general population. Analyzing the cause can be difficult. In case of doubt about the presence of major iron overload most guidelines advice to perform a MRI as a reliable non-invasive marker to measure liver iron concentration (LIC). In general, a LIC of ≥ 36 µmol/g dw is considered the be elevated however in hyperferritinemia associated with, for example, obesity or alcohol (over)consumption the LIC can be ≥ 36 µmol/g dw in abscence of major iron overload. So, unfortunately a clear cut-off value to differentiate iron overload from normal iron content is lacking. Previously the liver iron index (LII) (LIC measured in liver biopsy (LIC-b)/age (years)), was introduced to differentiate between patients with major (LII ≥ 2) and minor or no iron overload (LII < 2). Based on the good correlation between the LIC-b and LIC determined with MRI (LIC-MRI), our goal was to investigate whether a LII_MRI ≥ 2 is a good indicator of major iron overload, reflected by a significantly higher amount of iron needed to be mobilized to reach iron depletion. METHODS: We compared the amount of mobilized iron to reach depletion and inflammation-related characteristics in two groups: LII-MRI ≥ 2 versus LII-MRI <2 in 92 hyperferritinemia patients who underwent HFE genotyping and MRI-LIC determination. RESULTS: Significantly more iron needed to be mobilized to reach iron depletion in the LII ≥ 2 group (mean 4741, SD ± 4135 mg) versus the LII-MRI <2 group (mean 1340, SD ± 533 mg), P < 0.001. Furthermore, hyperferritinemia in LII-MRI < 2 patients was more often related to components of the metabolic syndrome while hyperferritinemia in LII-MRI ≥ 2 patients was more often related to HFE mutations. ROC curve analysis showed good performance of LII =2 as cut-off value. However the calculations showed that the optimal cut-off for the LII = 3.4. CONCLUSION: The LII-MRI with a cut-off value of 2 is an effective method to differentiate major from minor iron overload in patients with hyperferritinemia. But the LII-MRI = 3.4 seems a more promising diagnostic test for major iron overload.</description><identifier>ISSN: 2210-7401</identifier><language>eng</language><publisher>ELSEVIER MASSON, CORP OFF</publisher><ispartof>CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY, 2023-12, Vol.47 (10)</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,315,780,784,27859</link.rule.ids></links><search><creatorcontrib>Moris, Wenke</creatorcontrib><creatorcontrib>Verbeek, Jef</creatorcontrib><creatorcontrib>Bakers, Frans C</creatorcontrib><creatorcontrib>Rombout-Sestrienkova, Eva</creatorcontrib><creatorcontrib>Innocenti, Francesco</creatorcontrib><creatorcontrib>Masclee, Ad A.M</creatorcontrib><creatorcontrib>Koek, Ger H</creatorcontrib><creatorcontrib>van Deursen, Cees Th B.M</creatorcontrib><title>Hyperferritinemia and liver iron content determined with MRI: Reintroduction of the liver iron index</title><title>CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY</title><description>BACKGROUND: Hyperferritinemia is found in around 12 % of the general population. Analyzing the cause can be difficult. In case of doubt about the presence of major iron overload most guidelines advice to perform a MRI as a reliable non-invasive marker to measure liver iron concentration (LIC). In general, a LIC of ≥ 36 µmol/g dw is considered the be elevated however in hyperferritinemia associated with, for example, obesity or alcohol (over)consumption the LIC can be ≥ 36 µmol/g dw in abscence of major iron overload. So, unfortunately a clear cut-off value to differentiate iron overload from normal iron content is lacking. Previously the liver iron index (LII) (LIC measured in liver biopsy (LIC-b)/age (years)), was introduced to differentiate between patients with major (LII ≥ 2) and minor or no iron overload (LII < 2). Based on the good correlation between the LIC-b and LIC determined with MRI (LIC-MRI), our goal was to investigate whether a LII_MRI ≥ 2 is a good indicator of major iron overload, reflected by a significantly higher amount of iron needed to be mobilized to reach iron depletion. METHODS: We compared the amount of mobilized iron to reach depletion and inflammation-related characteristics in two groups: LII-MRI ≥ 2 versus LII-MRI <2 in 92 hyperferritinemia patients who underwent HFE genotyping and MRI-LIC determination. RESULTS: Significantly more iron needed to be mobilized to reach iron depletion in the LII ≥ 2 group (mean 4741, SD ± 4135 mg) versus the LII-MRI <2 group (mean 1340, SD ± 533 mg), P < 0.001. Furthermore, hyperferritinemia in LII-MRI < 2 patients was more often related to components of the metabolic syndrome while hyperferritinemia in LII-MRI ≥ 2 patients was more often related to HFE mutations. ROC curve analysis showed good performance of LII =2 as cut-off value. However the calculations showed that the optimal cut-off for the LII = 3.4. CONCLUSION: The LII-MRI with a cut-off value of 2 is an effective method to differentiate major from minor iron overload in patients with hyperferritinemia. But the LII-MRI = 3.4 seems a more promising diagnostic test for major iron overload.</description><issn>2210-7401</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>FZOIL</sourceid><recordid>eNqVyz0PgjAUheEOmmjU_3BnE01pIaCr0eDgQtwbQi_xKhRSLn78exkcHPUs7_KckZgqFchVHMpgIhZdd5XDwkgmcTAVNn216Ev0npgc1pRD7ixUdEcP5BsHReMYHYNFRl8PxsKD-AKn7LiFDMmxb2xfMA22KYEv-P0mZ_E5F-MyrzpcfDoTy8P-vEtXt77C_o7O2K7NCzRKmkhKE6hNqEystdSJ_hOvf8aGn6zfnWlX4A</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Moris, Wenke</creator><creator>Verbeek, Jef</creator><creator>Bakers, Frans C</creator><creator>Rombout-Sestrienkova, Eva</creator><creator>Innocenti, Francesco</creator><creator>Masclee, Ad A.M</creator><creator>Koek, Ger H</creator><creator>van Deursen, Cees Th B.M</creator><general>ELSEVIER MASSON, CORP OFF</general><scope>FZOIL</scope></search><sort><creationdate>202312</creationdate><title>Hyperferritinemia and liver iron content determined with MRI: Reintroduction of the liver iron index</title><author>Moris, Wenke ; Verbeek, Jef ; Bakers, Frans C ; Rombout-Sestrienkova, Eva ; Innocenti, Francesco ; Masclee, Ad A.M ; Koek, Ger H ; van Deursen, Cees Th B.M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kuleuven_dspace_20_500_12942_7330383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moris, Wenke</creatorcontrib><creatorcontrib>Verbeek, Jef</creatorcontrib><creatorcontrib>Bakers, Frans C</creatorcontrib><creatorcontrib>Rombout-Sestrienkova, Eva</creatorcontrib><creatorcontrib>Innocenti, Francesco</creatorcontrib><creatorcontrib>Masclee, Ad A.M</creatorcontrib><creatorcontrib>Koek, Ger H</creatorcontrib><creatorcontrib>van Deursen, Cees Th B.M</creatorcontrib><collection>Lirias (KU Leuven Association)</collection><jtitle>CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moris, Wenke</au><au>Verbeek, Jef</au><au>Bakers, Frans C</au><au>Rombout-Sestrienkova, Eva</au><au>Innocenti, Francesco</au><au>Masclee, Ad A.M</au><au>Koek, Ger H</au><au>van Deursen, Cees Th B.M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperferritinemia and liver iron content determined with MRI: Reintroduction of the liver iron index</atitle><jtitle>CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY</jtitle><date>2023-12</date><risdate>2023</risdate><volume>47</volume><issue>10</issue><issn>2210-7401</issn><abstract>BACKGROUND: Hyperferritinemia is found in around 12 % of the general population. Analyzing the cause can be difficult. In case of doubt about the presence of major iron overload most guidelines advice to perform a MRI as a reliable non-invasive marker to measure liver iron concentration (LIC). In general, a LIC of ≥ 36 µmol/g dw is considered the be elevated however in hyperferritinemia associated with, for example, obesity or alcohol (over)consumption the LIC can be ≥ 36 µmol/g dw in abscence of major iron overload. So, unfortunately a clear cut-off value to differentiate iron overload from normal iron content is lacking. Previously the liver iron index (LII) (LIC measured in liver biopsy (LIC-b)/age (years)), was introduced to differentiate between patients with major (LII ≥ 2) and minor or no iron overload (LII < 2). Based on the good correlation between the LIC-b and LIC determined with MRI (LIC-MRI), our goal was to investigate whether a LII_MRI ≥ 2 is a good indicator of major iron overload, reflected by a significantly higher amount of iron needed to be mobilized to reach iron depletion. METHODS: We compared the amount of mobilized iron to reach depletion and inflammation-related characteristics in two groups: LII-MRI ≥ 2 versus LII-MRI <2 in 92 hyperferritinemia patients who underwent HFE genotyping and MRI-LIC determination. RESULTS: Significantly more iron needed to be mobilized to reach iron depletion in the LII ≥ 2 group (mean 4741, SD ± 4135 mg) versus the LII-MRI <2 group (mean 1340, SD ± 533 mg), P < 0.001. Furthermore, hyperferritinemia in LII-MRI < 2 patients was more often related to components of the metabolic syndrome while hyperferritinemia in LII-MRI ≥ 2 patients was more often related to HFE mutations. ROC curve analysis showed good performance of LII =2 as cut-off value. However the calculations showed that the optimal cut-off for the LII = 3.4. CONCLUSION: The LII-MRI with a cut-off value of 2 is an effective method to differentiate major from minor iron overload in patients with hyperferritinemia. But the LII-MRI = 3.4 seems a more promising diagnostic test for major iron overload.</abstract><pub>ELSEVIER MASSON, CORP OFF</pub><oa>free_for_read</oa></addata></record> |
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| title | Hyperferritinemia and liver iron content determined with MRI: Reintroduction of the liver iron index |
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