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Title: A critical evaluation of the role of iron overload in fatty liver disease.
Austin Authors: Fernandez, Monique;Lokan, Julie ;Leung, Christopher ;Grigg, Andrew P 
Affiliation: Anatomical Pathology..
Gastroenterology and Hepatology..
Clinical Haematology..
Department of Medicine, the University of Melbourne, Parkville, Victoria, Australia..
Issue Date: 29-Jul-2022
Date: 2022
Publication information: Journal of Gastroenterology and Hepatology 2022; 37(10): 1873-1883
Abstract: Non-alcoholic fatty liver disease (NAFLD) has been associated with a condition known as the dysmetabolic iron overload syndrome (DIOS), but the frequency and severity of iron overload in NAFLD is not well described. There is emerging evidence that mild to moderate excess hepatic iron can aggravate the risk of progression of NAFLD to non-alcoholic steatohepatitis (NASH) and eventually cirrhosis. Mechanisms are postulated to be via reactive oxygen species, inflammatory cytokines, lipid oxidation and oxidative stress. The aim of this review is to assess the evidence for true hepatic iron overload in NAFLD, discuss the pathogenesis by which excess iron may be toxic and to critically evaluate the studies designed to deplete iron by regular venesection. In brief, the studies are inconclusive due to heterogeneity in eligibility criteria, sample size, randomisation, hepatic iron measurement, serial histological endpoints, target ferritin levels, length of venesection and degree of confounding lifestyle intervention. We propose a trial designed to overcome the limitations of these studies.
DOI: 10.1111/jgh.15971
ORCID: 0000-0002-5110-7559
Journal: Journal of gastroenterology and hepatology
PubMed URL: 35906772
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

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