Consensus Statement on the definition and classification of metabolic hyperferritinaemia
2023
Valenti, Luca | Corradini, Elena | Adams, Leon | Aigner, Elmar | Alqahtani, Saleh | Arrese, Marco | Bardou-Jacquet, Edouard | Bugianesi, Elisabetta | Fernandez-Real, Jose-Manuel | Girelli, Domenico | Hagström, Hannes | Henninger, Benjamin | Kowdley, Kris | Ligabue, Guido | Mcclain, Donald | Lainé, Fabrice | Miyanishi, Koji | Muckenthaler, Martina | Pagani, Alessia | Pedrotti, Patrizia | Pietrangelo, Antonello | Prati, Daniele | Ryan, John | Silvestri, Laura | Spearman, C Wendy | Stål, Per | Tsochatzis, Emmanuel | Vinchi, Francesca | Zheng, Ming-Hua | Zoller, Heinz | Università degli Studi di Milano = University of Milan (UNIMI) | Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE) | The University of Western Australia (UWA) | Paracelsus Medizinische Privatuniversität = Paracelsus Medical University (PMU) | Johns Hopkins University (JHU) | Pontificia Universidad Católica de Chile (UC) | Nutrition, Métabolismes et Cancer (NuMeCan) ; Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | CHU Pontchaillou [Rennes] | Centre d'Investigation Clinique [Rennes] (CIC) ; Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM) | Università degli studi di Torino = University of Turin (UNITO) | Universitat de Girona (UdG) | Università degli studi di Verona = University of Verona (UNIVR) | Karolinska University Hospital [Stockholm] | Leopold Franzens Universität Innsbruck - University of Innsbruck | Washington State University (WSU) | Wake Forest School of Medicine [Winston-Salem] ; Wake Forest Baptist Medical Center | Sapporo Medical University School of Medicine ; Sapporo Medical University | Universität Heidelberg [Heidelberg] = Heidelberg University | IRCCS Ospedale San Raffaele [Milan, Italy] | ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia] | Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico | Royal College of Surgeons in Ireland (RCSI) | University of Cape Town | University College of London [London] (UCL) | Weill Cornell Medicine [Cornell University] ; Cornell University [New York] | The First Affiliated Hospital of Wenzhou Medical University [Wenzhou, China] | Innsbruck Medical University = Medizinische Universität Innsbruck (IMU) | Ministero della Salute, Ricerca Finalizzata RF-2016-02364358, RC Rete cardiologica ‘CV PREVITAL’, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico ‘Liver BIBLE’ (PR-0391), Innovative Medicines Initiative 2 joint undertaking of European Union’s Horizon 2020 research and innovation programme and EFPIA European Union (EU) Programme Horizon 2020 (under grant agreement No. 777377) for the project LITMUS, H2020 under grant agreement ‘101016726’, the European Union, programme ‘Photonics’ under grant agreement ‘101016726’ for L.V. Fondo Nacional de Ciencia y Tecnología de Chile (FONDECYT #1191145 to M.A.) and from the Agencia Nacional de Investigación y Desarrollo, ANID through ANID ACE 210009 grant for M.A. NIH (P30DK124723), and Veterans Administration (2I01 BX001140) for D.M. SFB1036, SFB1118 and DFG (FerrOs — FOR5146; SPP2306) as well as Marsilius Kolleg for M.U.M. National Natural Science Foundation of China (82070588), High Level Creative Talents from Department of Public Health in Zhejiang Province (S2032102600032) for M.-H.Z. Swedish Cancer Society (170690) and Stockholm County Council (K2017-4579) for P.S.
International audience
Show more [+] Less [-]English. Hyperferritinaemia is a common laboratory finding that is often associated with metabolic dysfunction and fatty liver. Metabolic hyperferritinaemia reflects alterations in iron metabolism that facilitate iron accumulation in the body and is associated with an increased risk of cardiometabolic and liver diseases. Genetic variants that modulate iron homeostasis and tissue levels of iron are the main determinants of serum levels of ferritin in individuals with metabolic dysfunction, raising the hypothesis that iron accumulation might be implicated in the pathogenesis of insulin resistance and the related organ damage. However, validated criteria for the non-invasive diagnosis of metabolic hyperferritinaemia and the staging of iron overload are still lacking, and there is no clear evidence of a benefit for iron depletion therapy. Here, we provide an overview of the literature on the relationship between hyperferritinaemia and iron accumulation in individuals with metabolic dysfunction, and on the associated clinical outcomes. We propose an updated definition and a provisional staging system for metabolic hyperferritinaemia, which has been agreed on by a multidisciplinary global panel of expert researchers. The goal is to foster studies into the epidemiology, genetics, pathophysiology, clinical relevance and treatment of metabolic hyperferritinaemia, for which we provide suggestions on the main unmet needs, optimal design and clinically relevant outcomes.
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