Iron in Non-Alcoholic Fatty Liver Disease and Insulin Resistance
Iron is a potentially modifiable contributor to the progression of non-alcoholic fatty liver disease (NAFLD), the commonest cause of liver disease, and insulin resistance, which underlies the pathogenesis of the disorder. Excess iron is toxic to many organs, particularly to the liver, through the generation of oxidative stress which can drive liver fibrogenesis and injury.
Using serum, histological and imaging markers of iron status, John has recently demonstrated a progressive increase in iron occurs in patients with NAFLD, the commonest cause of liver disease worldwide, a disease closely linked to insulin resistance and obesity (Ryan et al, EASL 2016). As in other recent studies, iron status was also linked to insulin resistance markers in our cohort. To understand this better, morbidly obese patients undergoing bariatric surgery with a high prevalence of NAFLD have been enrolled. Blood, liver and adipose tissue samples are simultaneously collected in order to examine the molecular pathways enriched across the disease stages, with a particular focus on iron and oxidative stress, looking for novel markers of disease and potential therapeutic targets.