Stéato-hépatite, surcharge en fer et insulinorésistance

There is a close relationship between insulin resistance, non-alcoholic fatty liver (NAFLD) and abnormalities in iron metabolism (hyperferritinemia with/without liver siderosis). NAFLD has become the most frequent cause of chronic liver disease in developed countries. It results in an increased risk of life-threatening conditions including cirrhosis, hepatocellular carcinoma and cardiovascular complications. Liver siderosis associated with features of the metabolic syndrome (Dysmetabolic Iron Overload Syndrome, or DIOS) could aggravate or trigger insulin resistance, and, when associated with NAFLD, could increase the risk of hepatic fibrosis. Then, patients with metabolic syndrome should be checked for increased serum transaminase levels, hyperferritinemia and ultrasound abnormalities and followed with respect to their hepatic condition (regular liver function tests and 6-monthly ultrasound examination in case of severe fibrosis).