iron status and metabolic syndrome in patients with non-alcoholic fatty liver disease

background: a hypothesis has been presented about the role of serum iron, ferritin and transferrin saturation among patients with non-alcoholic fatty liver disease (nafld) and resistance to insulin (metabolic syndrome [mets]), but there is much controversy. this study aimed at investigating the level of serum iron and demographic characteristics in patients with nafld with or without mets. methods: a case-control study was conducted on patients with elevated liver enzymes referring to baqiyatallah clinic, tehran, iran during 2010-2011. after ruling out other causes of increased aminotransferases and approving the diagnosis of nafld, the patients were divided into two groups of with or without mets. then, the individuals’ demographic, sonographic, and laboratory characteristics were recorded. results: this research included 299 patients suffering from nafld who were divided into mets  (n=143; 47.8%) and non-mets (n=156; 52.2%) groups. the age, systolic and diastolic blood pressure, body mass index, waist/hip ratio, glucose tolerance test, serum insulin, c. peptide, triglyceride, and hb a1c were different between mets and non-mets groups ( p <0.05). there was no significant difference in serum iron and ferritin levels between the two groups, however, a significant correlation was found between serum ferritin and alanine transaminase ( p =0.005) and also aspartate aminotransferase ( p =0.032). conclusion: our findings did not show a significant relationship between iron, in free or storage form, and the presence of mets among patients with nafld, but serum ferritin can correlate with hepatocytes injuries indicated by raised aminotransferases. nevertheless, to clarify this relationship further molecular, genomic, and histopathological studies are required.