1. Measurement of liver iron by magnetic resonance imaging in the UK Biobank population.
- Author
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McKay A, Wilman HR, Dennis A, Kelly M, Gyngell ML, Neubauer S, Bell JD, Banerjee R, and Thomas EL
- Subjects
- Adult, Aged, Biological Specimen Banks, Cross-Sectional Studies, Fatty Liver diagnostic imaging, Fatty Liver metabolism, Female, Humans, Iron Overload diagnostic imaging, Iron Overload metabolism, Male, Middle Aged, Multivariate Analysis, United Kingdom, Iron metabolism, Liver diagnostic imaging, Liver metabolism, Magnetic Resonance Imaging methods
- Abstract
The burden of liver disease continues to increase in the UK, with liver cirrhosis reported to be the third most common cause of premature death. Iron overload, a condition that impacts liver health, was traditionally associated with genetic disorders such as hereditary haemochromatosis, however, it is now increasingly associated with obesity, type-2 diabetes and non-alcoholic fatty liver disease. The aim of this study was to assess the prevalence of elevated levels of liver iron within the UK Biobank imaging study in a cohort of 9108 individuals. Magnetic resonance imaging (MRI) was undertaken at the UK Biobank imaging centre, acquiring a multi-echo spoiled gradient-echo single-breath-hold MRI sequence from the liver. All images were analysed for liver iron and fat (expressed as proton density fat fraction or PDFF) content using LiverMultiScan. Liver iron was measured in 97.3% of the cohort. The mean liver iron content was 1.32 ± 0.32 mg/g while the median was 1.25 mg/g (min: 0.85 max: 6.44 mg/g). Overall 4.82% of the population were defined as having elevated liver iron, above commonly accepted 1.8 mg/g threshold based on biochemical iron measurements in liver specimens obtained by biopsy. Further analysis using univariate models showed elevated liver iron to be related to male sex (p<10(-16), r2 = 0.008), increasing age (p<10(-16), r2 = 0.013), and red meat intake (p<10(-16), r2 = 0.008). Elevated liver fat (>5.6% PDFF) was associated with a slight increase in prevalence of elevated liver iron (4.4% vs 6.3%, p = 0.0007). This study shows that population studies including measurement of liver iron concentration are feasible, which may in future be used to better inform patient stratification and treatment., Competing Interests: The authors of this manuscript have the following competing interests: Andy McKay, Andrea Dennis, Matt Kelly, Michael Gyngell and Rajarshi Banerjee are employees of a commercial funder: Perspectum Diagnostics. Andy McKay, Andrea Dennis, Matt Kelly, Michael Gyngell, Stefan Neubauer, Rajarshi Banerjee, Henry Wilman are also stockholders of Perspectum Diagnostics. Stefan Neubauer has a paid consultancy with Perspectum Diagnostics, and also holds the position of non-executive director for the company. Jimmy Bell and E. Louise Thomas hold a Knowledge Transfer Partnership award from Innovate UK in collaboration with Perspectum Diagnostics, which funds Henry Wilman’s employment at the University of Westminster. Jimmy Bell and E. Louise Thomas have also received funds for a contract research project from Perspectum Diagnostics to deliver image analysis for a project undertaken by Perspectum Diagnostics. Employment and consultancy of these authors does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Published
- 2018
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