nature reviews endocrinologyhttps:/doi.org/10.1038/s41574-023-00807-6Consensus statementCheck for updatesConsensus Statement on thedefinition and classification ofmetabolic hyperferritinaemiaLuca Valenti2 Elena Corradini45,Leon A.Adams,Elmar Aigner?,Saleh Alqahtani,Marco Arrese0Edouard Bardou-Jacquet",Elisabetta Bugianesi2,Jose-Manuel Fernandez-Real.4.15,Domenico GirelliHannes Hagstrom19,Benjamin Henninger19,Kris Kowdley2021,Guido Ligabue42,Donald Mcclain 23.24,Fabrice Laine25,Koji Miyanishi2,Martina U.Muckenthaler27229,Alessia Pagani,Patrizia Pedrotti",Antonello Pietrangelo5,Daniele Prati,John D.Ryan32,Laura Silvestri,C.Wendy Spearman33,Per Stal19,Emmanuel A.Tsochatzis34,Francesca Vinchi5,Ming-Hua Zheng 373&Heinz Zoller 340AbstractSectionsHyperferritinaemia is a common laboratory finding that is oftenIntroductionassociated with metabolic dysfunction and fatty liver.MetabolicMethodologyhyperferritinaemia reflects alterations in iron metabolism that facilitateRecommendationsiron accumulationin the body and is associated with an increased riskof cardiometabolic and liver diseases.Genetic variants that modulateFuture perspectivesiron homeostasis and tissue levels of iron are the main determinantsConclusionsof serumlevels of ferritin in individuals with metabolic dysfunction,raising the hypothesis that iron accumulation might be implicated inthe pathogenesis of insulin resistance and the related organ damage.However,validated criteria for the non-invasive diagnosis ofmetabolichyperferritinaemia and the staging of iron overload are still lacking,andthere is no clear evidence of a benefit for iron depletion therapy.Here,we provide an overview of the literature on the relationship betweenhyperferritinaemia and iron accumulation in individuals with metabolicdysfunction,and on the associated clinical outcomes.We proposean updated definition and a provisional staging system for metabolichyperferritinaemia,which has been agreed on by a multidisciplinaryglobal panel of expert researchers.Thegoal is tofoster studies intothe epidemiology,genetics,pathophysiology,clinical relevance andtreatment of metabolic hyperferritinaemia,for which we providesuggestions on the main unmet needs,optimal design and clinicallyrelevant outcomes.A full list of affiliations appears at the end of the paper.e-mail:luca.valenti@unimi.it;elena.corradini75@unimore.itNature Reviews Endocrinology
