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Hemoglobinopathies and Related Disorders / Iron Metabolism and Disorders · Journal article
Scientific Reports · August 16, 2026
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This cross-sectional study documents that metabolic hyperferritinaemia affects 18.51% of bariatric surgery candidates, with higher rates in males (32.67%) and those with higher BMI, and is associated with abnormalities in liver function and glycolipid metabolism. The associations are correlational only and do not establish causation or therapeutic benefit of iron regulation.
Cross-sectional case-control study. Patients scheduled for bariatric surgery, stratified by gender-specific serum ferritin values.. Compared with: Normal iron group (defined by gender-specific serum ferritin cut-off values). n = 695.
Overall MHF prevalence was 18.51%, markedly higher in males (32.67%) than females (10.54%) Significant upward trend in MHF prevalence with increased BMI MHF group exhibited significantly abnormal liver function, glycolipid metabolism, and hematological indices
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This study characterizes MHF as common in severely obese patients undergoing bariatric surgery and associates it with metabolic dysfunction, but provides no evidence that treating iron abnormalities improves clinical outcomes. The hypothesis that iron regulation may alleviate obesity-related complications requires intervention studies to test.
Cross-sectional observational study describing prevalence and associations in a bariatric surgery population; no intervention, control arm, or causal inference; hypothesis-generating for iron regulation as a therapeutic target.
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This study characterizes MHF as common in severely obese patients undergoing bariatric surgery and associates it with metabolic dysfunction, but provides no evidence that treating iron abnormalities improves clinical outcomes. The hypothesis that iron regulation may alleviate obesity-related complications requires intervention studies to test.
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Abstract. Background Metabolic hyperferritinaemia (MHF) is closely linked to obesity and metabolic disorders, yet large-sample quantitative evidence regarding its clinical characteristics and multisystem metabolic correlations in morbidly obese populations remains insufficient. This study aimed to investigate the prevalence of MHF among bariatric surgery candidates and clarify its associations with liver function, glycolipid metabolism, and hematological indicators. Methods A cross-sectional case-control study was conducted on 695 patients scheduled for bariatric surgery. Patients were stratified into MHF and normal iron groups based on gender-specific serum ferritin cut-off values. Independent-samples t-test and Wilcoxon rank-sum test were applied to compare 14 core metabolic and clinical indicators, and correlation analysis was performed to assess the association between ferritin levels and key parameters. Results The overall MHF prevalence was 18.51%, with a markedly higher rate in males (32.67%) than in females (10.54%) and a significant upward trend with increased BMI. The MHF group exhibited significantly abnormal liver function, glycolipid metabolism, and hematological indices. Serum ferritin showed moderate positive correlations with alanine aminotransferase and γ-glutamyl transferase. Conclusion MHF is highly prevalent in patients undergoing bariatric surgery and is closely associated with systematic metabolic and hematological abnormalities. Targeted iron regulation may be a promising strategy to alleviate obesity-related metabolic complications, providing novel clinical insights for high-risk population management.
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