TF and metabolic dysfunction-associated steatotic liver disease: Adult NAFLD patients often experience changes in serum iron metabolism, manifested by increased serum ferritin levels and normal transferrin saturation, which is known as the metabolic abnormal iron load syndrome.25 Iron accumulation in adult patients with NAFLD is due to impaired iron mobilization in the liver cells and Kupffer cells.31 Serum ferritin, a major marker of liver iron storage, positively correlated with liver fat accumulation.