Correlation Study Between Hemoglobin Level And Non-alcoholic Fatty Liver Disease (NAFLD)

Part I The study on the relationship between hemoglobin level andnon-alcoholic fatty liver disease(NAFLD)Aims: To investigate the relationship between hemoglobin level and non-alcoholic fattyliver disease (NAFLD) based on gender. Methods: We conduct a cross-sectional study of60619subjects aged older than18undergoing a routine health check-up of Health CareCenter, Renji hospital, School of Medicine Shanghai Jiao-tong University in the periodbetween1January2012and31December2012.The incidence of NAFLD was evaluatedaccording to gender and the level of hemoglobin. Results: Of60619subjects, the meanage was45years and34043(56.2%) were male.20101(33.2%) were diagnosed withNAFLD by ultrasound. The prevalence of NAFLD increased steadily as hemoglobin levelincreased in both male and female (P＜0.001for both). The prevalence of NAFLD washigher in male than in female (44.5%vs.18.6%，X2=4517.017，P＜0.001). In multivariatelogistic forward regression adjusted for age and other metabolic risk factors showed thathemoglobin level was positively associated with the prevalence of NAFLD.(For male，OR=1.43,95%CI=1.28-1.59in the second quartile; OR=1.52,95%CI=1.35-1.70in the third quartile; OR=1.49,95%CI=1.18-1.88in the fourth quartile vs. the lowest quartile; P＜0.05，respectively. For female, OR=1.15,95%CI=1.02-1.31in the second quartile;OR=1.43,95%CI=1.24-1.64in the third quartile; OR=2.16,95%CI=1.43-3.26in thefourth quartile vs. the lowest quartile; P＜0.05respectively；P＞0.05in the second quartilevs. the lowest quartile). Conclusions: Hemoglobin level is positively associated with theprevalence of NALFD.Part II High hemoglobin level is a risk factor for NAFLDindependently of obesity and metabolic syndromeAims: To investigate the relationship between hemoglobin level and non-alcoholic fattyliver disease (NAFLD) among the population in the absence of metabolic syndrome (MS)and obesity. Methods: The risk of NAFLD was evaluated according to the level ofhemoglobin after the exclusion of the people with metabolic syndrome and obesity.Results: There were remaining37616subjects after the exclusion of the people withmetabolic syndrome and obesity. The prevalence of NAFLD increased steadily ashemoglobin level increased in both male and female no matter how to group thehemoglobin. Male had a greater risk of the prevalence of NALFD（OR:3.338，95%CI：3.121-3.570，P＜0.001）.In multivariate logistic forward regression adjusted for age andother metabolic risk factors showed that hemoglobin level was positively associated withthe prevalence of NAFLD. For male，the odd ratios was1.47（95%CI1.24-1.72，P＜0.001）in the second quartile,1.44（95%CI1.21-1.71，P＜0.001）in the third quartile,1.36（95%CI0.95-1.95，P=0.092）in the fourth quartile vs. the control quartile, respectively.For female, the odd ratios was1.14（95%CI0.95-1.36，P=0.173）in the second quartile,1.37（95%CI1.12-1.68，P=0.002）in the third quartile,1.74（95%CI0.99-3.08，P=0.055）in the fourth quartile vs. the control quartile, respectively. Conclusions: High hemoglobin level is another risk factor for NAFLD independently of obesity and metabolic syndrome.The prevalence of NAFLD in male is higher with the risk was3.34times that of female.Part III High hemoglobin level is a risk factor for advancednon-alcoholic fatty liver disease (NAFLD)Aims: To investigate the relationship between hemoglobin and advanced non-alcoholicfatty liver disease (NAFLD). Methods: The participants were divided into two groupsbased on metabolic syndrome; Patients with NAFLD as well as metabolic syndrome wereincluded in the group of advanced NAFLD, while the rest belongs to the group of NAFL.Then, the levels of hemoglobin between these groups were analyzed. Results: There were20101subjects diagnosed with NAFLD. The mean age was48years old, and15154(75.4%) were male,7756(38.6%) were advanced NAFLD. Compared to the NAFLpatients, those patients with advanced NAFLD had higher hemoglobin level (149±14vs.147±14，P＜0.001).In multivariate logistic forward regression showed that the age, BMI,γ-GT, TG, TC, FPG, HDL and UA adjusted odd ratios for subjects with hemoglobin levelin quartile2,3and4vs. quartile1was1.17（95%CI0.98-1.40，P=0.77）,1.27（95%CI1.06-1.52，P=0.01）,1.48（95%CI1.09-2.01，P=0.011）respectively in male and1.31（95%CI1.00-1.72，P=0.05）,1.82（95%CI1.37-2.42，P＜0.001）,1.40（95%CI0.69-2.86，P=0.35）respectively in female. Conclusions: High hemoglobin level is another risk factorfor advanced NAFLD.