Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Diabetes Care. 2011 Dec;34(12):2548-50. doi: 10.2337/dc11-0944. Epub 2011 Sep 27.
To characterize the association of low HbA(1c) values (<4.0%) with liver enzymes and steatosis.
Cross-sectional study of 12,533 participants without diabetes aged <20 years in the Third National Health and Nutrition Examination Survey (1988-1994). Logistic regression models were adjusted for demographic, lifestyle, and health status variables.
HbA(1c) values ranged from 3.2 to 15.7%, and 84 participants had HbA(1c) <4.0% in the population (mean age 44, 52% female, 15% black or Hispanic). We observed J-shaped associations between HbA(1c) and liver enzymes and hepatic steatosis. In adjusted models, HbA(1c) <4.0% was strongly associated with elevated alanine aminotransferase (OR 3.62 [95% CI 1.09-12.02]) and aspartate aminotransferase (6.80 [2.99-15.43]).
Low HbA(1c) values were associated with liver enzymes and steatosis in the U.S. population. Liver disease may partially explain the association of HbA(1c) with mortality and other long-term outcomes.
描述低 HbA(1c) 值（<4.0%）与肝酶和脂肪变性的关系。
横断面研究纳入了 1988-1994 年第三次国家健康和营养调查（NHANES III）中年龄<20 岁、无糖尿病的 12533 名参与者。使用逻辑回归模型调整了人口统计学、生活方式和健康状况变量。
HbA(1c)值范围为 3.2-15.7%，人群中有 84 名 HbA(1c)<4.0%（平均年龄 44 岁，52%为女性，15%为黑人和西班牙裔）。我们观察到 HbA(1c)与肝酶和肝脂肪变性之间存在 J 形关联。在调整后的模型中，HbA(1c)<4.0%与丙氨酸氨基转移酶（OR 3.62[95%CI 1.09-12.02]）和天冬氨酸氨基转移酶（6.80[2.99-15.43]）升高显著相关。
在美国人群中，低 HbA(1c)值与肝酶和脂肪变性有关。肝脏疾病可能部分解释了 HbA(1c)与死亡率和其他长期结局的关系。
