Jiang Youzhao, Zeng Jun, Chen Bing
Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, China.
J Gastroenterol Hepatol. 2014;29(7):1508-14. doi: 10.1111/jgh.12580.
The red blood cells (RBC) count is closely associated with insulin resistance (IR), which is origin of non-alcoholic fatty liver disease (NAFLD). This study aimed to investigate the correlation of RBC indices with NAFLD.
A total of 977 cases including 446 NAFLD patients and 531 controls were enrolled and examined for biochemical and metabolic indices. RBC, hematocrit (HCT), hemoglobin (HGB), insulin, and ferritin were detected. The IR indicator latest homeostasis model assessment-insulin resistance and fatty liver index were calculated. The correlation analysis was assessed by Spearman's rank test. Receiver operating characteristic was used to evaluate diagnostic performance. After quartile classification of RBC indices, logistic regression analysis was conducted to evaluate the odds ratios (OR) of NAFLD.
RBC, HCT, and HGB levels were obviously higher in NAFLD group. RBC, HCT, and HGB showed significant positive correlation with homeostasis model assessment-insulin resistance and NAFLD. Multivariate analysis revealed HGB, ferritin, and triglyceride (TG) as independent parameters associated with NAFLD. The predictive value after combination of HGB with ferritin and TG was equal to fatty liver index. After adjustment for age,body mass index, systolic blood pressure, total cholesterol, TG, low-density lipoprotein, high-density lipoprotein and smoking, comparing the groups with the highest and lowest HGB, HCT, and RBC, the OR (95% confidence intervals) of NAFLD were 2.369 (1.279-4.368) (P < 0.05), 1.504 (0.819-2.713) (P > 0.05), and 2.332 (0.823-2.550) (P > 0.05) in men. In women, the OR were 2.541 (1.118-5.771), 3.578 (1.464-8.748), and 3.215 (1.387-7.455) (P < 0.05).
Our data suggest that HGB combined with TG and ferritin may serve as the indicator of predicting NAFLD.
红细胞（RBC）计数与胰岛素抵抗（IR）密切相关，胰岛素抵抗是非酒精性脂肪性肝病（NAFLD）的根源。本研究旨在探讨红细胞指标与非酒精性脂肪性肝病的相关性。
共纳入977例患者，其中包括446例非酒精性脂肪性肝病患者和531例对照者，并对其进行生化和代谢指标检测。检测红细胞、血细胞比容（HCT）、血红蛋白（HGB）、胰岛素和铁蛋白。计算胰岛素抵抗指标最新稳态模型评估-胰岛素抵抗和脂肪肝指数。采用Spearman秩检验进行相关性分析。采用受试者工作特征曲线评估诊断性能。对红细胞指标进行四分位数分类后，进行逻辑回归分析以评估非酒精性脂肪性肝病的比值比（OR）。
非酒精性脂肪性肝病组的红细胞、血细胞比容和血红蛋白水平明显更高。红细胞、血细胞比容和血红蛋白与稳态模型评估-胰岛素抵抗和非酒精性脂肪性肝病呈显著正相关。多变量分析显示血红蛋白、铁蛋白和甘油三酯（TG）是与非酒精性脂肪性肝病相关的独立参数。血红蛋白与铁蛋白和甘油三酯联合后的预测价值与脂肪肝指数相当。在调整年龄、体重指数、收缩压、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白和吸烟因素后，比较血红蛋白、血细胞比容和红细胞最高组与最低组，男性非酒精性脂肪性肝病的OR（95%置信区间）分别为2.369（1.279 - 4.368）（P < 0.05）、1.504（0.819 - 2.713）（P > 0.05）和2.332（0.823 - 2.550）（P > 0.05）。在女性中，OR分别为2.541（1.118 - 5.771）、3.578（1.464 - 8.748）和3.215（1.387 - 7.455）（P < 0.05）。
我们的数据表明，血红蛋白联合甘油三酯和铁蛋白可能作为预测非酒精性脂肪性肝病的指标。
