High Hemoglobin Level Predicts Non-alcoholic Fatty Liver

Abstract

AIM: To identify whether hemoglobin (Hb) level is a predictor of non-alcoholic fatty liver disease (NAFLD) in Japanese women. METHODS: The subjects were 1673 Japanese women (mean age: 52.1±8.7 years, age range: 30-82 years) who underwent a physical checkup during 2009. Women with hepatitis B or C virus infection, other hepatobiliary disease or alcohol consumption>20 g/day were excluded from the study. NAFLD was diagnosed by ultrasonography. Alanine aminotransferase (ALT) >30 U/L was defined as elevated ALT. Ferritin level was measured in 100 selected subjects to examine the relationship between Hb and ferritin levels. RESULTS: NAFLD was diagnosed in 245 subjects and NAFLD with elevated ALT were detected in 73 subjects. Hb level was significantly higher in subjects with NAFLD than those without NAFLD. BMI, menopausal status and Hb, triglycerides and glucose levels were independently associated with ALT level. Logistic regression analysis showed that BMI (odds ratios (OR) =1.54, 95% CI 1.45-1.63), menopausal status (OR=1.98, 95% CI 1.34-2.74) and Q4 (top 25th percentile) Hb level (OR=2.18, 95% CI 1.36-3.50) were associated with NAFLD. Q3 (51st-75th percentiles) Hb level (OR=2.71, 95% CI 1.07-6.87) and Q4 Hb level (OR=2.69, 95% CI 1.07-6.76) were associated with NAFLD with elevated ALT. Multivariate analysis showed that Hb level was independently associated with ferritin level and insulin resistance. CONCLUSION: High Hb level is a predictor of NAFLD. Hb level is associated with iron stores and insulin resistance in Japanese women.