Relationship between hemoglobin levels and risk for suspected non-alcoholic fatty liver in taiwanese adults

Chyi Huey Bai, Ming Shun Wu, Eddy Owaga, Shu Yu Cheng, Wen Harn Pan, Jung Su Chang

Research output: Contribution to journalArticle

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Abstract

Body iron levels have recently been shown to be a strong predictor for non-alcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence of NAFLD in a general adult population, and to investigate the relationship between body iron levels, NAFLD and the metabolic syndrome (MetS). 2186 adults participated in the third National Nutrition and Health Survey in Taiwan (NAHSIT, 2005-2008). The participants underwent anthropometry measurements and phlebotomy after an overnight fast, and those with excessive alcohol intake, iron overload of serum ferritin > 600 ng/ml, hepatitis viral infection and hepatocellular carcinoma were excluded. Suspected NAFLD was diagnosed by three alanine transaminase (ALT) cut-points: cut-point 1: serum ALT > 40 U/l; cut-point 2: ALT ≧ 25 U/l for male and ALT ≧ 17 U/l for female; and cut-point 3: ALT ≧ 35 U/l for male and ALT ≧ 26 U/l for female. The prevalence proportion of suspected NAFLD among Taiwanese adults was 6.6% (cut-point 1), 36% (cut-point 2); and 14.3% (cut-point 3). Body iron levels were significantly higher in individuals with suspected NAFLD compared with those without. Distribution of hemoglobin levels, but not serum ferritin levels, by decade of age showed strong correlation with the prevalence of suspected NAFLD in individuals with MetS. Multivariate adjusted odds ratio (OR) showed that the best predictors for suspected NAFLD with the MetS were hemoglobin [OR 1.43 (1.21-1.68); P <0.0001] and hyperlipidemia [OR 1.52 (1.19-1.94); P = 0.0007]. In individuals without MetS, the adjusted OR of suspected NAFLD was markedly higher for hemoglobin [OR 1.25 (1.12-1.41); P <0.0001]. In conclusion, adults with high hemoglobin levels (14.4 μg/dl for male and 13.2 μg/dl for female) are at the greatest risk for developing abnormal liver function. Hemoglobin test should be considered as a part of clinical evaluation for patients with NAFLD.

Original languageEnglish
Pages (from-to)286-294
Number of pages9
JournalChinese Journal of Physiology
Volume57
Issue number5
DOIs
Publication statusPublished - 2014

Fingerprint

Fatty Liver
Hemoglobins
Alanine Transaminase
Odds Ratio
Iron
Ferritins
Serum
Non-alcoholic Fatty Liver Disease
Anthropometry
Iron Overload
Phlebotomy
Nutrition Surveys
Virus Diseases
Hyperlipidemias
Health Surveys
Taiwan
Hepatitis
Hepatocellular Carcinoma
Alcohols
Liver

Keywords

  • Alanine transaminase
  • Body iron levels
  • Metabolic syndrome
  • Non-alcoholic fatty liver Disease

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Relationship between hemoglobin levels and risk for suspected non-alcoholic fatty liver in taiwanese adults. / Bai, Chyi Huey; Wu, Ming Shun; Owaga, Eddy; Cheng, Shu Yu; Pan, Wen Harn; Chang, Jung Su.

In: Chinese Journal of Physiology, Vol. 57, No. 5, 2014, p. 286-294.

Research output: Contribution to journalArticle

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abstract = "Body iron levels have recently been shown to be a strong predictor for non-alcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence of NAFLD in a general adult population, and to investigate the relationship between body iron levels, NAFLD and the metabolic syndrome (MetS). 2186 adults participated in the third National Nutrition and Health Survey in Taiwan (NAHSIT, 2005-2008). The participants underwent anthropometry measurements and phlebotomy after an overnight fast, and those with excessive alcohol intake, iron overload of serum ferritin > 600 ng/ml, hepatitis viral infection and hepatocellular carcinoma were excluded. Suspected NAFLD was diagnosed by three alanine transaminase (ALT) cut-points: cut-point 1: serum ALT > 40 U/l; cut-point 2: ALT ≧ 25 U/l for male and ALT ≧ 17 U/l for female; and cut-point 3: ALT ≧ 35 U/l for male and ALT ≧ 26 U/l for female. The prevalence proportion of suspected NAFLD among Taiwanese adults was 6.6{\%} (cut-point 1), 36{\%} (cut-point 2); and 14.3{\%} (cut-point 3). Body iron levels were significantly higher in individuals with suspected NAFLD compared with those without. Distribution of hemoglobin levels, but not serum ferritin levels, by decade of age showed strong correlation with the prevalence of suspected NAFLD in individuals with MetS. Multivariate adjusted odds ratio (OR) showed that the best predictors for suspected NAFLD with the MetS were hemoglobin [OR 1.43 (1.21-1.68); P <0.0001] and hyperlipidemia [OR 1.52 (1.19-1.94); P = 0.0007]. In individuals without MetS, the adjusted OR of suspected NAFLD was markedly higher for hemoglobin [OR 1.25 (1.12-1.41); P <0.0001]. In conclusion, adults with high hemoglobin levels (14.4 μg/dl for male and 13.2 μg/dl for female) are at the greatest risk for developing abnormal liver function. Hemoglobin test should be considered as a part of clinical evaluation for patients with NAFLD.",
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AU - Pan, Wen Harn

AU - Chang, Jung Su

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N2 - Body iron levels have recently been shown to be a strong predictor for non-alcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence of NAFLD in a general adult population, and to investigate the relationship between body iron levels, NAFLD and the metabolic syndrome (MetS). 2186 adults participated in the third National Nutrition and Health Survey in Taiwan (NAHSIT, 2005-2008). The participants underwent anthropometry measurements and phlebotomy after an overnight fast, and those with excessive alcohol intake, iron overload of serum ferritin > 600 ng/ml, hepatitis viral infection and hepatocellular carcinoma were excluded. Suspected NAFLD was diagnosed by three alanine transaminase (ALT) cut-points: cut-point 1: serum ALT > 40 U/l; cut-point 2: ALT ≧ 25 U/l for male and ALT ≧ 17 U/l for female; and cut-point 3: ALT ≧ 35 U/l for male and ALT ≧ 26 U/l for female. The prevalence proportion of suspected NAFLD among Taiwanese adults was 6.6% (cut-point 1), 36% (cut-point 2); and 14.3% (cut-point 3). Body iron levels were significantly higher in individuals with suspected NAFLD compared with those without. Distribution of hemoglobin levels, but not serum ferritin levels, by decade of age showed strong correlation with the prevalence of suspected NAFLD in individuals with MetS. Multivariate adjusted odds ratio (OR) showed that the best predictors for suspected NAFLD with the MetS were hemoglobin [OR 1.43 (1.21-1.68); P <0.0001] and hyperlipidemia [OR 1.52 (1.19-1.94); P = 0.0007]. In individuals without MetS, the adjusted OR of suspected NAFLD was markedly higher for hemoglobin [OR 1.25 (1.12-1.41); P <0.0001]. In conclusion, adults with high hemoglobin levels (14.4 μg/dl for male and 13.2 μg/dl for female) are at the greatest risk for developing abnormal liver function. Hemoglobin test should be considered as a part of clinical evaluation for patients with NAFLD.

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