Hemoglobin combined with triglyceride and ferritin in predicting non-alcoholic fatty liver

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Background and Aim:

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.

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