非酒精性脂肪性肝病患者血红蛋白水平变化及其临床意义  

Blood hemoglobin levels for risk of individuals apt to have nonalcoholic fatty liver disease risk

作　　者：陈光榆[1] 王鸿 王耀晟[1] 张熙 张伟 曾静[2] 沈峰[2] 胡颖 范建高[2] Chen Guangyu;Wang Hong;Wang Yaoshen(Department of Gastroenterology,Xinhua Hospital Affricated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,Shanghai,China)

机构地区：[1]上海交通大学医学院附属新华医院临床研究与创新中心,上海市200092 [2]上海交通大学医学院附属新华医院消化内科,上海市200092 [3]上海交通大学医学院附属新华医院崇明分院消化内科,上海市200092

出　　处：《实用肝脏病杂志》2021年第1期39-42,共4页Journal of Practical Hepatology

基　　金：上海交通大学医学院附属新华医院院级临床研究培育基金项目(编号:17CSK04)。

摘　　要：目的探讨血红蛋白升高与非酒精性脂肪性肝病(NAFLD)发生风险的相关性。方法利用1995年~1996年宝钢职工体检资料,收集血糖、血脂和血红蛋白等指标,对6540例无脂肪肝人群随访6年,分析基线血红蛋白水平与NAFLD发生风险之间的相关性。结果在随访过程中,106例基线贫血患者新发NAFLD 2例(1.9%),5884例基线血红蛋白正常者新发645例(11.0%),550例基线血红蛋白升高患者新发116例(21.1%);Cox单因素回归分析结果显示不同血红蛋白水平者NAFLD发生率不同(血红蛋白升高组与贫血组比,HR=11.18,95%CI:2.76~45.23,P=0.001;血红蛋白正常组与贫血组比,HR=5.81,95%CI:1.45~23.28,P=0.013);经Cox多因素回归分析结果显示男性(HR=1.465,95%CI:1.114~1.928,P=0.006)、体质指数(HR=1.298,95%CI:1.259~1.320,P<0.001)、高甘油三酯血症(HR=1.781,95%CI:1.533~2.068,P<0.001)和血红蛋白水平(HR=1.008,95%CI:1.002~1.015 P=0.014)是影响NAFLD发生的独立危险因素。结论血红蛋白升高与NAFLD发病相关,早期筛查Hb有助于风险提示,其相关机制值得进一步研究。Objective To explore the relationship between high blood hemoglobin levels and the risk of non-alcoholic fatty liver disease(NAFLD).Methods 6540 NAFLD-free participants at physical examination in Baoshan Steel were recruited and their data including blood glucose,blood lipids and hemoglobin in 1995 to 1996 were collected.We explored the baseline blood hemoglobin level longitudinal associations with NAFLD risk throughout 6 years.Results During follow-up,2(11.7%)cases of NAFLD developed among 106 patients with anemia,645(11.0%)NAFLD in 5884 participants with normal hemoglobin,and 116(21.1%)NAFLD in 550 patients with high blood hemoglobin;Cox univariate analysis showed that hemoglobin level was related to the risk of NAFLD(high hemoglobin group vs.anemia group,HR=11.18,95%CI:2.76-45.23,P=0.001;normal hemoglobin vs.anemia group,HR=5.81,95%CI:1.45-23.28,P=0.013);Cox multivariate analysis showed that male(HR=1.465,95%CI:1.114-1.928,P=0.006),BMI(HR=1.298,95%CI:1.259-1.320,P<0.001),hypertriglyceridemia(HR=1.781,95%CI:1.533-2.068,P<0.001)and hemoglobin(HR=1.008,95%CI:1.002-1.015,P=0.014)were the independent risk factors for occurrence of NAFLD.Conclusion High blood hemoglobin levels is correlated with NAFLD risk.The potential value of early screening blood hemoglobin and intervention for NAFLD deserve further study.

关 键 词：非酒精性脂肪性肝病 血红蛋白 贫血 危险因素 

分 类 号：R575.5[医药卫生—消化系统]