Association of glycated hemoglobin with the risk of advanced fibrosis in non-alcoholic fatty liver disease patients without diabetes - 07/02/19
, Liqing Wang c, 1, Hongliang Xue b, Hongmei Lin a, Yanping Li b, Sun-On Chan dBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | HbA1c levels within normal range are independently associated with the presence of non-alcoholic fatty liver disease (NAFLD) in non-diabetics, in a dose-response manner. |
• | High HbA1c levels are associated with increased risks of advanced fibrosis in NAFLD patients without diabetes, independent of potential confounders. |
• | HbA1c may be a novel biomarker for the management of NAFLD patients with or without diabetes. |
• | A proactive approach in assessment of HbA1c should be routinely performed in the management of patients with NAFLD. |
Summary |
Background |
Association of diabetes with non-alcoholic steatohepatitis has been well documented. However, it remains unclear whether there is an association between levels of glycated hemoglobin (HbA1c) with severity of non-alcoholic fatty liver disease (NAFLD). This study was aimed to explore the relationship between levels of HbA1c and the risk of advanced fibrosis in patients with NAFLD.
Methods |
A cross-sectional study was performed on 4826 apparently healthy Chinese, who underwent a health check between January 2015 and December 2016. NAFLD was defined as hepatic steatosis on ultrasonography in the absence of excessive alcohol use or other identifiable causes. The risk of advanced fibrosis was assessed by NAFLD fibrosis Score.
Results |
Among 4826 individuals studied, 1630 were diagnosed with NAFLD. In a multivariable-adjusted model, high HbA1c levels were associated independently with increased prevalence of NAFLD. The adjusted odds ratio [95% confidence interval (95% CI)] for NAFLD, when compared with the highest HbA1c quartile and the lowest HbA1c quartile, was 2.72 (2.07–3.58; P for trend < 0.001). A strong association was also observed between HbA1c level and the risk of fibrosis in patients with NAFLD in multivariable analyses, with the extreme-quartile odds ratio of 2.69 (95% CI: 1.60–4.53; P for trend < 0.001). This association remained significant even in subjects without diabetes.
Conclusions |
We concluded that high HbA1c level was associated strongly and independently with increased risk of advanced fibrosis in NAFLD patients without diabetes.
Le texte complet de cet article est disponible en PDF.Keywords : Advanced fibrosis, Glycated hemoglobin A1c, Non-alcoholic fatty liver disease, Obesity
Plan
Vol 43 - N° 1
P. 58-66 - février 2019 Retour au numéro
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