Red Blood Cell Count: An Unrecognized Risk Factor for Nonalcoholic Fatty Liver Disease.
Red Blood Cell Count: An Unrecognized Risk Factor for Nonalcoholic Fatty Liver Disease.
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红细胞计数：非酒精性脂肪肝的一个未被认识的危险因素。
DOI：
10.3389/fendo.2021.760981
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发表时间：
2021
影响因子：
5.2
通讯作者：
Zhao J
中科院分区：
文献类型：
--
作者：
Zhong F;Guan L;Lin H;Zhao M;Qin Y;Li Q;Yuan Z;Yang G;Gao L;Zhao J
非酒精性脂肪性肝病（NAFLD）正在成为一个全球性的公共卫生挑战。一个方便的NAFLD指标将极大地促进风险评估和预防。作为常规临床检查中一种容易获得且价格低廉的血液学指标，红细胞（rbc）在许多疾病（如代谢综合征）中得到越来越多的关注，但其与NAFLD的关系尚不清楚。这项健康管理队列研究包括27,112名受试者（17,383名非NAFLD和9,729名NAFLD），随访时间长达5年（中位2.8年）。超声诊断NAFLD。NAFLD严重程度分为轻度、中度和重度。广义估计方程（GEE）是广义线性模型的扩展，允许重复测量分析，用于分析RBC计数与NAFLD之间的关系。总体而言，17383例基线时无NAFLD的受试者中有4332例（24.9%）发展为NAFLD。发生NAFLD的风险与RBC计数呈正相关。在调整血红蛋白和其他混杂因素后，第二、第三和第四个红细胞计数四分位数发生NAFLD的风险分别比最低四分位数高21%、32%和51%。在9476名NAFLD患者中，1798名（19.0%）在基线时NAFLD的严重程度增加。随着红细胞计数的增加，NAFLD进展风险逐渐增加（趋势P < 0.001）。RBC计数每增加一个单位（1012个细胞/升），NAFLD进展风险增加53% [OR 1.53 (95% CI 1.32-1.77)]。RBC计数升高与NAFLD发生和进展的高风险独立相关。这一发现揭示了一个方便的NAFLD风险指标。
Nonalcoholic fatty liver disease (NAFLD) is becoming a global public health challenge. A convenient NAFLD indicator will greatly facilitate risk appraisal and prevention. As a readily available and inexpensive hematological index in routine clinical examinations, red blood cells (RBCs) are gaining increasing attention in many diseases, such as metabolic syndrome, but their association with NAFLD is unknown. This health management cohort study included 27,112 subjects (17,383 non-NAFLD and 9,729 NAFLD) with up to 5 years of follow-up (median 2.8 years). NAFLD was diagnosed by ultrasonography. NAFLD severity was categorized as mild, moderate, or severe. The generalized estimation equation (GEE), an extension of generalized linear models that allows for analysis of repeated measurements, was used to analyze the association between RBC count and NAFLD. Overall, 4,332 of 17,383 (24.9%) subjects without NAFLD at baseline developed NAFLD. Incident NAFLD risk was positively associated with RBC count. After adjustment for hemoglobin and other confounders, the risk of incident NAFLD was 21%, 32%, and 51% higher in the second, third, and fourth RBC count quartiles, respectively, than in the lowest quartile. In 1,798 of 9,476 (19.0%) subjects with NAFLD at baseline, the severity of NAFLD increased. NAFLD progression risk increased progressively as RBC count increased (P for trend < 0.001). Every one-unit (1012 cells/L) increase in RBC count was associated with a 53% [OR 1.53 (95% CI 1.32-1.77)] increased risk for NAFLD progression. Elevated RBC count was independently associated with a high risk of NAFLD incidence and progression. This finding revealed a convenient NAFLD risk indicator.
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