ONO Masafumi
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Epidemiological survey of hemoglobin A1c and liver fibrosis in a general population with non-alcoholic fatty liver disease.
Journal Formal name：Hepatology research : the official journal of the Japan Society of Hepatology
Abbreviation：Hepatol Res
ISSN code：13866346/13866346
Domestic / ForeginDomestic
Volume, Issue, Page 49(3),pp.296-303
Author and coauthor Tanaka Kenichi, Takahashi Hirokazu, Hyogo Hideyuki, Ono Masafumi, Oza Noriko, Kitajima Yoichiro, Kawanaka Miwa, Chayama Kazuaki, Saibara Toshiji, Anzai Keizo, Eguchi Yuichiro
Publication date 2019/03
Summary AIM:The association between glycemia and liver fibrosis was analyzed using hemoglobin A1c (HbA1c) and the Fibrosis-4 (FIB-4) index in a large general population cohort that underwent a health checkup.METHODS:A total of 6927 subjects without hepatitis B or C virus infection or habitual alcohol intake were enrolled. Non-alcoholic fatty liver disease (NAFLD) was diagnosed by ultrasonography and potential liver fibrosis (FIB-4 index ≥1.3) in NAFLD was analyzed in relation to HbA1c level. Factors associated with potential liver fibrosis of NAFLD were also analyzed.RESULTS:The overall frequency of NAFLD was 27.9% (1935 subjects) and the frequency of NAFLD by HbA1c level (<4.9%, 5.0-5.9%, 6.0-6.9%, 7.0-7.9%, ≥8.0%) was 16%, 27%, 54%, 53%, and 54%, respectively. Among the 1935 NAFLD cases, the frequency of potential liver fibrosis was 25.2% (487 subjects) overall and 19%, 22%, 30%, 52%, and 31%, respectively, by HbA1c category. From multivariate analysis, an HbA1c level ≥6.5% was significantly associated with potential liver fibrosis (P = 0.017, hazard ratio = 1.7).CONCLUSIONS:The prevalence of NAFLD and liver fibrosis of NAFLD increased according to glycemia, up to 8.0% HbA1c. Measuring HbA1c and calculating the FIB-4 index in health checkups could help to identify potential cases of liver fibrosis of NAFLD, which should then be further evaluated using other techniques to confirm liver fibrosis.
DOI 10.1111/hepr.13282
PMID 30367534