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

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 . Methods 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 S pearman'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 . Results 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). Conclusions Our data suggest that HGB combined with TG and ferritin may serve as the indicator of predicting NAFLD .