Korean J Fam Pract. 2018; 8(1): 131-135  https://doi.org/10.21215/kjfp.2018.8.1.131
Correlation between Non-Alcoholic Fatty Liver Disease and Hemoglobin A1c Level in Adult Males without Diabetes
Tai Chi Lin1, Hye Mi Lee1, Han Na Seo1, Joon Suk Oh1, Hye Rim Kong2, Sung A Cho2, Bong Gyu Choi1,*
1Department of Family Medicine, Gwangmyeong Sungae Hospital, Gwangmyeong; 2Department of Family Medicine, Sungae Hospital, Seoul, Korea
Bong Gyu Choi
Tel: +82-2-2680-7114, Fax: +82-2-2680-7755
E-mail: stapy74@hanmail.net
ORCID: http://orcid.org/0000-0002-3721-4913
Received: March 3, 2017; Revised: May 17, 2017; Accepted: September 29, 2017; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Type 2 diabetes and obesity are known to be related with non-alcoholic fatty liver disease (NAFLD) owing to insulin resistance. However, it is also a fact that NAFLD is found even among those who do not have type 2 diabetes and obesity. The purpose of this study was to investigate the correlation between Hemoglobin A1c (HbA1c) level and the prevalence of NAFLD.
Methods: Adult males, aged >20 years, who underwent a medical examination between January 2014 and December 2016 participated in the study. A bright liver observed on body ultrasonography was interpreted as NAFLD. HbA1c values with or without NAFLD were compared, and the prevalence of NAFLD according to HbA1c values was investigated.
Results: The mean HbA1c value was 5.38% in the normal group and 5.51% in the NAFLD group, which was higher (P<0.05). As the HbA1c value was higher, the prevalence of NAFLD was also increased (P<0.05). The degree of risk of developing NAFLD in group 4 was increased in comparison with that in group 1.
Conclusion: Among those who did not have diabetes, the NAFLD group showed higher HbA1c level, and the prevalence of NAFLD was increased as much as the HbA1c level was increased. Therefore, in the cases without diabetes, the HbA1c value could be used as a predictor. Further studies with larger samples are needed to confirm the usefulness of HbA1c level as a general predictor.
Keywords: Hemoblobin A1c; Non-Alcoholic Fatty Liver Disease; Diabetes Mellitus; Obesity
  1. Bugianesi E, McCullough AJ, Marchesini G. Insulin resistance: a metabolic pathway to chronic liver disease. Hepatology 2005; 42: 987-1000.
    Pubmed CrossRef
  2. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes 2001; 50: 1844-50.
    Pubmed CrossRef
  3. Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, et al. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med 1999; 107: 450-5.
  4. Nathan DM, Singer DE, Hurxthal K, Goodson JD. The clinical information value of the glycosylated hemoglobin assay. N Engl J Med 1984; 310: 341-6.
    Pubmed CrossRef
  5. Goldstein DE. Is glycosylated hemoglobin clinically useful? N Engl J Med 1984; 310: 384-5.
    Pubmed CrossRef
  6. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010; 33 Suppl 1: S62-9.
    Pubmed KoreaMed CrossRef
  7. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346: 1221-31.
    Pubmed CrossRef
  8. Marchesini G, Bugianesi E, Forlani G, Cerrelli F, Lenzi M, Manini R, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 2003; 37: 917-23.
    Pubmed CrossRef
  9. Moscatiello S, Manini R, Marchesini G. Diabetes and liver disease: an ominous association. Nutr Metab Cardiovasc Dis 2007; 17: 63-70.
    Pubmed CrossRef
  10. Fan JG, Saibara T, Chitturi S, Kim BI, Sung JJ, Chutaputti A; Asia-Pacific Working Party for NAFLD. What are the risk factors and settings for nonalcoholic fatty liver disease in Asia-Pacific? J Gastroenterol Hepatol 2007;22: 794-800.
    Pubmed CrossRef
  11. Gu D, Reynolds K, Wu X, Chen J, Duan X, Reynolds RF, et al. Prevalence of the metabolic syndrome and overweight among adults in China. Lancet 2005; 365: 1398-405.
  12. Cheon HK, Lee TY, Kim YR. The correlation of sonographic finding of fatty liver with hematologic examination and body fat percentage. J Radiol Sci Technol 2009; 32: 437-44.
  13. Yoon KS, Baek SH, Shin ES, Park HS. Factors related to patients with fatty liver. J Korean Acad Fam Med 1997; 18: 1426-35.
  14. Im CS, Kim SS. Risk factors associated with metabolic syndrome in ultrasonographic fatty liver. Korean J Obes 2008; 17: 124-31.
  15. Wanless IR, Lentz JS. Fatty liver hepatitis (steatohepatitis) and obesity: an autopsy study with analysis of risk factors. Hepatology 1990; 12: 1106-10.
  16. Seppälä-Lindroos A, Vehkavaara S, Häkkinen AM, Goto T, Westerbacka J, Sovijärvi A, et al. Fat accumulation in the liver is associated with defects in insulin suppression of glucose production and serum free fatty acids independent of obesity in normal men. J Clin Endocrinol Metab 2002; 87: 3023-8.
    Pubmed CrossRef
  17. Parés A, Tresserras R, Núñez I, Cerralbo M, Plana P, Pujol FJ, et al. Prevalence and factors associated to the presence of fatty liver in apparently healthy adult men. Med Clin (Barc) 2000; 114: 561-5.
  18. Kim KH, Kim YL, Hwang BW, Cho IJ, Kim SH, Hwang DY. The prevalence and risk factors of fatty liver diagnosed using abdominal ultrasonography. Korean J Fam Pract 2016; 6: 503-8.
  19. Adams LA, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgrad Med J 2006; 82: 315-22.
    Pubmed KoreaMed CrossRef
  20. Yates AP, Laing I. Age-related increase in haemoglobin A1c and fasting plasma glucose is accompanied by a decrease in beta cell function without change in insulin sensitivity: evidence from a cross-sectional study of hospital personnel. Diabet Med 2002; 19: 254-8.
  21. Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A, et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of european prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 2001; 322: 15-8.
    Pubmed KoreaMed CrossRef
  22. Park JM, Han SI, Gwon YT, Lee MH, Byeon JS, Jo WS, et al. Abdominal ultrasonograms in health screen. J Korean Soc Ultrasound Med 1989; 8: 93-7.

This Article

Author ORCID Information

Social Network Service